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FAQ:  Orthodontics - Children - Teens



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Question:
Undo orthodontics and get implants: I got braces about 2 years ago at 45 years old and am so unhappy with the results.

I had 4 extractions to correct an overbite. Prior to braces I had a big beautiful smile. Now I feel like my face is caved in and you can hardly see my teeth anymore.

I went to another orthodontist to ask about reversing the procedure (open closed spaces) and placing implants where teeth were removed. He recommends against it. What would you suggest? ....Visitor from TX

Answer:
I do not have access to your records, but I'm guessing that treating you for an overbite at age forty five with four premolar extractions was probably the wrong treatment.

If you had a nice straight profile, full lips and severe crowding that would have been a better reason for extractions.

The majority of overbites or what we as orthodontists refer to as excessive overjet is a direct result of a deficiency in the length of the lower jaw bone.

Since you were a non-growing adult and no growth of the lower jaw was expected, the entire reduction in overbite was performed by retracting the upper teeth. This unfortunately resulted in retraction of the lips, giving you the appearance of a caved-in profile.

Now to answer your question. Can you re-open the space and place implants? Yes, you can, but the extended amount of time in braces and the additional cost of implants may not be beneficial.

I have had many adults that were treated as teenagers, prior to the advent of advanced surgical procedures, present to my office with the same scenerio as yours. The treatment recommendation is placing these patients back into braces, reversing the orthodontic mechanics to reestablish the excessive amount of overbite. We call this decompensation in orthodontics.

Decompensation will restablish the upper teeth in their normal positions and help regain that lip support. We then, approximately 8-10 months into treatment, advance the lower jaw surgically. The advancement helps us reduce the overbite by extending the length of the lower jaw, establish a normal tooth relationship, reduce the excessive overjet and indirectly straighten the profile and improves chin neck contour. The esthetic benefits can be quite dramatic.

My recommendation is to see a Dr. Jacobs in Dallas. He is an instructor at the Orthodontic School at Baylor and he can give you a better opinion concerning your situation.

Editorial Staff

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