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Orthodontics/Jaw/Braces, surgery, dislocation, braces


Hello can a orthodontist tell you if you have a broken, dislocated or misaligned jaw? Also my general dentist told me I have a class three malaclussion with anterior and posterior open bite, how are those usually treated would they require orthogantic surgery? I also believe he wrote down the open bite was a couple millimeters i think 4, if that helps.


Hi Randy,

Orthodontists, oral surgeons, and general dentists can all provide you counsel on whether you have a broken, dislocated or otherwise misaligned jaw. Many general dentists now perform procedures formerly provided mainly by oral surgeons or orthodontists. The difference is that oral surgeons and orthodontists are dental specialists as recognized by the ADA, the American Dental Association. I would say the best thing to do is check with BOTH an oral surgeon and an orthodontist. Also realize that a surgeon will likely favor surgical approaches; the orthodontist may be more inclined to surgical as well as non-surgical options.

Before I get any further....What I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused on <b. " a class three malocclusion with anterior and posterior open bite  </b>

Randy, you have some of the most profound challenges which both oral surgeons and orthodontists face. If in fact you do have the combination cluster of conditions, then you are likely a candidate for a multi-specialty consultation. To really address and diagnose your condition will likely take a team effort. Indeed, if restorative procedures are going to be needed such as crowns and veneers for some of the teeth, your family dentist definitely needs to not only be part of the team, but to be brought into this at the beginning so that a careful road map for your treatment course can be developed.

It has been my experience with skeletal open bites that these often tend to relapse. This has also been supported in the dental scientific literature.  I have treated most of my cases  with the help of oral surgery. I have had several cases where surgery was simply not possible under any conditions for the patient due to financial limitations. After great deliberation with the patient re the limitations, treatment proceeded, and in several cases it worked out. In several others it was not quite what I would have liked. When a strong Class III skeletal anterior cross-bite exists, it is sometimes possible to camouflage this condition with certain dental compensations.

In such cases are the results ideal? Of course they are not. Nevertheless, the change is sometimes profoundly better than what the patient had prior to any treatment. Moreover, the situation is fully explained via informed consent forms and discussions. Realistic, not unrealistic expectations are defined, and  in the end everyone is happy even if an ideal result has not been achieved.

Randy, in your case, get a diagnostic work up. Find out what your options are to solve some and/or all of your conditions. I had a case that required $60,000 dollars or so of jaw surgery. In the end the patient ended up doing nothing. No Oral Surgery. No Orthodontics. Nothing.

Finally, Randy ask your consulting doctors to see if they can get your surgery covered under your medical insurance policy, if any. In other words, insurance carriers may be reluctant to cover a condition based on dental needs, but far more likely to cover your surgery and orthodontics if it is based on medical needs ( can not eat, unable to speak properly, etc.)

I wish I could answer more of this for you, but I have no photos, no x-rays, and no study models to examine your  bite. Also, if the  conditions are as serious as you describe, a personal clinical examination would be required before really saying anything definitive. You had a very short question Randy, but wow it sure covers some very profound conditions. I wish you all the best luck in your consultations. Also, if you wish to write back, please do, but if possible see if you can attach some x-rays and/or photos of your  bite. I think you can appreciate the position I am in here trying to respond with no dental records at all. It is difficult to accurately visualize with only words available.

Thank you for writing.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health  


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Paul Supan, DDS, MA, MPH


First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites and are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.


Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Available upon Request.

BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

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Available upon Request Please see my personal websites and for further personal background.

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