The Bite Stuff

mouldEarlier this year, I mentioned I was seeing an orthodontist. This resulted partly from having a broken tooth removed about this time last year. Having had the tooth removed, I was told to let it heal for a month or so before considering my options – plate, bridge or implant.

When I returned in February this year, I discovered the dentist I had been seeing had left the practice, and so I had a new dentist. One of the things we discussed was my bite – something I have been asking dentists about for the last 10 years. For once, I found myself talking to someone interested in more than a “quick descale and polish”, and after examining me, she encouraged me to see an orthodonist before doing anything about my gap.

Hence my post earlier this year about possibly having braces. Unfortunately, it has been quite a long, drawn out consult – mainly because each time I try to book a new appointment, there is another month’s wait. As a result, I still have a gappy smile – thank goodness the gap is at the side, and not in the front!

The upshot of my many visits with the private orthodontist is that he has decided that braces won’t help me. He thinks the problem is a misaligned jaw – in his opinion my lower jaw is more developed than the upper. The problem with this diagnosis is that he is adament that this would have happened during my teens – or my early twenties at the latest. This does not match the known facts – I know that I had a good bite during most of my thirties: photos bear that out; and I could hold a guitar pick in my front teeth, and they don’t even meet now. My belief has always been that my problems stemmed from some botched dental work done in my late 30’s (which I did complain about at the time, but got no satisfaction whatsoever).

Anyway, he says the best option is surgery, which is why I had an appointment with the orthdontist department at Peterborough City Hospital this afternoon. As it happened, the consultant I was due to see was taken ill earlier in the day, so I saw a junior colleague who was going to report back to him. I suspect this meant I actually got more attention and information than I might have got with a busy consultant.

I explained the history, and that I wasn’t actually that eager to go with surgery (if I want someone to break my jaw, I’ll get mugged, thank you!), but before deciding to just live with the problem, I wanted to know what the cause was, and – most importantly – would it get worse if untreated. After a thorough examination and case history, I had been there an hour, and was then sent for more X-rays. Finally the orthodontist said she had everything she needed, and would discuss my case at their next meeting. To make sure they had time for everything their end to happen, it was suggested my next appointment be at the end of February. As I will be flying out to California about then, we agreed it would be after my return, at the beginning of April.

The really interesting thing is she took notice of my sleep apnoea. She was saying that recent studies they had done had shown that they had a relatively high proportion of patients with sleep apnoea coming to see them for orthodontist consults. Furthermore, there is some evidence that the surgery to fix jaw alignment problems may actually help reduce apnoea problems. For this reason, whereas the private orthodontist was talking about shortening and realigning the lower jaw, this doctor was saying it might be more helpful to bring my upper jaw forward.

I am still fairly certain that I don’t want surgery over something that isn’t, in itself, life threatening. However, the possibility of my sleep apnoea being improved swings the scale the other way a little, and I think I am going to have to keep an open mind about the whole thing.


  1. December 16, 2010

    I was looking through a dental technician’s trade magazine recently when I was in a dentist’s waiting room. Not being a dental technician, it didn’t all mean much to me, but I did notice there was an article on sleep apnoea that mentioned jaw realignment can help in some cases (but it did also say that CPAP was “the gold standard” for apnoea treatment).

    • chris
      December 16, 2010

      Oh indeed. I have had a CPAP since 2000, and it’s a godsend – when I am using it, it is as if I don’t have a problem.

      However, it has got to the point that for the last year or so, I don’t always take it with me if I am going away – particularly if I am not going by car, so have to carry my luggage. I find that I can easily manage one night without it, and still function. Furthermore, folk have told me that – when I am without my CPAP – I no longer seem to make alarming noises in my sleep. Which seems to indicate that the problem isn’t as bad as it once was.

      One thing I do know – because I use a nose mask, and because it is damned uncomfortable to keep your mouth open when using a nose mask, it has trained me to keep my mouth shut when I am asleep, and I suspect this is probably as much so when I am not using the CPAP as when I am.

      Using the CPAP isn’t such a chore. I’m currently single, but I have been in two relationships since first getting the machine, and then it can be a bit of a pain – partly because the person sharing the bed has to put up with the noise of the machine, but also because the appearance of the mask and hose is a complete romance killer.

      So while I am comfortable with using the machine, if there was any chance that I could get myself to a point where I could do without it, I would probably want to give it a try.

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