Orthodontist recommended SFOT or jaw surgery - unsure what to do

[Gnomenclature]

Hello!

I am trying to get advice on two possible treatment plans that were recommended to me by my orthodontist.

To start, I never had braces as a kid because the dentist said my teeth were aligned and straight, and though I had a slight overbite I was told braces would have been purely cosmetic. Fast forward to my early twenties and I had severe TMJ due to not fixing said overbite. I have now done a year of splint therapy for TMJ, and I have finally stabilized my bite at age 28. The next step involves braces and turbos on my back molars for 1.5-2 years until my teeth are aligned in the proper position. I just had my first consultation with my orthodontist and was shocked to hear that my treatment plans are not as straightforward as just getting braces.

The goal is to have my lower dental midline match my upper for my teeth to fit and function properly. I was previously unaware, but my jaw is crooked (off to the left?) and I also have a somewhat recessed jawline which I guess complicates things?

I have two options for treatment:

Option 1: SFOT and braces for 2-2.5 years – Turbos and brackets put on same day, then on another day, have the SFOT done and have the wires placed. They believe I might have to get the SFOT done twice but it is unknown when the second time would occur. Jaw would remain crooked.

Option 2: Braces for 3-3.5 years and jaw surgery. Would have turbos and braces placed and in 1.5 years, undergo surgery to align my jaw which also allows them to fix larger discrepancies. They still believe I would need SFOT at some point in life.

I have already taken a lot into consideration such as cost, downtime, length of treatment, and likelihood of my jaw coming out of alignment again. I know it is vapid, but one of my concerns are about my facial features after treatment.

With the SFOT – they said my appearance won’t change too much but there will be a bit of a difference due to aligning my midlines while having my jaw stay crooked.

I am concerned because they are unsure how much my face will change, and I don’t want to bring more attention to my jawline and smile, especially if my face or smile will be more asymmetrical.

For the jaw surgery, I don’t know what I will look like yet, but I have a consultation in March and hopefully that can show me how big of a difference it would make.

I have always had an insecurity about my soft jawline but had never considered changing it unless there was a medical reason. While I am leaning towards doing the SFOT without jaw surgery, I would like some opinions on a couple questions below or advice in general. I did talk to my orthodontist but was hoping to get other’s opinions.

1. SFOT - Does anyone have an idea how noticeable it will be in terms of accentuating the crookedness of my jaw or my smile?

2.Will braces have any change on my jaw even if I am an adult (28)? I know it will not be aligned but I am wondering if the braces may strengthen my jawline since I have heard differing opinions on the matter. My orthodontist says it won’t because I am too old.

Any general advice or opinions would be greatly appreciated. Thanks!

 

[Dental cure and care]

Depending on the severity of your jaw misalignment, functional appliances may also be suggested before or during brace treatment to help guide jaw growth and improve alignment.

1. Traditional braces will be used to gradually move your teeth into their correct positions. This process typically takes 1.5 to 2 years, as mentioned by your orthodontist.
2. Turbos on Black Molars- These are small devices placed on the back molars to prevent certain teeth from touching during biting or chewing. They help in managing the bite relationship while braces are applied, particularly important for patients with TMJ issues.
3. In some cases, if the skeletal discrepancies are significant, surgery might be recommended after braces have aligned the teeth properly. This would involve repositioning the jaw for better alignment and function.
4. Depending on the severity of your jaw misalignment, functional appliances may also be suggested before or during brace treatment to help guide jaw growth and improve alignment.

Choosing between these two options ultimately depends on weighing immediate versus long-term benefits and risks:

• If you prioritize a shorter treatment duration and less invasive procedures without major concerns about jaw alignment or aesthetic changes, then Option 1 might suit you better.
• However, if you seek comprehensive correction that addresses both functional issues and aesthetic improvements over a longer timeline, then Option 2 would likely be more beneficial despite its invasiveness.

Given these considerations, I would recommend discussing further with your orthodontist or oral surgeon about how each option aligns with your personal goals regarding function and aesthetics before making a final decision.

while SFOT has the potential for noticeable changes in facial aesthetics over time—especially if you are addressing asymmetries braces will primarily focus on aligning teeth without significantly altering jaw structure at your age.