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Oral Surgery/Dentist tried to


QUESTION: I am not sure if you can answer this, but nobody was available in the orthodontist category. My dentist noticed one tooth on my left side was hitting just a little harder than the other teeth. He filed it down, and then it felt like the right side was off, so he just kept trying to "fix" my bite. I tried to tell him my top teeth are slanted (left top teeth hang just a little lower than right top teeth), and that I also have a slight overbite. Therefore, any adjustments he made still felt weird because my mouth isn't perfectly aligned to begin with! I am so mad at myself for letting him do this because now I feel like one of my front bottom teeth is hitting my top tooth. My question is, is reshaping my bite even possible without braces? I can't afford braces right now, but now I'm afraid that when I do get them my teeth will still not have a good bite because he shaved down my teeth. I've attached photos of my teeth in hopes you can tell me whether reshaping is really going to solve anything.

ANSWER: Emily, Thank you for your question. I will pass it along to an orthodontist I work with very often so you have at least two opinions (only with your permission). Obviously, he is the expert regarding aligning the teeth. I would leave things alone until you can get the ortho / invisalign. If you plan on getting your teeth straitened with ortho in the future, I would not recommend filing or changing any part of the teeth without a real symptom, like pain or discomfort or teeth chipping. Teeth are always shifting around until they find a stable place they like to be. Thats why even after braces, orthodontists always recommend wearing retainers to keep them where they were placed. Try not to dwell so much on what happened, things should work them self out. The teeth will shift a bit until they like where they are. I will send you the response from the orthodontist I work with. Is it okay with you is I send your question ago him?
I hope that helps! James

---------- FOLLOW-UP ----------

QUESTION: Thanks so much, a second opinion would be great.

Emily, The following is the reply from Dr. Orbach:
Good morning James,
I would not do any more shaving or reshaping of teeth from now on. This is an orthodontic case that involves mal-aligned teeth and a fairly deep Overbite. When the patient bites down, her lower front teeth are hitting her top teeth fairly heavily so her bite would need to be corrected by intruding (pushing down) her lower front teeth with an orthodontic appliance (whether it would be braces/Invisalign/Lingual braces) to open up the bite. From this point forward, if patient cannot afford orthodontic treatment, I would recommend a night guard (from either her dentist or a drug store) to prevent further damage to her teeth due to her bite. Occlusal equilibration (which is what her dentist did) works well to adjust the bite in most cases. However, her case may not be a great case for occlusal equilibration due to her un-even teeth and bite.
Hope that helps,
-Dror Orbach DMD
Orbach Orthodontics

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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