Author Topic: Fixing the facial problem after camouflage orthodontics for dental overbite  (Read 9190 times)

OrthodontistExpert

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I think this YouTube video explains how to fix the big nose, small chin, open lips, gummy smile effect from camouflage orthodontics and dental extractions that's often used to orthodontically fix dental overbites.

If you treat dental overbite as the whole "disease" or as the whole problem, then it's easy to ignore the underlying cause, and just treat it orthodontically. Orthodontists are notorious at selling their treatments as "helping you to avoid invasive surgery" and by saving you "from nasty jaw breaking surgery".

But retraction style orthodontics does really fix a dental overbite... By pulling the upper front teeth BACKWARDS. With disastrous facial effects.

Whether you use a Herbst, or a TwinBlock or a MyoSplint... Or even dental extractions... Splints and braces can't grow lower jaws forward... But they are really good at pulling upper front teeth backwards...
And that has disastrous effects on facial profiles, or how lips meet (or rather don't meet).

Anyway, this video helps explain the "fix"... And hopefully gives you a good idea about what to talk around when you visit your orthodontist or maxillofacial surgeon.

Good luck

http://m.youtube.com/watch?v=bIivMIcwGhQ

sean89

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #1 on: September 27, 2014, 12:24:18 PM »
At the same time, having flared front teeth is a disastrous feature to have.

For men, having too much support for the lips caused by prognathism or flared teeth is a very feminising feature, and in those circumstances, orthodontic compensation is probably the best option whether or not you have the money for jaw surgery.

OrthodontistExpert

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #2 on: September 27, 2014, 01:02:00 PM »
Are you saying everyone with an overbite has big flared front teeth?

I mean, that seems to be a bit superficial.

It's also a bit of scare mongoring.

Of course, if you play along with a child's or parents concern of having big front teeth, then you are validating treatment to wholly focus on "bringing them back in". Which of course means orthodontics, right?

Can you show an example of where someone was primarily corrected of a small lower jaw, but where the treatment did NOT involve Dental efforts to "deflare" them.

I just want to test your assertions that "flared upper teeth" up to be treated in order to illustrate that not doing it makes for a disastrous female feature.

How thoroughly self serving and paternalistic.

sean89

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #3 on: September 27, 2014, 01:11:50 PM »
I can't be bothered searching about for before/afters, but the orthodontic decompensation phase prior to the advancement of the lower jaw often involves flaring the maxillary incisors out even more to create maximum room for advancement.

My point is not that lower jaw surgery is a bad choice for overbites. I agree that it is the best choice in a ot of circumstances, but I do not agree that it is the best choice in every circumstance.

For example, I don't think lower jaw surgery should be indicated where the overbite is caused exclusively by a vertically excessive maxilla, or where the patient has a big chin, or where the movements are so small that it could be corrected a lot quicker, a lot cheaper, and with a lot more precision using orthodontics alone.


OrthodontistExpert

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #4 on: September 27, 2014, 02:08:38 PM »
So are there no other points of validation for surgical advancement jaw surgery?

Forgive me, but it appears you speak about validation only in terms of correcting dental overjet (or dental overbite).

Shouldn't the validation (dentally at least) be focused on providing a class I molar occlusion for instance?

Another dental validation may be a little more medical, when we focus on balanced TM joint function. Or what some dentists still seek which is a coincident CO-CR relationship, again in a Class I pattern.

Another set of potential validations are purely medical. Such as prevention of forward jaw posturing, and the prevention of jaw joint dysfunction, or of temporal tension headache from this. Maybe that medical validation could be extended to a consideration of day time airway to improve exercise tolerance, or night time airway to prevent snoring.

Then of course there are the psychological benefits of normalized facial form on the self esteem... Or even more extrapolatively to the socialization consequences or on others perceptions of ugliness vs beauty.

Of course talk of braces and years of "benign" orthodontic treatment, involving dental braces, cat whiskers or dental splints, throughout a child's growing years, ignores completely the development of a normal teenage psyche.

That the orthodontist seeks to validate surgery, or not, in reference to their own orthodontic treatment... Is like asking a chiropractor to validate spinal surgery against their own treatments. Chiropractors often self represent their treatments as "benign", and without adverse consequence, and opportunistic in helping to avoid surgery.

It's a very self serving, self oriented form of clinical practice. And it serves the clinician first and the patient last.

Tiny

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #5 on: September 27, 2014, 02:14:05 PM »
OP, you are kindof preaching to the choir here.  Most of us had orthodontic work as teens and are now seeking the surgery we needed all along

sean89

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #6 on: September 27, 2014, 02:31:30 PM »
So are there no other points of validation for surgical advancement jaw surgery?

Forgive me, but it appears you speak about validation only in terms of correcting dental overjet (or dental overbite).

Shouldn't the validation (dentally at least) be focused on providing a class I molar occlusion for instance?

Another dental validation may be a little more medical, when we focus on balanced TM joint function. Or what some dentists still seek which is a coincident CO-CR relationship, again in a Class I pattern.

Another set of potential validations are purely medical. Such as prevention of forward jaw posturing, and the prevention of jaw joint dysfunction, or of temporal tension headache from this. Maybe that medical validation could be extended to a consideration of day time airway to improve exercise tolerance, or night time airway to prevent snoring.

Then of course there are the psychological benefits of normalized facial form on the self esteem... Or even more extrapolatively to the socialization consequences or on others perceptions of ugliness vs beauty.

Of course talk of braces and years of "benign" orthodontic treatment, involving dental braces, cat whiskers or dental splints, throughout a child's growing years, ignores completely the development of a normal teenage psyche.

That the orthodontist seeks to validate surgery, or not, in reference to their own orthodontic treatment... Is like asking a chiropractor to validate spinal surgery against their own treatments. Chiropractors often self represent their treatments as "benign", and without adverse consequence, and opportunistic in helping to avoid surgery.

It's a very self serving, self oriented form of clinical practice. And it serves the clinician first and the patient last.

Yes, I'm talking about surgery for overbites because that is what the thread is about. And we are pretty much on the same page, apart from the fact that I don't think lower jaw advancement is the best cure in all cases for dental overbites.

OrthodontistExpert

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #7 on: September 27, 2014, 02:41:11 PM »
There is no other cure for advancing a mandible forwards, apart from physically putting it there, and that is through using the nasty word of "surgery".

There is no alternative to surgery in bringing forward a lower jaw, and the lower teeth it contains.

You can reduce a dental overjet without surgery, but all "non-surgical" treatments pull backwards the upper teeth...

Claims by orthodontists that they can "grow" lower jaws with races or splints is just so blatantly wrong. My orthodontist colleagues are frankly unethical if they do claim it, because all it leads to are a large majority of adult patients regretting their childhood treatments and who seek remedial treatment for those lies... And mostly it is to fix the one thing orthodontists cant "fix" which is an under down face.

Alue

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #8 on: September 28, 2014, 10:54:20 PM »
Great now I just need a time machine.   I wouldn't have nearly the same problems I do now had my ortho not extracted premolars and put me in cervical headgear to 'fix' my overbite.  Now instead of one recessed jaw I have two. 

I actually had one orthodontist that I saw last year tell me that headgear worn on the upper arch promoted growth of the mandible by 'disengaging the joint'.   

OrthodontistExpert

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Re: Fixing the facial problem after camouflage orthodontics for dental overbite
« Reply #9 on: September 29, 2014, 05:37:09 AM »
It seems that half the people in this blog complain about their orthodontic treatment
And the other half complain about their surgical treatment

Real surgeons are doctors who really don't understand the black Art of orthodontics

Orthodontist are dentists who've never done medicine, or surgery, but call themselves doctors

And patients are stuck in the middle, hoping they're getting an honest unbiased opinion based on faith in Jesus

And everyone complains about each other, not knowing that no one gives a damn

Meanwhile people like me read these blogs and feel just so disempowered.

If only you all just stopped whingeing, and just looked at the videos I put up for you to watch.

Eventually all would become known to you, and you would stop this idolization of who is better than whom with what and when and where

dantheman

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At 55 seconds of that video, is that not a class I molar relationship?