Jaw Surgery - Orthognathic surgery

[sg_guy]

Hi all,

I am a 28 yr old guy. I have a cleft-lip palate since I was born....meaning my upper lip is stitched up (but very well, without scarring, done by my plastic surgeon) and my lower jaw is protruding out. As my family is not the rich type, I never thought of doing any orthodontics in the past and don't know anything abt jaw surgery as in the past, there was no internet and information not widely spread and readily available compared to now.

When i was in primary school, I like to talk a lot of make jokes and sometimes cross the line ... I remember classmate rebutted me saying I look like elephant man and kettlespout. It didn't mattered much to me back then.

WHen I was 16, I remembered my classmate saying something like I could be handsome but "ke xi"...I knew somehow he was referring to my cleft-lip... to be honest, I think I would look handsome cos I have boyish looks and I agree with him.... but alas..

As i entered late teens and early adulthood 18-21, I realised looks do matter as a measure of self confidence of how u appear to others... especially when I know I can't smile as well as other people...

When I was 18 and jus before going into NS, I though of doing orthodontics... my parents didn't mind but my brother advised me against it. During one of my visits to my aged plastic surgeon who repaired my cleft when I was a baby... he recommended a malaysian orthodontist... the orthodontist told me he was not confident in my case and suggested me seeking treatment in Singapore instead or jus abandon the thought altogether. So, I went to NDC and was given a waiting list of 2 years!! 2 years was a long time to wait and the thought of doing orthodontics or watever eventually diminised from my mind.

At the age 25 in my 3rd yr of university, the thought came again and I went for consultation at Alexandra Hospital. The orthodontist made me feel uncomfortable saying comments like " I"ve never seen such crooked teeth before..." I thought she was supposed to be experienced.. but I was left disappointed.... then I spoke to the jaw surgeon in the other room and she a bit more reassuring but i was informed of the hospitalisation and I felt I cudn't commit the time... so in the end I abandoned the idea again...

Recently I have been looking in the mirror these days and the thought came about again...as I work in the education sector, I have to face young kids who readily make fun of my lower jaw... I think this op may benefit me in the long term but again there is the issue of time commmitment in hospitalization and curing.. and of cos pain of op and complications etc...

Any adivse? I really glad to chance upon this support group.. solli if i a bit loh soh but this idea has haggled me for 10 yrs on and off... it's only when i went for consultation at 25 did I know that my case definitely requires jaw surgery.

 

[wisqix]

My fren went for the op. Tink over a period of abt two years, she had to extract teeth and wear braces that kinda thing. After that, she went for the op and had to rest at home for 1 mth and after the 1 mth, she still had a support band outside her jaw but I'm not sure for how long. She mentioned before that she put aside 10k for all these.

 

[jacqueline97]

I have a friend went for the upper jaw surgery about 8 years ago. She went for braces first and then opt.Two doctors work hand in hand...No pain no gain. She used to look so so, but after the opt, a complete change...no lack of suitors...n now happily married...

 

[sg_guy]

Hi,

May I know what is the sequence of treatment? Like how many appointments of what puporse u need to attend before finally doing the op one day?

After op, how long do u need to be hospitalized and how long before u can go back to work?

 

[sg_guy]

For NDC consultation, do I have to wait again like 1 yr or so before they can start putting in braces???

 

[sg_guy]

Just to add....I don't have problems with eating or drinking.... it's purely for cosmetic reasons if I do it.. and being in the education line facing kids all day... they make fun of me from time to time..

 

[wisqix]

Hmm... I'm not too sure about the details but my friend went to an orthodontist in west coast area. Initially she only wanted to correct her teeth but after examining her, the orthodontist sugg she opt for surgery for her lower jaw. They referred her to NUH. I don't think she faced any delays in starting on the braces. If you want I can pass you the contacts to the orthodontist.

 

[sg_guy]

I found that Dr. Ho Kee Hai has started his own clinic called "Ho Kee Hai and partners maxillofacial ....." (long name) located at Paragon Medical Center which is inside Orchard Paragon shopping center.

He is no longer working at NUH.

 

[sg_guy]

Dr.Ho is really nice man... gentle and approachable and reassuring... I wud like him to do the jaw surgery for me but the cost is 12k.. even with Medisave cannot use much also... so it's a great pity... but I can manage to save to that amount 2 yrs or so later after braces, I might wan him to do for me.

 

[jacqueline97]

My friend told me that DR teh luan yoke from SGH is good and she did her surgery there. For braces, she did it with Dr Lien li choo located in mandarin hotel.Both are ladies and very good in their hands.

 

[sg_guy]

Mandarin hotel has a dental clinic? What is the name of the clinic? any website?

But I think since i have taken the plaster mould, X rays at Dr. Ho's clinic, I would do the braces over there, and they're located at Orchard which is 10min from my home by MRT... I think i'll do it there bah...

For Dr. Ho's clinic website, it's www.hkhdentalimplant.com

 

[jacqueline97]

Sori,I mean the arcade along mandarin hotel.Not sure they have a clinic but its call lien li choo clinic

 

[sg_guy]

Sunshine coast,

Thank u for ur help... i appreciate it very much... but i will stick with Dr. Ho's clinic for braces treatment since I've gone for the consultation and taken the X rays there.

For those who need this treatment, I recommend braces treatment at Dr. Ho's clinic and if u can afford the $12 000 jaw surgery costs by the experienced and approachable Dr. Ho, do go ahead, otherwise u can ask for a referral after your braces treatment to go govt. places like NDC to do the surgery. As braces prices are privatised, the cost is the same everywhere, govt. or private clinic... but private clinic like Dr. Ho's wud save on time waiting for appointments if u need to extract out-of-place teeth before putting braces (if needed) and extra consultations, I believe so...

 

[sg_guy]

I wish i can do the surgery tomorrow.
I look weird with the outer jaw protruding out.. I shud have jus plucked up the courage and do it like "Chin Chin" last time... really regret..
Looks do matter especially when u start working.

 

[inex]

Hey sgguy,

just go ahead and do it. I was like you hesitating for so many years till I finally go for it, when my wisdom tooth made my problem worse.

I had a protruding jaw that wasn't very obvious only until I smile.

lucky for me, my case wasn't severe enough to require the jaw surgery, braces alone helped to push my jaw back.

I agree with you that looks do matter when you start working. We all only live once, so why not live it looking the best we can? better do it now when we still have smooth skin and thick hair then when we are old and regretting.

 

[sg_guy]

Hi Jean,

How long did u wait and why did u wait? are they the same reasons as mine? I'm now waiting for the clinic to call me for follow up consultation with the orthodontist ... it's been 3 weeks.. supposed to wait for 1 to 2 weeks but i wud like to assume the delay is due to holidays bah... how long were u on braces?

Kelvin tan weilian, the blind singer who won project superstar 2 yrs ago, also having braces and he goes for tightening every 2 weeks instead of the normal once a month in order to speed up the treatment... I admire his guts and I think i wanna follow in his footsteps too.

Why hasn't the clinic called me??

 

[inex]

I waited as i was hesitant of the pain. For one thing I wanted to make sure all my wisdom teeth are grown and removed before I go for braces. (they will disrupt the alignment of my teeth if they grow out)

In the end I had my teeth done when I was 23. removed then I was 25. In all I took out 8 teeth - 4 wisdom and 4 premolars.

But in the end it was all worth it. I had a beautiful smile to boast of now

and if the clinic didn't call you.. you can call the clinic right?

 

[sg_guy]

HI Jean,

I've called the clinic already. They didn't return my call. Anyway, I'll assume it's due to backlog of patients cos of the holiday period.

I abandoned the idea of treatment in the past due partly to time commitment and inconvenience ...if given another chance, I'd have called for appointment in my second yr of NS and put on waiting list for treatment when i enter University. I wud have had my op done by the time i grad and things wudn't be so messy now....

By the way, wat do u feel after putting on the braces? i read that first few hours after braces are put on, u'll feel soreness of gums is it? How long does it take for it to go away? My teeth needs a lot of re-alignment as the wisdom teeth caused plenty of overcrowding... I'm seriously thinking of tightening every 2 weeks instead of a month.... how will it be like?

 

[inex]

It was more then just gum sores... I had pain of the dull sort simply by chewing.. takes anywhere from 2 or 3 days to 1 week before it goes away.

and you'll get plenty of ulcers too.

as for the frequency of adjustments, you have to discuss with your doc for that.

 

[sg_guy]

HI Jean,

In my case, I definitely need to go through this cos it affects my appearance...haiz!

1 week for the pain to go away? Then 1 week later i go for tightening again... it'll come back again... haha! Weilian must be a brave guy to endure all these.. i think with the lack of sight, he is less afraid of things in life compared to us.

In your case, cud u tighten once every 2 weeks?

So u removed ur braces at 25? Where did u do it?is it at NDC? if so, were u put on waiting list?

 

[inex]

I didn't ask if I can tighten every week as I'm in no hurry to get them off.

Besides you have to understand everyone's case is different. You have to direct your question to your orthodontist.

I did my braces at AH. No waiting list. I don't understand why there is a waiting list at NDC even.

But be reminded that it is VERY VERY IMPORTANT YOU TURN UP FOR YOUR APPOINTMENTS ON TIME AND NOT MISS A SINGLE ONE.

missing one will delay your treatment. and prepare to wait up to an hr or more in the dentist rm each time you go, so try and show up early.

 

[sg_guy]

Hi Jean,

The NDC has a waiting list cos there are many patients, majority of them students... it's subsidised costs, there is also immediate ... but the patient will pay at privatised costs.. Dr. Ho told me the braces are privatised everywhere at market rate.

How much did u spend on braces treatment? THe extractions are charged separately rite? how much did u pay for extraction and which teeth did u take out after jus before putting braces ? The Dr said my case wud be abt 5k...i think he added the extractions costs in already.

I originally went to AH 4 yrs ago.. but the orthodontist didn't make me feel comfortable.. she say she never seen teeth of my case before... she shocked and stressed.... as a result, I didn't feel I wanna go thru treatement with her... so i din follow up.

 

[sg_guy]

HI Jean,

How many appointments u went at AH before u put the braces? how long did u wait after appointment to put the braces?

 

[sg_guy]

HI Jean,

Will food be easily stuck in the braces? I scared of tat and brushing will be more tedious rite? my teeth are overcrowded and out of place.. the teeth at the back (wisdom teeth) are also slanted out and i'm afraid with braces on i cannot brush them properly.. how?

 

[inex]

Then find yourself another orthodontist. ok my case is a little different. I put my braces on after I heal from my wisdom teeth surgery (I removed ALL of them before my braces)

It takes about 3 to 4 appointments btn removal of my wisdom teeth to putting on my braces. Because I had to wait for my wisdom teeth to heal, it took me more then 2 weeks I recall.

If you had a referal from the polyclinic to remove your wisdom teeth, you can pay using medisave. I took 3 out (1 extraction 2 surgeries) at $550 deductable by medisave. I pay about 100+ for consultation and X-rays.

Be aware that for overcrowding teeth you may have to remove your premolars (extraction at AH is at $32 per teeth) to space out your other teeth. and before your braces, you should have gone for your jaw surgery beforehand.

Yes food will easily be stuck btn your braces. brush with the ortho brush from oral b. Use the interdental brush (tiny brush thats like a miniature of the brush used to clean milk bottles) to go in btn the braces.

Finally, rinse off with a mouth wash. Use Oral B.. its less minty with flouride protection.

 

[sg_guy]

Hi Jean,

I was told wisdom teeth can be made useful .. they are not totally useless. So when I went to AH to take them out, the dentist told me to confirm with the orthodontist first before taking them out.

The jaw surgery can only be done after braces treatmtent for sure.. think u made a mistake there.

How much is the ortho brush from oral b? So u got to buy another interdental brush? how much is that? how much is the mouthwash?

By the way, how much did u pay for the braces?

I still got 3 wisdom teeth (2 upper, 1 lower).. dunno if they can be kept.

I wud need to take out 2 upper and 2 lower premolars. 1 upper incisor need to be taken out also. All those are pushed out of place due to overcrowding. In addition to jaw surgery, I also need to do a bone graft which is a minor surgery.

So u went to remove wisdom teeth first before making appointment for braces treatment? or are u referred to take out the wisdom teeth after consulting the orthodontist?

Jus to confirm, u meant u removed all the wisdom teeth by 23 and put in braces and removed braces at 25 is it?

I'll wait for my clinic for this week bah.. I hope they'll call me by this week. I'll call them again in 2 days time if they haven't called me back.

U can also MSN or email me at [email protected]

Thanx for ur support Jean

 

[inex]

Well it really depends on your condition. Perhaps having the surgery first works for you. Besides I'm no expert on this matter. As far as I'm concern, from my dental training last time as a dental assistant, wisdom teeth usually do more harm then good in the long run as they are too far back in the mouth to be clean properly.

I spent around $3k for my braces. mine was metal braces. I did not want ceramic as they are expensive and whats the point of having them when I only need them for 2 years and have to pay 1k more? you may wanna use damon braces instead. they are also metal, but speed up the process faster. you can google them.

"Jus to confirm, u meant u removed all the wisdom teeth by 23 and put in braces and removed braces at 25 is it? "

yes

and you are welcome

 

[sg_guy]

HI Jean,

Wat's damon braces? wat u mean by google them?

Can't do the jaw surgery first when the teeth are all overcrowded and out of place...

Are u still a dental assistant now? I remember visiting a dentist whose dental assistant also wore braces.... but it's ceramic ones.

I hope the wisdom teeth can be kept and moved in front to be cleaned more easily after removing the out-of-place premolars... otherwise it's going to cost me more $$ to extract them...

 

[inex]

www.damonbraces.com

google them is to do a search for them on google.com

nope.

I cant give you advice on your surgery or the treatment of your teeth. you still need to consult a professional. There are so many orthodontist in the market (and AH for that matter) you dun have to die die stick to NDC right?

 

[sg_guy]

Hi Jean,

I'm not doing braces at NDC.... it's at Dr. Ho Kee Hai's clinic. He makes the patient will at ease with him.... pity he charge jaw surgery too high (12K) , i wud have to do the jaw surgery at NDC instead.

 

[inex]

there is also AH and other hospitals.

 

[sg_guy]

Hi Jean,

I like Dr. Ho's personality... i don't know abt the orthodontist though... but i can't afford to wait any longer ... i'm old liao..

 

[sg_guy]

Hi Jean,

I've switched to NTUC Denticare at Toa Payoh. It's nearer my home and cheaper. They use Damon braces and I can have them as soon as next week. cos the Damon technique focus on shaping the outline of the teeth first so that those teeth which cannot fit into the outline wud be pushed out and make it obvious to be extracted.

Thus, I wud not need extraction at the moment. But i'll probably need to wear braces for over 2.5 years before undergoing jaw surgery.

 

[sg_guy]

I've just got my Damon 2 braces in for $3790 at NTUC after 10% member discount.

I also got 3 fake molar teeth on top of my 3 real molar teeth cos i will bite off the metal brackets when my top and bottom front teeth bite together... so i can't bite completely and it feels weird... my top and bottom front teeth only meet but not overlapping to bite...

Haven't taken out any tooth yet... but i predict will have to take out at least some in future..

 

[inex]

Congrats sgguy in taking the first steps to looking good!

I'm glad you opt for damon. I bet they are less painful to wear too then normal metal braces.. mine gave me so much ulcers over the years.

an important note for you to wear your retainers after your braces nightly when you sleep, for the rest of your life, to keep your teeth in shape because they shift everyday.

friends who neglect to wear their retainers have their teeth became crooked again.. waste of money and time!

mine is still straight and neat after one year of nightly retainer wearing

 

[sg_guy]

Hi Jean,

Retainers are still 2.5 yrs away for me... i jus started on braces... actually Damon is by chance, cos the ortho is at my place nearby and she practises Damon only.

I intend to choose permanent retainers after braces if possible cos my case is quite bad.

 

[monster6]

Hello,

This is a very interesting discussion.I'm reading it fr a point of a dentist,coz I am one.New to this forum.

1)Dr.Ho Kai Kee is an oral surgeon,not an orthodontist.That means he is trained in oral & maxillofacial surgery.

2)It's best to consult ur dentist for more info re:wisdom teeth,how long u have to have braces,how many extractions,whether wisdom teeth have to be taken out b4 or after braces etc.Every case is different.What other ppl r saying are wat they hear.May not be 100% accurate coz every case is different.must remember that.

3) I get a lot of patients coming in & telling me that something ridiculous & when i ask them where they hear/read abt it,they say,"Fr my collegues." ur collegues are not dentist,remmeber that.everyone's experience at the dentist will be different.Ur collegues teeth are not the same as ur teeth.

4)Permanent retainers are good,as they prevent relapse,esp in lower front teeth.But they also pose a problem for cleaning.I see lots of patients with very bad tartar build up when they have bonded retainers.If u r committed enough,removable retainers worn every night for the rest of ur life is the best.I still use mine! I had my braces out in 1998.

5)If anyone has any queries,pls feel free to post a msg & I'll see how I can give more info.

 

[jacqueline97]

Hi Monster6

I thought I am the only one who wear retainer since I took out my braces for ages...like in 1995.I still wear it before I sleep daily...

 

[yue]

Hi monster6 &jacqueline97,

What type of retainers r you referring to?
Those transparent plastic retainer?
If that is the type both of you r referring to, do you have a new set made every year since it is subject to wear and tear such as breakage?

 

[monster6]

Hello Luna,

The type of retainers I wear is made of acrylic (plastic).They are called Hawleys retainers.There is a wire in the retainers.they come in several colours.U can actually choose the colour.

There is another type of retainers which is totally clear,with no wires.

Hawleys retainers have to be soaked in water when u're not wearing them,otherwise the acrylic will dry out,leading to an increased risk of breakage.

Retainers may need to be made again once they break.I only wear my lower Hawleys retainers,as my upper one does not fit anymore.

But I have since made myself another set of clear hard plastic retainers.They act as a whitening trays as well.I'm going to whiten my teeth b4 my ROM (24 Feb).I've also made my fiance whitening trays so we can both flaunt our pearly whites on our big day.haha

 

[yue]

Hi Monster6,

What I'm wearing is e 2nd type which u mentioned, clear hard plastic retainers.

But somehow, they always starts to chip off after 1 year of wearing and I have to go to my orthodontist to make a new set of mould in order to have the plastic retainers.

The nurse said the mould will sometime break thus not able to use back the same mould to make another set of retainer. End up going to the orthodontist almost on a yrly basis.

Btw, how do you maintain the cleanliness of the plastic retainer? Somehow, after sometime, there always seem to hv some build up at the end of the lower retainer & it can't remove no matter how I brush it.

 

[monster6]

Hi Luna,

yes,u're right.there is a problem with the rigid kind of retianers.they r prone to breaking.My upper rigid retainer has broken down the midline just after 2 uses.

The mould does sometime break during construction of the retainers.In most cases,they are thrown away after the retainers have been constructed,as the dentist has no more use for it,and keeping it takes up space.That's probably why you have to always have the mould taken.

Try asking for Hawleys retainers the next time.They are less prone to breakage,compared to the rigid ones.

Brush the inner & outer surfaces of the retainers under running water (there is no need to use toothpaste).If you have really good oral hygiene (little plaque),you shouldn't find much build up.The build up u have mentioned seems to be stuck in some little grooves that your toothbrush cannot reach.Remember,you have to brush ur retainers after every use so that the build up will be minimal.

Alternatively,try soaking your retainers in denture cleaning tablets which u can buy from the supermarket or pharmacy.Do not soak for extended period of time.Soaking it for 15-20 mins should be enough.

 

[yue]

Hi Monster6,

Once again thanks for your reply.

The Hawlyes retainer which you mentioned, is it those with a wire across the teeth type?
But I think my orthodontist only has those clear plastic retainer.......

Only the lower retainer always this problem...wonder why. Will try the cleaning tablets but is there any particular reason of not soaking for extended period of time?

I noted one thing, if both upper & lower retainers cover the whole row of teeth, I could not actually have a proper closure/bite of my mouth thus the nurse will trim off a bit....Is this the normal case?

The new set of retainer does not have the 'tightness feeling', it just fit nicely. Will that pose any problem in helping the teeth to remain in place? Or will it actually in the long run, resulting in the teeth being spaced out? And end up with all subsequent loose retainers being made?

 

[sg_guy]

I thought this thread wud be dead... was pleasantly surprised it's revived.. haha!

Thanks to Monster 6 dentist for coming in to answer our queries... i have no idea abt retainers since I've jus started braces treatment... I am a CLEFT palate patient and my case is very bad as mentioned by my ortho and i need jaw surgery and I guess I'll be needing permanent retainers ...

I don't know why i was tended to by Dr. HO on my first visit... but since i needed jaw surgery anyway, I wanted to be seen by the famous man himself ... lol ... unfortuantely he is jus started his own private clinic and his charges are very high... 60% of the clinic's clients are foreigners... so one can guess it's a high end place.

Anyway, now I'm jus hoping my treatment will not take too long to finish.

There is another thread on braces at flowerpod community http://www.flowerpod.com.sg.

Click on "Orthodontics Talk..

 

[monster6]

Hi Luna,

1)I don't know how the material for rigid retainers react to chemicals in the denture cleaning tablets.therefore,it's better to use it for a shorter period of time.I alwyas advise patients that.

2)Yes,it's normal to trim retainers to adjust your bite.

3)If u use ur retainers diligently every night,there shouldn't be a problem with teeth shifting,unless yours is a very serious case to start with.It's ok not to feel the tightness,as u really only want the tightness ifu want ur teeth to move/be repositioned.


To sgguy:

Good on you for taking such a bold step.It takes lots of courage,patience,and commitment to start on ur treatment.

I just want to say: in times of difficulty/pain/discomfort etc.,press on,coz u know the end result will always be better than wat u start with.so it's all going to be worth it.

 

[sg_guy]

TO monster6,

I have hesitated for years since i went for my first consult at 18 due to $$ issue and most of all, afraid of looking weird with braces among schoolmates cos in the past, ppl with braces are somewhat "special" in a way. But now, I realise appearance is an important factor of life esp when young, so I'll do whatever it takes to have a chance to see a normal look of myself in the future. With braces on, I felt a sense of joy in spite of the inconveniences and discomfort of the braces, anticipation of long treatment time and upcoming surgery. And like u said, the end result wud be better than what i started with.

 

[sg_guy]

Anyone who wans to receive pte msgs should click on their profile name and click "profile" and then un-check the tick on "don't receive pte emails"

Becos all of us when after registering, the system will check the tick box so none of us will get pte msgs.

 

[janay]

Hi,anyone here could tell me how much the total cost involves for the orthognathic surgery? any doctor to recommend. I have been thinking for so long if I should go for this operation. of course $$$ issue is my priority concern but I do not feel comfortable with the way i am looking at the moment, thanks

 

[ezekiel]

How come my post doesn't appear?

 

[yue]

Hi Monster6,

Are you there?