Correcting Teeth and Facial Contours: A Guide to Orthodontics and Surgery

Orthodontics and facial contouring?

Hello, my lower back teeth are all tilted to the left.
I had my molars extracted on both sides when I was in elementary school, and I did not subsequently get dentures, which has resulted in my jaw and facial shape being asymmetrical.
Currently, I still do not have teeth on both sides where the molars were extracted.
I would like to ask Dr.
Chiang Bai-Tsong if I need to first align my back teeth and undergo orthodontic treatment with braces before proceeding with orthognathic surgery for my facial shape.
Could you also recommend a good doctor for this, and what are the estimated costs? Thank you.

Xiao Lin, 20~29 year old female. Ask Date: 2004/02/16

Dr. Jiang Baicong reply Plastic Surgery

Indeed, tooth extraction can sometimes lead to issues with the gums and alveolar bone! In your case, it would be advisable to first undergo special X-ray imaging at the hospital (cephalometric and panoramic views).
Additionally, a dental impression can be taken to create a model of your teeth and alveolar bone.
Only then should your treatment plan begin! Typically, the focus will be on addressing the teeth first to ensure that there is space for the alveolar bone to retract.
Otherwise, in such surgeries, the priority is usually given to the skeletal structure.
This is similar to building a house; the steel framework and foundation need to be solid before progressing step by step! Jiang Baicong

Reply Date: 2004/02/16

More Info

Correcting teeth misalignment and facial contours is a complex process that often involves both orthodontic treatment and surgical intervention. In your case, where you have experienced significant dental issues due to the extraction of molars at a young age, leading to a misaligned jaw and facial asymmetry, a comprehensive treatment plan is essential.

Initial Assessment and Treatment Planning
The first step in addressing your concerns is to undergo a thorough evaluation by a dental professional, preferably an orthodontist or a maxillofacial surgeon. This evaluation typically includes:
1. X-rays and Imaging: Specialized imaging, such as cephalometric X-rays and panoramic views, will help assess the current state of your teeth, jaw, and facial structure. These images provide critical information about the alignment of your teeth and the relationship between your upper and lower jaws.

2. Dental Models: Creating dental impressions or models of your teeth can help visualize how your teeth fit together and identify any discrepancies that need to be addressed.

Orthodontic Treatment
Based on the assessment, the orthodontist will likely recommend starting with orthodontic treatment to align your teeth properly. This may involve:
- Braces or Clear Aligners: Depending on your specific needs, you may be fitted with traditional braces or clear aligners (like Invisalign). The goal here is to correct the positioning of your teeth and ensure that your bite is functional and aesthetically pleasing.

- Duration: Orthodontic treatment can take anywhere from several months to a few years, depending on the severity of the misalignment and your compliance with wearing the appliances.

Surgical Intervention
Once your teeth are properly aligned, the next step may involve surgical intervention to correct any underlying skeletal issues. This is particularly relevant in your case, where the extraction of molars has led to a shift in your jaw position. The surgical options may include:
- Orthognathic Surgery: This type of surgery is performed to realign the jaw and improve facial symmetry. It is typically done after orthodontic treatment to ensure that the teeth are in the correct position for optimal surgical outcomes.

- Recovery and Follow-Up: Post-surgery, you will likely need additional orthodontic adjustments to fine-tune your bite and ensure that everything aligns correctly.

Choosing the Right Professionals
When selecting a dental professional for your treatment, consider the following:
- Specialization: Look for an orthodontist who has experience with complex cases involving jaw misalignment and facial asymmetry. Additionally, a maxillofacial surgeon with a strong background in orthognathic surgery will be crucial for the surgical aspect of your treatment.

- Consultations: Schedule consultations with multiple professionals to discuss your case, treatment options, and their approach. This will help you find a provider you feel comfortable with and trust.

Cost Considerations
The costs associated with orthodontic treatment and surgery can vary widely based on several factors, including:
- Location: Prices can differ significantly depending on where you live.

- Complexity of the Case: More complex cases may require more extensive treatment, which can increase costs.

- Insurance Coverage: Check with your dental insurance provider to see what treatments are covered and what your out-of-pocket expenses may be.

In general, orthodontic treatment can range from $3,000 to $8,000, while orthognathic surgery can cost anywhere from $20,000 to $40,000 or more, depending on the specifics of the procedure and the surgeon's fees.

Conclusion
In summary, addressing your dental and facial concerns will likely require a combination of orthodontic treatment followed by surgical intervention. It is essential to work closely with qualified professionals who can guide you through each step of the process. With the right treatment plan, you can achieve a functional bite and improved facial symmetry, enhancing both your oral health and overall appearance.

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