Jaw looks fine straight on but significantly worse from profile (pics)

[chimrichalds]

I originally found this forum because I was trying to find out how to keep my mouth closed throughout the night to avoid bad breath, so this is both a functional and aesthetic concern for me

1) Is there any way to ensure I keep my mouth closed while asleep, I've literally never been able to do it, my teeth are straight, my bite is fine, I sleep with a very flat pillow to keep my held titled back, but for some reason as soon as I fall asleep my jaw drops, there have been countless nights where I lay in bed consciously being aware that my mouth is closed and I'll start to doze off and realize my mouth is opening and wake up again and it's incredibly frustrating, is this possible to correct without surgery in a 25 year old

2) If surgery is the only option or I do decide I want to improve my jaw in terms of looks what would need to be done and what is it that makes my jaw appear 'off' from the profile compared to straight on

Thanks for the help

https://imgur.com/a/6EghE

[kavan]

There's a chin strap thing that can be ordered from companies selling CPAP sleep apnea machines. It keeps the mouth shut when sleeping.

[chimrichalds]

There's a chin strap thing that can be ordered from companies selling CPAP sleep apnea machines. It keeps the mouth shut when sleeping.

I've looked into that and might get one, it addresses the problem but will I always have to rely on that or will it 'train' me to keep my mouth closed without it eventually? Also I'm curious as to why I have such a hard time keeping my mouth closed while sleeping, seems like something I should just be able to do naturally but have never been able to

Thanks for the reply

[kavan]

Not sure if it trains or not.

[Framboise]

Hello chimrichalds,
My partner is a mouth breather and has a high level of sleep apnea (35 !)
They gave him a machine but it wakes him up because he cannot breathe with his mouth. His airway must be very narrow so he cannot breathe through his nose.
By the way, CPAP machine does not solve the obstruction issue, it just send oxygen.
My partner is not satisfied with it, he's looking for an orthodontic treatment and maybe orthognatic surgery (but he is very reluctant to and scared of it).

[chimrichalds]

Hello chimrichalds,
My partner is a mouth breather and has a high level of sleep apnea (35 !)
They gave him a machine but it wakes him up because he cannot breathe with his mouth. His airway must be very narrow so he cannot breathe through his nose.
By the way, CPAP machine does not solve the obstruction issue, it just send oxygen.
My partner is not satisfied with it, he's looking for an orthodontic treatment and maybe orthognatic surgery (but he is very reluctant to and scared of it).

I don't believe I have sleep apnea, I breathe fine through my nose throughout the day with my mouth closed. The only issue is keeping it closed at night which I'd like to be able to do without a breathing machine haha

[kavan]

For #2, I detect somewhat of a class3 skeletal pattern. Have you ever had braces to push your lower teeth backwards as to compensate for that?

I'm asking because in profile, you lack the lip/chin 'dip in' curve (labiomental groove).

My morph study is suggesting class 3 skeletal. Recession to Lefort 1 area, recession of BSSO area and also chin recession; the type which makes the chin appear LONG from the front.

My observations suggest Lefort 1 advancement, BSSO advance to what ever is needed to best fit the L1 advancement and a sliding genio along a diagonal cut where the chin is slid forward on that cut to provide an aspect of horizontal advancement and vertical shortening as H and V vector components of the displacement.

In terms of functional 'mechanics', the suggested chin displacement would make it easier to keep lips together when sleeping.

The frontal morph is an artistic approximation of the frontal changes with the profile displacements. The chin would project SHORTER. The labial ledge (upper lip area) would be less curved, (straighter) and project slightly longer, the nasal spine would come forward for less 'droop' to the columella and the lips would come more forward.

[chimrichalds]

For #2, I detect somewhat of a class3 skeletal pattern. Have you ever had braces to push your lower teeth backwards as to compensate for that?

I'm asking because in profile, you lack the lip/chin 'dip in' curve (labiomental groove).

My morph study is suggesting class 3 skeletal. Recession to Lefort 1 area, recession of BSSO area and also chin recession; the type which makes the chin appear LONG from the front.

My observations suggest Lefort 1 advancement, BSSO advance to what ever is needed to best fit the L1 advancement and a sliding genio along a diagonal cut where the chin is slid forward on that cut to provide an aspect of horizontal advancement and vertical shortening as H and V vector components of the displacement.

In terms of functional 'mechanics', the suggested chin displacement would make it easier to keep lips together when sleeping.

The frontal morph is an artistic approximation of the frontal changes with the profile displacements. The chin would project SHORTER. The labial ledge (upper lip area) would be less curved, (straighter) and project slightly longer, the nasal spine would come forward for less 'droop' to the columella and the lips would come more forward.

Wow that small change pretty much addresses what I was seeing as 'off' in my profile. Yes I did have braces when I was younger and had the elastics to move my jaw, I don't specifically remember which way they moved it, but what you've said is most likely correct.

You've listed a lot of surgical procedures to fix something that was caused by braces and elastics, is it not possible to have the jaw moved back into the proper position in a similar way that they were originally moved out of place? If surgery is the only option who would I go to in order to speak about this, I don't think telling my orthodontist that the braces they put on me caused this will go over very well lol.

Can you list the procedures you mentioned again in order with a short description so I can look into it more myself, I don't understand some of the terms and acronyms.

Thanks again, your post was a huge help!

[kavan]

Wow that small change pretty much addresses what I was seeing as 'off' in my profile. Yes I did have braces when I was younger and had the elastics to move my jaw, I don't specifically remember which way they moved it, but what you've said is most likely correct.

You've listed a lot of surgical procedures to fix something that was caused by braces and elastics, is it not possible to have the jaw moved back into the proper position in a similar way that they were originally moved out of place? If surgery is the only option who would I go to in order to speak about this, I don't think telling my orthodontist that the braces they put on me caused this will go over very well lol.

Can you list the procedures you mentioned again in order with a short description so I can look into it more myself, I don't understand some of the terms and acronyms.

Thanks again, your post was a huge help!

Procedures:
Lefort 1 advance
BSSO lower jaw advance


Those are things you can look up.

sliding genio, chin advance upward and outward over a diagonal cut for it to be shorter but also projected more forward. 'H' is short for horizontal. 'V' is short for vertical. A 'forward' chin displacement along a diagonal cut is a VECTOR displacement where vector components are a vertically upward and horizontally forward displacement. Movements along diagonal cuts or lines is elementary geometry.


As to moving your jaw 'back' or backwards, the morph suggests moving it forwards via a BSSO.

'Maxfax' doctors perform maxillo-facial surgery to displace the jaws and chin.

[ditterbo]

Geometric displacements and all, sure he can technically get better with bimax.  But as this guy's probably going to find out when he googles this stuff, his problems are extremely minor aesthetically and functionally.  If any particular thing bothers you enough, you can do much smaller things like a chin strap or SG or chin implant or rhinoplasty for a fraction of the pain, time and money and for probably a majority of the improvement you'd get with bimax. Insurance won't pay for your bimax either, if that was something you were banking on.  In a way its good that your jaw slacks open as opposed to grinding your teeth overnight.  You could also try breathe right strips and/or other things that can just keep your jaw shut overnight.  Aesthetically I wouldn't run the risks of surgery on your face, personally.  Your face looks solidly above average.

[chimrichalds]

Geometric displacements and all, sure he can technically get better with bimax.  But as this guy's probably going to find out when he googles this stuff, his problems are extremely minor aesthetically and functionally.  If any particular thing bothers you enough, you can do much smaller things like a chin strap or SG or chin implant or rhinoplasty for a fraction of the pain, time and money and for probably a majority of the improvement you'd get with bimax. Insurance won't pay for your bimax either, if that was something you were banking on.  In a way its good that your jaw slacks open as opposed to grinding your teeth overnight.  You could also try breathe right strips and/or other things that can just keep your jaw shut overnight.  Aesthetically I wouldn't run the risks of surgery on your face, personally.  Your face looks solidly above average.

Thanks for the perspective, you're right it does seem as though these procedures are typically done on people with more physically noticeable issues. The functional issues of my jaw definitely bother me, sleeping with my mouth open has caused some gum recession due to the bacteria that builds up overnight, on and off for as long as I can remember I've been waking up with an extremely dry mouth and irritated nose to the point where I have to blow my nose immediately after waking up to clear my nose and throat and often find a slight amount of blood in my mucus from the irritation, I also find I get sick frequently and get recurring ear aches which apparently may be caused by jaw issues as well.

Time and money aren't a factor in my decision, if I do choose to do something I want it to be the best choice thinking long term. My concern is the risks involved, the suggestions you offered are fortunately less invasive but unfortunately don't really address the underlying problem, but on the other hand a more invasive solution is more invasive. Would a bimax carry more risk than say an implant, the answer seems obvious but I'm not a doctor so I can't assume, and you can find cases of good and bad results on the internet for any procedure. My only surgery experiences have been wisdom teeth extraction many years ago and a septoplasty a year ago, neither of which were difficult at all for me to handle but I'm aware that surgery on the jaw is much more significant.

This forum is a huuuge help, would love to hear more thoughts/info!

[ditterbo]

I also have gum recession and dry mouth in the mornings, but moreso in the winter and for different reasons than you.. my nose doesn't work well especially since the rhino/septo.  Also gotta blow it in the morning but thought that was common/don't find it particularly annoying anyway since I grew up with that.  I largely counteract the dry mouth though with a humidifier. Also if you use a retainer or anything like that overnight, I noticed that also naturally increased saliva production overnight. My wisdom teeth extraction was a 1 month long nightmare and all of my plastic surgeries weren't worth it with all the complications for only middling improvement so yeah different perspectives too maybe.

[kavan]

Geometric displacements and all, sure he can technically get better with bimax.  But as this guy's probably going to find out when he googles this stuff, his problems are extremely minor aesthetically and functionally.  If any particular thing bothers you enough, you can do much smaller things like a chin strap or SG or chin implant or rhinoplasty for a fraction of the pain, time and money and for probably a majority of the improvement you'd get with bimax. Insurance won't pay for your bimax either, if that was something you were banking on.  In a way its good that your jaw slacks open as opposed to grinding your teeth overnight.  You could also try breathe right strips and/or other things that can just keep your jaw shut overnight.  Aesthetically I wouldn't run the risks of surgery on your face, personally.  Your face looks solidly above average.

Googles this 'stuff'. He needs to google what a BSSO and Lefort1 is . Basics for communication on here. Proof is in the pudding. If he likes the pudding, (contour changes to the morph), the explanation WITH it might be worth it for him to explore (procedures mentioned) which can improve his profile (and frontal).

[kavan]

Thanks for the perspective, you're right it does seem as though these procedures are typically done on people with more physically noticeable issues. The functional issues of my jaw definitely bother me, sleeping with my mouth open has caused some gum recession due to the bacteria that builds up overnight, on and off for as long as I can remember I've been waking up with an extremely dry mouth and irritated nose to the point where I have to blow my nose immediately after waking up to clear my nose and throat and often find a slight amount of blood in my mucus from the irritation, I also find I get sick frequently and get recurring ear aches which apparently may be caused by jaw issues as well.

Time and money aren't a factor in my decision, if I do choose to do something I want it to be the best choice thinking long term. My concern is the risks involved, the suggestions you offered are fortunately less invasive but unfortunately don't really address the underlying problem, but on the other hand a more invasive solution is more invasive. Would a bimax carry more risk than say an implant, the answer seems obvious but I'm not a doctor so I can't assume, and you can find cases of good and bad results on the internet for any procedure. My only surgery experiences have been wisdom teeth extraction many years ago and a septoplasty a year ago, neither of which were difficult at all for me to handle but I'm aware that surgery on the jaw is much more significant.

This forum is a huuuge help, would love to hear more thoughts/info!

There are MILLIONS of people walking around with jaw imbalances. So, it depends what type of perspective you are looking for; the POV of someone with one who has resigned himself to live with a max fax imbalance or the POV of someone who can show you what it is and what to think about consulting about IF you want to correct it? I gave you the latter.

Of course, doing NOTHING or maybe slapping in an implant is less risky then getting your face bones cut to move them to a better balance. But that works best for types for whom nothing would benefit or who could mask with only an implant. IF you were that type, I'd tell you so.