Expert: Zev Kaufman, D.D.S. - 11/5/2008

Question
Hello, and thank you in advance for your answer...
My name is Brenda and I had braces from the age of 13 to the age of 16. My case was defined as severe, with my two front teeth protruding almost horizontally from my mouth and completely in front of the second teeth. I had my second teeth removed and the two front teeth pulled back with braces. After the treatment time, my bite and teeth were almost perfect.
I do not have to tell you that this treatment caused severe root loss on the front teeth (and because of the way my teeth grew out, there was not much root to begin with). I wore the prescribed retainer for about a year, then lost it and never went back for another. My teeth did shift a bit, and I lost the perfect bite, which was ok for a couple of years.
I am now 29 years old, and have a new, troubling problem. I just came back from the dentist and spent the last half hour bawling my eyes out. I have noticed that for the last couple of months, my two front teeth have been shifting severely, with each of them protruding and going opposite directions. This is not the worst, however. What really troubles me is that I've noticed my jaw line shifting to the "overbite look". My lower jaw is receding to the point that I am losing chin and neck definition. Call me vain, but this is really troubling to me. I endured severe teasing before I had braces. It made my childhood very rough. After the braces, I became quite attractive and was even able to do some amateur modeling. I cry thinking of the fact that I would lose so quickly what was achieved through months of hard work and pain.
As mentioned before, I just came back from a certain dentist (general dentistry) and was told that there was nothing that could be done for my condition. My teeth were going to keep shifting, and my jaw definition would be lost and there was nothing I could do about it. He said the reason was because of the root loss, I could not apply braces again.
I am by no means an expert on dentistry, or facial jaw reconstruction, but I am sure that something could be done, even as an adult. I do not mind the overbite, but I do the shifting jaw and loss of chin and neck definition. Call me vain, but I do not want to lose my looks!
Please correct me if I'm wrong, but I think I could maybe have jaw reconstruction surgery to fix the jaw issue, and maybe apply a permanent retainer to prevent the teeth from shifting any further...
I know you have many questions, but I need some hope! Could you please give me some options, or point me in the right direction? Again, thanks in advance

Answer
Dear Brenda:
I feel for you.  I treat many patients, like yourself, who feel like they are loosing control of their mouth.  You are not alone, and You are not vain!  You are normal.  Our looks are very important to our self image and self esteem.
There is hope for you.  Go to www.prosthodontics.org and look up a Prosthodontist in your are.  The Prosthodontist is the true specialist in restorative, cosmetic, and impalnt dentistry.  Typically Prosthodontists have at least three more years of education on top of their doctorate in dentistry.  Part of our training is in treating cases such as yours.  It is impossible for me to diagnose your case and give you treatment options on this limited forum, especially since I cannot perform a proper examination and look at the applicable X-rays.  However, going to a Prosthodontist, colleague is the best way to look at your case.   Since most Prosthodontists deal with complicated cases on a routine manner, he/she would be able to refer you to other sub-specialty dentists such as a Orthodontist, Periodontist, or and Oral surgeon, who are trained to help in cases like yours.  The chances that the Prosthodontist will know the top people in your area are much better than you, trying to do this on your own.  It is like building a sky-scraper... go to the architect who is licensed to build the complicated buildings, get a plan, and let him/her select the builders who know how to the deliver the proper work.
If you have any problems locating a Prosthodontist through the website, please call me a the office 212-758-2758 (info at www.DrZevKaufman.com) and I'll gladly look up a colleague for you.
Now you know what to do...
Best of luck,
Dr. Zev Kaufman