Oral and Maxillofacial Surgery Expert Forum
Hereditary Class II Occlusion
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Hereditary Class II Occlusion

Since the age of 5, I had a very noticeable Class II Occlusion (overbite) which caused my front teeth to protrude a reasonable distance.

I initially had orthodontic treatment at the age of 10 - 14 which had a minor effect but still left me with a very, very noticable overbite (I could not close my mouth around my front teeth easily, it required effort).

At the age of 21 I began further orthodontic treatment and last year at the age of 23, I underwent surgery to both jaws to correct the malocclusion. The upper jaw had grown downwards due to the recessed lower jaw and so was raised, I believe by around 5mm. The lower jaw was broken and brought forward to better align. I now have a fully functioning bite and no protrusion, with my facial proportions also being more equal.

However, this malocclusion was inherited from my Father and I am now in a position where myself and my wife would like to start our own family and I was wondering what percentage of such conditions are hereditary, i.e. are we guaranteed that our children will suffer the same problem I did? If this is the case, how early can it be corrected?

I had an extremely unpleasant time during childhood due to bullying and harassment due to my protruding teeth and would hate to see my kids go through the same.

Also, if it is hereditary, does this mean it is a pre-existing condition in the eyes of insurance companies? We are living in the United States, my own treatment was completed while I was a citizen of the United Kingdom however and it was provided free of charge by the National Health Service as it was determined that the malocclusion affected me medically due to an abnormal bite and clicking jaw. Will we be able to get coverage for treatment? If not, is there a ballpark figure for this type of treatment?
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I recommend you and your wife see a genetic counselor to determine if either of you has any traits suggestive of a craniofacial syndrome.  Some syndomes are associated with more serious medical conditions such as cardiac abnormalities.

Insurance coverage varies greatly by state and individual companies.  Unfortunately, the treatment can easily run into the tens of thousands of dollars if not covered.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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