Melissa has what is known as a class 2 malocclusion, resulting in a large gap between her upper and lower teeth.
Melissa Fishbein has an attractive smile - but it's hard to see it. Whenever she smiles, she ducks her head or covers her mouth with her hand. "I'm very self-conscious about my teeth," she says. "I don't like to show them too often."
Eighteen-year-old Melissa has a congenital condition called retrognathic mandible. In profile, her lower jaw is noticeably recessed, leaving a large gap between the upper and lower front teeth. "My mouth has been this way for as long as I can remember," she says. "When I was a child, I tried to hide it by sticking my jaw out. Kids still noticed, though. It looked like I had a huge overbite. I've had to put up with a lot of teasing."
"Melissa's lower jaw did not develop properly in childhood, and it is positioned too far back in relation to the rest of her face," says orthodontic resident Mary Richmond, DMD. "Sometimes both jaws are affected. In Melissa's case it is limited to one jaw. Ideally, this condition is corrected during childhood, while the jaw is still growing. But it can be corrected in adulthood as well."
Financial considerations prevented Melissa from having treatment as a child. Upon graduation from high school, she went to work as a receptionist in a car dealership-and was happy to learn that her insurance would pay some of the cost of orthodontic treatment. Because she had been a patient at the NJDS clinic, she went there for an evaluation in March, 1997.
Melissa's treatment will be completed in several phases. First, braces were put on her teeth to move them to their proper position. Within the next few months, she will undergo oral surgery to bring her jaw forward. Some minor finishing of tooth position is done after the surgery, before the braces are removed.
"I'm a little nervous about the surgery, but I know it will be worth it,"
says Melissa. "I've wanted to have my teeth fixed for a long time. Now I feel I'm