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FAQ:  Jaw Surgery

Jaw Surgery - Treatment for underbite: I am a 21 year old male, who consulted about fixing an underbite at 18.

It was cost prohibitive, but I now have an insurance that would cover the surgery and am interested again.

I was told that I would need braces for 6 months before and after. I would also like to have veneers done on my top 8 teeth and bottom 8.

My question is if I want veneers which cover my teeth, do I need braces for the surgery? ... Visitor from AR

Yes, you absolutely need to have braces prior to surgery and after the braces are removed than consider having veneers.

So many people are going the route of having veneers to straighten their teeth. Yes, this is a quick and easy route but more times than not your best alternatives to treatment. I will tell you the majority of the population have a well proportioned tooth of good color.

If these teeth are straightened with orthodontic treatment (braces) and bleached, their is absolutely no reason to have veneers placed put on your teeth and at nearly a fraction of the cost of what sixteen veneers would run you.

Now, if your teeth have severe external or internal staining from say, tetracycline, or the teeth have an abnormal shape, still, after the teeth are straightened, veneers would be indicated.

Veneers can be quite costly and in many case more than the price of orthodontics and your in pocket expenses for the portion of jaw surgery not covered by your medical insurance. Also, you need to think of the future. These veneers will not last a lifetime and will have to be replaced one day. At that time, you may not be financially capable to cover the expense of redoing these veneers, such as in retirement or a cut in pay from a change in jobs. You have to think of these things.

Let me briefly educate you about a very important truth we all learned as dentist in our dental education, but for some reason so many have forgotten in their private practices. This is true for nearly everyone who is going to have veneers placed on their teeth. When we eat food actually slides down the face of our teeth and physically massages our gum tissue. This is extremely important for maintaining the periodontal health of our gum tissue.

The contour of a tooth has what we as dentists refer to as an "emergence profile". If you violate this emergence profile you can drastically affect the health of your gum tissue around those particular teeth. This is one of those simple commandments we were taught in dental school and it is was meant to be strictly adhered to the treatment of our patients.

Take for instance, a poorly rotated tooth. In order to give an appearance that the tooth is straight, the porcelain material on the most rotated portion has to be thicker. This thicker portion would violate the emergence profile of the tooth and the gum tissue underneath. This will have a drastic affect on the health and supporting tissue of that teeth for the years to come.

Now, in your situation, have a presurgical phase of orthodontics (braces) to align the upper and lower teeth, surgery to align the jaw bones and correct your bite and than reevaluate whether sixteen veneers are a good choice or not.

It is imperative that every patient that we see be given all the options to a particular treatment plan. It is after this discussion that you can make your own decision about which is the best treatment for you. This is the sign of a good dentist, whose patients come before himself.

Editorial Staff

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