anemo
6'2 15 Year Old Aryan
- Joined
- Oct 11, 2025
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This is from my ortho. What can I do??? I thought most people get appliances at my age??
Hi
I have some answers for you! Dr. X did a little math on xs head, and I have attached the tracing/drawing.
Xs biggest problem is that his lower jaw did not grow as far forward as it should have in comparison to other skeletal structures (skull and front of maxilla).
Due to his age, there is most likely not enough growth remaining to advance his lower jaw orthodontically with a Herbst Appliance. To correct this orthodontically the
patient is typically age 12.5 with lots of growth forthcoming and most of their permanent teeth in. If you told me xs is 3 years delayed in his bone growth and development (diagnosed by an endocrinologist), then there might be some growth forthcoming but looking at his pics he doesn’t look like a delayed grower.
To get the best result for x, he should be treated with braces and orthognathic surgery to move the jaw forward. Some Dr.’s might want to use braces and lots of rubber bands to get his bite as good as possible. Just remember, elastics move teeth, they do not move jaws, therefore there will be minimal to no change in his profile.
Dr. X surgical fee is somewhere in the ballpark of 10K for the orthodontic part of treatment and then you have the surgeon and hospital fees which can be anywhere from 15K to 40K depending on case difficulty and 1 jaw or 2 jaws being moved. Only about 50% of the medical policies even cover orthognathic surgery so many patients have to pay that out of pocket.
The way a case like this works is the patient is in braces for 14-16 months before surgery, then we refer you back to the surgeon for orthognathic surgery (mandibular advancement) then we begin seeing you frequently about 2-3 weeks after surgery. It typically takes 4-6 months to complete the treatment after surgery.
You can always start his treatment non-surgical and get things as good as possible then when he is an adult he can be retreated and do the surgery for the profile change.
Xd malocclusion is not considered a skeletal deformity from a medical insurance viewpoint, just a malocclusion due to a deficient mandible, therefor it can’t truly be called medically necessary because he won’t die from a bad bite. X will eventually have “function” issues if he doesn’t already as his lower teeth will end up biting into the roof of his mouth, a deficient mandible can cause airway issues such as Apnea, and when the teeth do not fit together correctly, they will wear out and breakdown at a much faster rate.
So that’s about everything I can tell you. I wish you guys lived closer and Dr. Jensen could treat him, but that is such a long drive, and he would miss a lot of school. I feel confident that there is an orthodontist out there that can take care of x
Hi
I have some answers for you! Dr. X did a little math on xs head, and I have attached the tracing/drawing.
Xs biggest problem is that his lower jaw did not grow as far forward as it should have in comparison to other skeletal structures (skull and front of maxilla).
Due to his age, there is most likely not enough growth remaining to advance his lower jaw orthodontically with a Herbst Appliance. To correct this orthodontically the
patient is typically age 12.5 with lots of growth forthcoming and most of their permanent teeth in. If you told me xs is 3 years delayed in his bone growth and development (diagnosed by an endocrinologist), then there might be some growth forthcoming but looking at his pics he doesn’t look like a delayed grower.
To get the best result for x, he should be treated with braces and orthognathic surgery to move the jaw forward. Some Dr.’s might want to use braces and lots of rubber bands to get his bite as good as possible. Just remember, elastics move teeth, they do not move jaws, therefore there will be minimal to no change in his profile.
Dr. X surgical fee is somewhere in the ballpark of 10K for the orthodontic part of treatment and then you have the surgeon and hospital fees which can be anywhere from 15K to 40K depending on case difficulty and 1 jaw or 2 jaws being moved. Only about 50% of the medical policies even cover orthognathic surgery so many patients have to pay that out of pocket.
The way a case like this works is the patient is in braces for 14-16 months before surgery, then we refer you back to the surgeon for orthognathic surgery (mandibular advancement) then we begin seeing you frequently about 2-3 weeks after surgery. It typically takes 4-6 months to complete the treatment after surgery.
You can always start his treatment non-surgical and get things as good as possible then when he is an adult he can be retreated and do the surgery for the profile change.
Xd malocclusion is not considered a skeletal deformity from a medical insurance viewpoint, just a malocclusion due to a deficient mandible, therefor it can’t truly be called medically necessary because he won’t die from a bad bite. X will eventually have “function” issues if he doesn’t already as his lower teeth will end up biting into the roof of his mouth, a deficient mandible can cause airway issues such as Apnea, and when the teeth do not fit together correctly, they will wear out and breakdown at a much faster rate.
So that’s about everything I can tell you. I wish you guys lived closer and Dr. Jensen could treat him, but that is such a long drive, and he would miss a lot of school. I feel confident that there is an orthodontist out there that can take care of x
)
