Hey everyone,
I’m 20M and I’m posting here because I want informed opinions before I do something irreversible.
I’ve attached photos from multiple angles so you can judge for yourselves rather than me over-describing.
Main issues:
My jaw clicks when opening/closing
Bite doesn’t feel fully stable
Some asymmetry concerns
I was previously told by an orthodontist that I should extract a tooth and get braces, but that advice didn’t sit right with me
I’m not looking to rush into extractions or aggressive orthodontics without understanding the long-term facial and functional consequences.
I’m planning to visit an orthodontist again soon, but I want to go in educated and ask the right questions.
Also:
I’m aware my teeth look yellow. I recently got some money and plan to get professional whitening. The discoloration is mostly from the water I used to drink, not neglect.
What I’m asking from this sub:
Based on what you see, does this look more like a functional / TMJ / bite issue than a simple alignment problem?
Is jaw clicking something that should be addressed before braces?
What should I specifically talk about or ask when I see an orthodontist?
Are there non-surgical, non-extraction paths I should explore first?
I’d really appreciate serious, experience-based advice especially from people who’ve dealt with TMJ, orthotropics, or had to choose between extractions vs alternatives.
Thanks in advance.
Do you ever bite your tongue because of that one tooth pointing inwards?
I don’t bite my tongue, but I do bite my lips pretty often, especially when chewing.
do NOT get any extractions, you have an extremely narrow palate and need palatal expansion, at your age MARPE or even SARPE is the answer. go to a different orthodontist, extractions will make all your issues even worse at the point youre currently at. if you dont want to jump into orthodontics you can start with thumbpulling, but your palate seems excessively narrow and even if there is widening i doubt it will be enough to fully solve all issues, but it doesnt hurt to try.
for TMJ, dont get masseter botox, way overused. myofascial and myofunctional release + interoral massage on a daily basis is the way. if you clench your jaw, try to break out of the habit, and if you teeth grind try to find the underlying cause and treat it as in my exprience theres almost never teeth grinding caused by truely no issues. it can be something as simple as feeling some pressure mentally, or it can be something health related where your body is going through alot of stress or working too hard and causing teeth grinding as a stress response. if you have an extremely severe case, getting TMJ surgery is still miles better than masseter botox, masseter botox is not needed in the average person. some people it makes a great change, but with most people even though it may fix their TMJ it can leave them with alot of other issues, both functional and aesthetically. you dont want surgery though and doubt you need it, i suggest trying the things i already mentioned.
your bite seems pretty okay. jaw clicking is a common side effect of TMJ, also.
I appreciate the detailed response. One thing I’m unsure about though isn’t MARPE still semi-surgical, since it involves placing screws into the palate? I’m a bit hesitant to jump into anything invasive without exhausting non-surgical options first. Are there cases at my age where non-surgical expansion (slow expansion, orthodontic expansion combined with myofunctional work, etc.) actually provides meaningful improvement, or is MARPE usually the minimum once you’re past adolescence?
yes, MARPE is semi-surgical, and obviously SARPE is just outright surgical.
unfortunately, its very hard to tell you how much improvement it can give you, or if maybe just none at all, but the latter is very unlikely at your age. the only way to truely know is working with an orthodontist that is not against palatal expansion, and one that will access your bone structure. at your age, its very individual. its fully dependant on how closed your skull sutures are, and at your age theyve just started meaningfully closing, so the level of how closed they are is hard to tell just based on your age. but yes, i have seen cases of people your age or even a couple years older that got great results from completely non surgical palatal expansion, but itd also be even harder to find an orthodontist willing to do it for you.
If you have any advice on what to specifically look for or ask when choosing an orthodontist for this, I’d appreciate it.
i unfortunately cant give any more clinical advice. sorry. wish you the best of luck!!
Do NOT extract teeth. Trust me MARPE is the key here
I’m definitely trying to avoid extractions, but I’m hesitant about jumping straight to MARPE because from what I understand it’s still invasive (screws into the palate). At my age, are there situations where non-surgical / non-skeletal expansion or a conservative orthodontic + myofunctional approach is actually enough to improve function and stability, or is MARPE usually considered the baseline once growth is finished?
I mean i don’t think there are many methods except for marpe at your age. If you were a bit younger a palatel expander would help
I get what you’re saying. My hesitation with MARPE is mainly that it is invasive, and honestly I don’t fully trust the level of orthodontic care where I live. If it’s done poorly, is MARPE risky in terms of asymmetrical expansion, screw issues, or worsening TMJ? That’s what I’m worried about. I know growth is basically done and sutures are mostly fused, but from what I’ve read in orthotropics there can still be some degree of slow dental/alveolar expansion in adults with conservative expanders + myofunctional work, even if it’s limited and takes time. So I’m trying to understand realistically Is MARPE truly the only meaningful option at my age? Or can a non-surgical expander still provide functional improvement (even if not dramatic skeletal change)? I’m not expecting miracles, just trying to avoid jumping into something invasive if a slower, safer path exists.