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The Challenge: A 10mm Overjet and Trauma Risk
The patient first presented to our clinic during her primary school years in the mixed dentition stage. A comprehensive specialist evaluation by Orthodontist Claire O’Sullivan identified several complex structural issues:
- Severe Overjet (10mm): The upper front teeth protruded 10mm ahead of the lower teeth, creating a severe "lip trap" where the lower lip sat behind the upper teeth, pushing them further outward.
- Trauma & Palatal Bite Risk: The upper teeth were at high risk of accidental fracture from sports or falls, while the lower front teeth were biting directly into the soft tissue of the roof of the mouth (palatal bite).
- Vertical Growth Pattern: An underlying jaw growth mismatch that threatened to worsen as the patient reached her teenage growth spurt.
The Strategic Treatment Programme
To guide the patient’s jaw growth naturally and bring her front teeth into a safe position, Dr Claire O’Sullivan design-engineered a two-phase treatment plan.
[10mm Overjet & Trauma Risk] ➔ [Twin Block Growth Guidance] ➔ [Fixed Damon Braces] ➔ [Stable 2mm Bite]1. Phase One: Twin Block Growth Modification & The Compliance Turning Point
We began by fitting custom-moulded Twin Block functional appliances to encourage forward growth of the lower jaw.
- Overcoming Initial Hurdles: Like many young teenagers, the patient initially struggled with wearing her appliances during summer camps and school hours, causing her overjet to stall at 9mm–10mm.
- The Candid Clinical Discussion: Rather than letting treatment fail, Dr Claire O'Sullivan held an authentic, compassionate discussion with the patient and her mother. She explained directly that if the growth modification phase was missed, the opportunity to guide jaw growth naturally would close, leaving invasive orthognathic (jaw) surgery in adulthood as the only remaining option.
- The Turnaround: Motivated by this honest guidance, the patient committed to full-time appliance wear. Within months, her jaw responded magnificently—halving her overjet from 10mm down to 5mm and eliminating the dangerous lip trap non-surgically!
2. Phase Two: Precision Fixed Braces (2023 – 2024)
In December 2023, once the structural jaw foundation was established, high-precision fixed metal braces were bonded to both arches. Over an 11-month period, our clinical team utilised specialized wire progressions and Class II elastics to pull the remaining space closed, level her deep bite, and align her smile line into perfect Class I canine guidance.
Long-Term Retention and Preventive Care (2025 – 2026)
In late 2024, the braces were de-bonded, revealing an exceptionally straight, flat, and harmonious smile. Bonded retainers were placed behind her front teeth, paired with custom clear Essix retainers for night-time protection.
- Routine Maintenance: In October 2025, general dentist Dr Stephen Taylor conducted her routine annual check-up, confirming clean interproximal health on X-rays and placing preventive fissure sealants on her lower molars.
- Prompt Repairs: When a section of her lower bonded retainer wire fractured in July 2026, Dr Claire O'Sullivan acted immediately, taking fresh impressions for a replacement custom Essix retainer to ensure zero relapse occurred.
The Life-Changing Result
Through early interceptive orthopaedics and dedicated clinical support, the patient transformed a high-risk 10mm protrusion into a stable, healthy 2mm overjet. By addressing the jaw mismatch during her growth window, our team completely eliminated the need for adult jaw surgery, delivering a radiant, safe smile that will last a lifetime.
The Specialist Advantage: Treating large overjets requires an elite orthodontic team that knows how to motivate young patients when compliance dips. At Dublin Orthodontist, our transparent communication and evidence-based orthopaedic care ensure your child achieves a safe, functional bite without unnecessary surgery.
Protect Your Child's Protruding Teeth Today
Does your child have protruding front teeth or a deep overbite? Early specialist intervention during the growth window can transform your child’s jaw profile and protect their teeth from trauma.
