Corrective Jaw Surgery

 Orthognathic surgery combined with orthodontic treatment

chronological age doesn't always match dental age
Smiling Adult with Braces

Creating a beautiful smile is an art and a science that often requires multiple experts with different specialties within the discipline of dentistry. For certain patients, orthodontics alone cannot completely address the patient’s dental and skeletal issues. If the root of the problem is the alignment of the jaw, which stems from atypical skeletal growth, surgery accompanied with braces may be the best choice to correct the bite.

Orthodontists work together with oral surgeons to ensure a successful planning of the treatment as well as the execution of the plan. As one of our patients, if we believe that you may benefit from jaw surgery, Dr. Rooz will discuss this option with you and will walk you through the details of the treatment plan.

While everyone’s situation and needs are a little different, we wanted to address some of our patients’ most frequently asked questions about corrective jaw surgery.

What is jaw surgery?

Corrective jaw surgery, also known as orthognathic surgery, is an operation that is performed to correct a range of minor and major skeletal irregularities in the jaw area. This may include the misalignment of jaws and teeth, uneven asymmetrical jaw growth, and other dental irregularities that go beyond tooth alignment.

Corrective jaw surgery is typically performed by an oral and maxillofacial surgeon (OMS) who is a dentist with additional education and training in surgical practice. Some plastic surgeons are also trained to operate on corrective surgeries for complex craniofacial deformities.

chronological age doesn't always match dental age

How do I know if I need corrective jaw surgery?

In most cases, your dentist or your orthodontist will be able to tell if you might require jaw surgery fairly early on. Genetics plays a strong role in atypical skeletal growth.

Jaw alignment issues can come from several different origins. In some cases, the patient’s upper and lower jaws may have grown at different rates. The most prevalent jaw problem in the United States is small lower jaw, and the second most common issue is a protruding lower jaw.

Asymmetric skeletal problems are generally detectable during adolescence and are one of the other reasons for corrective jaw surgery. For example, an asymmetrical lower jaw creates an asymmetric bite, which will most likely lead to the teeth suffering more wear and tear than properly aligned teeth do. Birth defects, injuries, and other damage may also impact your jaw alignment.

Corrective jaw surgery at Porth

Some of the conditions that may indicate the need for corrective jaw surgery include:

Difficulty chewing or biting food:

If the jaws are not in proper alignment, it can be difficult to consume and chew food at a normal rate without pain or discomfort. This can negatively impact a patient’s quality of life. A great example of this is an open bite, (photo) where front teeth don’t touch.

Receding or protruding lower jaw and chin:

If the upper and lower jaws are not correctly proportioned to each other, alignment issues and damage can occur.

Sleep disorder:

corrective both jaw surgery is one of the options for patients with sleep disorder. This procedure helps both jaws and the soft tissues attached to them, including the tongue and throat to move forward creating more space in the airway path. Success in two jaws surgery to treat sleep disorders depends on multiple factors. We will provide you with a wealth of knowledge at your consultation about this if you are interested.

Unbalanced facial appearance from the front or side:

This cosmetic concern is often indicative of jaw alignment issues. Chin augmentation or reduction is one of these cosmetic procedures.

Injury or birth defects:

Many kinds of damage or bone deformities can be addressed and corrected with jaw surgery.

Collectively, corrective jaw surgery (orthognathic surgery) is performed to correct functional problems as well as cosmetic problems. Jaw surgery can, in some cases, results in drastic changes in the patient's appearance, especially in patients with strong lower jaw.

How does jaw surgery work?

The first medical professional to note that you may benefit from jaw surgery can be your pediatric dentist if the signs of misalignment emerge early (Taylor + Deviated mandible jaw).

When it comes time to prepare for the surgery, your dentist, orthodontist and oral maxillofacial surgeon will work together to determine the best course of action for your individual needs.

The oral and maxillofacial surgeon ultimately determines which corrective jaw surgical procedure is appropriate, and performs the surgery itself. However, it is important to understand that the treatment, which usually includes orthodontics before and after the actual surgery, may take a few years to complete. This is a long-term commitment, and your medical professionals will do their best to realistically estimate the time required for your treatment.

Of course, every patient’s situation is different in the degrees of misalignment. Your orthodontist and maxillofacial surgeon will create a specific treatment plan for you. Nonetheless, most treatment plans include specific stages.

Orthodontic prep surgical work

Orthodontic treatment is typically required before and after jaw surgery. This is to prepare the bite for corrective jaw surgery and optimize the bite after the surgery.

Orthodontists often start the treatment by correcting the position of the teeth for the new position of the jaws. At this stage, the patient may notice their bite appearing more misaligned, since pre-surgical orthodontic treatment is intended to reverse all the physiological compensations for the misaligned bite. For example, some patients will have a temporary underbite before surgery. Once the surgery is complete, the patient’s teeth will fit together properly.

What is surgery-first approach in corrective jaw surgery?

For a small portion of patients, the surgery is performed first. In these cases, the maxillofacial surgeon performs corrective jaw surgery without pre-orthodontic care, and the orthodontist only render the treatment after surgery. This approach has its pros and cons, and ultimately depends on the conditions of the patient’s issues. Your orthodontist and surgeon will discuss this option with you if they believe it may be applicable.

Common Correction Procedures

Depending on the patient’s needs, bone may be added, taken away, grafted, or reshaped. Surgical plates and screws are often used to hold the jaws in the new positions, while wires and rubber bands may be used in conjunction with the patient’s braces to hold their jaws in their new position until the bones have healed.

Most misalignments fall into a few major categories:

Open bite

To surgically correct an open bite, the plan can be involved of one or two jaw surgery. The origin of open bite as well as esthetic aspects of smile determine the surgical approach to move jaws toward each other.

Setting lower jaw back

To surgically correct a protruded lower jaw, also known as an underbite, the bone in the back portion of the lower jaw is separated from the front portion of the jaw and modified so that the front, tooth-bearing portion of the lower jaw can be moved back. Moving lower jaw back is sometimes accompanied with moving the upper jaw for a better coupling and esthetic reasons.

Moving lower jaw forward

To surgically correct a small receding lower jaw, the bone in the lower jaw is separated from its base. The tooth-bearing portion of the lower jaw and chin are then repositioned forward.

Is jaw surgery dangerous?

While every kind of surgery or medical procedure has its risks, the risk of life threatening complications from jaw surgery is low. Maxillofacial surgeons are required to undergo extensive, specialized training, and most facilities perform jaw surgery on a regular basis. At Porth, we know several surgeons who we regularly work with, and we are happy to help our patients find the most qualified surgeon for their specific surgical needs.

Of course, every patient and operation is different. Jaw surgeries range in severity, and can take anywhere from one to many hours to complete. Some operations may be performed in the oral and maxillofacial surgeon’s office, while others may be performed in a hospital or surgical center. Typically, patients need to be under general anesthesia for the operation.

If a patient is completely opposed to jaw surgery, we will discuss alternative treatment options if these choices are feasible. Ultimately, it is the patient’s decision to make to us. We strive to provide our patients with their best chance at a happy and healthy life.

What is the recovery process like for jaw surgery patients?

Your recovery process will vary in length and difficulty depending on your own situation and the degree of correction that was needed. For example, patients that only require surgery on the lower jaw rather than both jaws will typically experience a quicker recovery.

In order to get a better sense of what your own recovery process will be like, talk to your maxillofacial surgeon about your specific case. Many jaw surgery patients have documented their recovery journeys through blogs and YouTube videos, such as this video about double jaw surgery and this video about open bite corrective surgery.

How long are you in the hospital after jaw surgery?

Jaw surgery patients can typically expect to stay at this hospital for one night. The average stay is generally 23 hours. This time gives your medical staff the chance to make sure everything is set to heal properly, and gives you time to recover from the anesthesia and make sure you are able to feed yourself.

How long does your mouth stay wired shut after jaw surgery?

Most surgeons no longer wire patients’ jaws shut after surgery. Instead, they use tight rubber bands to keep the teeth in place. The bands are gradually loosened at subsequent follow up appointments with the surgeon. Most patients have rubber bands for 3-5 weeks to help train the jaw to learn the new bite. If you will require rubber bands for longer, your surgeon and orthodontist will be able to give you an estimated time frame.

When can I go back to work after jaw surgery?

The time it takes to return to your normal, daily life depends on the severity of your surgery and the nature of your work. Generally, patients take about 1-3 weeks off from work. If your job requires a lot of speaking or physical activity, such as teaching, personal training, or manual labor, you will need to take a little more time off of work. If you work from home or spend most of your time working quietly at a computer, you will be able to go back to work sooner.

Is jaw surgery painful?

Pain from the surgery varies from patient to patient, but most people report experiencing less pain than they expected. This is because a common side effect of the surgery is numbness, which helps reduce the pain. Many patients need to take some kind of pain medicine about a week after the surgery when the feeling begins to return, but typically over the counter or drugstore painkillers will do.

How long does it take for swelling to go away after jaw surgery?

Face swelling is difficult to conceal, so it is a very common concern for patients to have. Generally, you can expect about two weeks of major, noticeable face swelling. After that, you and your loved ones who are familiar with your normal face shape will notice that you have a little face swelling for a few months. While it does take some time for the swelling to gradually go down, it becomes less and less noticeable.

How long does it take for a jaw surgery to heal?

The surgical incisions will heal after two weeks, and the jaw bones will heal after about six weeks. During this time, you will need to avoid chewing and stick to soft foods and liquids. While most people consider this the end of the healing process, there are other symptoms that take more time. For example, the residual numbness in your lips or gums can take up to a year to go away.

Will I have scarring?

Incisions are typically made inside the patient’s mouth to reduce visible scarring. However, some cases do require that the surgeon make small incisions outside of the mouth. Your surgeon should know ahead of time if this is necessary, and will discuss this with you. When outside incisions are necessary, care is taken to minimize their appearance.

What Can I Eat During Recovery?

While you are recovering from the surgery, your surgeon will provide instructions for a modified diet, as well as an estimated schedule for transitioning to a normal diet and slowly releasing the jaw from the wires or rubber bands as you heal.

Pain following surgery is typically easily controlled with medication, and patients are generally able to return to work or school from one to three weeks after surgery, depending on the nature of their work or education.

Patients will want to refrain from strenuous physical activity or risky behavior while their jaw is healing, and will need to visit their surgeon for regular checkups. The initial healing phase is about six weeks, meaning the at that point most patients will have access to a normal range of motion in their jaw. However, the complete healing of the jaws takes between nine and twelve months, and patients may experience slight swelling or numbness during this period.

Does insurance cover jaw surgery?

Of course, every insurance policy is different. In general, it is more likely that your insurance will cover your jaw surgery if it is necessary for medical reasons rather than cosmetic reasons. Fortunately, most jaw surgeries are beneficial for both medical and cosmetic purposes. You’ll want to discuss your insurance situation with the staff at your surgical center and your insurance company.

Success Stories

Although the primary purpose of jaw surgery is to correct the alignment of the teeth and jaws into more functional, healthy positions, many patients experience residual benefits such as enhancements to their appearance and speech. These changes can be dramatically positive.

While the idea of jaw surgery can be a little intimidating, the results are absolutely worth the process. If you have any more questions, feel free to contact us directly.

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