Can Orthognathic Surgery Help Me? If So, How Long Would I Wear Braces?

I'm a forty-two-year old male who was born with unattractive teeth. That being, it was both a blessing and a curse that I had absolutely no upper tooth show. None. Not when I speak and not when I smile. After saving money for years I was able to, a little over four years ago, have 10 upper veneers placed with 10 lower crowns. Yet now, after investing the financial equivalent of a BMW in my mouth, I have beautiful upper teeth . . . that don't show. At all. None.

Doctor Answers 7

Seek other opinions

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Orthognathic surgery is a huge decision! Each person’s needs are different.  Seek other opinions and see which doctor makes the most sense to you.

Fairfax Dentist

Teeth does not show

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When decision is made how long should your front teeth be there are few factors that play very important role. One and most obvious - aesthetics, another is phonetics, which will determine if you can speak normally without any sounds being mispronounced. Another factor ( and this one is the most important) is your bite and what is the range of function,which means that the length of your front teeth have to be in harmony with healthy function. Some people have long upper lip and in those cases elongation of the front teeth in order for them to be visible during the speech or smiling is unrealistic. I don't know what your dentist promised you when he was working on your veneers, but looks like you did not communicated very well in between, sorry to hear that you are not happy about the outcome of your treatment. 

Zina Kaleinikova, DDS, MS
Cleveland Dentist

Dental surgery to display more teeth

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Normally, when having veneers placed, the amount of tooth structure that shows is determined in the planning phase.  It sounds as if this wasn't communicated enough to you and a surgical option is considered.

Sometimes a fairly minor surgery to the lips or soft tissues can help display more teeth.  If the surgeon feels that  it won't be enough, then orthognathic may be an option.  However, this is a fairly major surgery and should be considered a last option.

Showing more upper teeth

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Usually, orthognathic surgery to help in showing more upper teeth is not the way to go. This is a very, very aggresive, severe surgery. I would have to see photos in person of you to make a suggestion on what to do.

Mitchell A. Josephs, DDS
Palm Beach Dentist

How to improve tooth visibility

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There are a few measurements that need to be made prior to moving forward with a cosmetic reconstruction

1. What is the length of your upper incisors? The range should be from 10-11.5 mm for unworn teeth

2. What is the length of your upper lip? For a male you should expect a range of 22-24 mm.

3. What distance does your lip move with smiling? The normal range should be 6-8mm.

After these basic measurements are completed you can see if you are in the normal or abnormal range. Also from age 40 on, for every 10 years your upper lip lengthens 1mm. So if at 40 your lip is 23mm then at age 50 your lip will be 24 mm and you will show even less tooth.

With all this being said if you do have an abnormally long upper lip then the solutions are limited. A lip repositioning surgery is not reliable and can cause more problems. Some people have weak smile muscles and I have heard of exercises to strengthen these but cannot remember the name of the orthodontist that uses the technique. 

J. Willis Baker, DDS
Wichita Dentist

How Do I Get My Teeth To Show?

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Your problem could be one of several different issues. The most common reason that upper teeth don't show in a young person is that they are "over closed." This situation also promotes premature wear of the front teeth thus making the problem of not showing teeth even more pronounced. There are solutions for correcting an "over closed" bite but must be addressed carefully by a dentist who understands occlusion (how teeth bite together) and also the affects that changing the occlusion have on the TMJ. Solutions to your concern are possible but should only be addressed by a highly skilled dentist. 


Good luck!

Can surgery help me?

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Surgery may help but it is really a big deal......If your bite and the rest of your facial features are relatively normal it just may be the way your'e built...I myself show very little teeth on smiling.  I would certainly think that the dentist who did your veneers should have known that it wouldn't help!

Robert Waxler, DMD, MS
Saint Louis Orthodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.