Preparation For Surgery

In less than 2 weeks, I will be heading into the oral surgeon's office for a consultation to have another congenital defect corrected. (The first correction was the deviated septum.) For those that don't know what I'm referring to, it's my underbite.

The technical name for this facial skeletal deformity is known medically as mandibular prognathism. This is where the lower jaw (the mandible) extends out farther than the upper jaw (the maxilla). In my case, when I last had it measured, my jaw extends out 8 mm. This measurement was taken when I was 17 for my first ever visit to a dentist when I was in Basic Training in the US Navy. It's possible that my underbite may have progressed even further as I was still growing all the way up until the age of 26.

I also have several crossbites (an abnormal relation of one or more teeth of one arch to the opposing tooth or teeth of the other arch, caused by deviation of tooth position or abnormal jaw position.), overjets (increased projection of the upper teeth in front of the lower teeth, usually measured parallel to the occlusal plane. Also called horizontal overlap), general tooth crowding (you can figure this out for yourself) and a malocclusion (a reversal of the normal relationship of the mandibular and maxillary teeth, with lateral displacement of opposing teeth–i.e. a poor bite).
The result for me is that rather than all of my teeth matching up as they are supposed to, I currently only have 4 major contact points in my mouth where my teeth come together. This is a problem when it comes to eating - I have to eat closer to the corner of my mouth in order to tear food apart when not using utensils like knives as my upper and lower front teeth don't match up.
This also affects my appearance. Many people think that I'm mad about something since my jaw is "jutting out." It's not uncommon for one of my female co-workers to constantly ask me, "What's wrong?" when in fact, there is nothing wrong. It also resulted in the highlight of my first visit Dr. Kheim Tran. She is the dentist who referred me to the surgeon. After discussing the surgery procedures I had been advised of back when I was in the USN as a Dental Assistant (DT-8707) and what I could expect as far as follow up and whatnot, she stated, "When they do that, then you'll be handsome."

What I can look forward to, based on what I was told back in the late 80's/early 90's is about 18 months of orthodontic appliances (braces) prior to the surgery, as well as about a year or so of braces after the surgery. The surgery itself will possibly involve incisions in the mandible and moving it back, as well as removing the maxilla and replacing it further forward, lower and possibly to the side. This could result in screws, pins or other metal items in my mouth which could make going into the airport a lot of fun.

Also, from what I've been studying, the old technique of wiring a patient's jaw shut after the surgery has been phased out in most cases. Instead, they're now using strong rubber bands to help keep the jaw set rather than wires, which was the older way of doing this type of surgery. The rubber bands are much easier to remove in the case of vomiting, as opposed to carrying wire cutters in case such a thing should happen. Also, with the recent introduction of rigid internal fixation (plates and screws) for this surgery, much of the immobilization of the jaw has been eliminated so that the mouth is kept closed for only a few days, versus several weeks.

I also get to look forward to finding out what kind of orthodontic appliances I will be getting and seeing how much of the cost of that will be covered under insurance. In my studies, I've found that $1,000 is covered in most cases; however, in severe cases of malocclusion, the entire cost is covered under dental insurance. From what I've read, things like Invisalign, which a co-worker of mine is going for this year, and colored braces are not an option for cases such as mine.

The actual surgery itself is not covered under my dental plan, but it is covered under my medical insurance. This, I think, is very odd, but hey.

All in all, if it helps my appearance, that's fine. I'm doing this, though, so I can eat properly. However, all of the surgical information is still up in the air as I've not actually had my first visit with the surgeon to find out what is in store. I will update you on this once I actually find out what I can expect in the coming months.

Sources:

http://medical-dictionary.thefreedictionary.com/crossbite

http://medical-dictionary.thefreedictionary.com/overjet

http://medical-dictionary.thefreedictionary.com/malocclusion+of+teeth