Corrective Jaw Surgery

many cases, problems with the bite or the alignment of the teeth can be corrected using today's advanced methods of dental and orthodontic treatment. Sometimes, however, skeletal and dental irregularities aren't so easy to remedy, even with the most up-to-date non-surgical techniques. That's when corrective jaw surgery (also called orthognathic surgery) may be recommended.

Jaw surgery can be used to remedy severe orthodontic problems involving the relationship between the teeth and jaws, including the correction of underbites (the most frequent surgical correction) and congenital abnormalities (birth defects) related to jaw development. It can even help alleviate sleep apnea, a potentially life-threatening condition.

Orthognathic surgery is always performed by an oral and maxillofacial surgeon, who spends four years in a hospital-based residency program after completing the standard four years of dental school. There, we dental surgeons train alongside other medical and surgical residents in areas like emergency medicine, general surgery, and anesthesiology. In fact, we are the only medical practitioners besides anesthesiologists who can administer all levels of sedation and general anesthesia.

How do People Develop Jaw Bone Problems ?

Generally speaking, jaw bone problems are either present at birth (congenital) or caused later in life by injuries or other medical conditions that affect your jaw.

Who Can Benefit From Jaw (Orthognathic) Surgery

People who have problems related to the jaws, tooth alignment and facial asymmetries, which create difficulties chewing, talking, sleeping, or carrying on routine activities, may benefit from having orthognathic (jaw) surgery. These procedures can also be used to correct aesthetic issues, such as a protruding jaw, a congenital defect, or an unbalanced facial appearance.

After a thorough examination at our office — and perhaps, a consultation with your regular dentist or orthodontist — we can let you know if you're a candidate for orthognathic surgery. In general, if orthodontic treatment can solve the problem, that's where you will start. Yet, while orthodontics can successfully align the teeth, it's sometimes the jaws themselves that need to be brought into line. In most cases, orthodontic appliances, such as braces and retainers, will be used before and after the surgical phase of treatment, to ensure that you end up with an effective — and aesthetically pleasing — result.

Conditions that can be successfully treated with corrective orthognathic surgery include the following:

• Open bite, protruding jaw or receding chin
• Congenital defects such as a cleft palate
• Malocclusions (bite problems) resulting from underbites or severe overbites
• Obstructive Sleep Apnea, when more conservative methods fail
• Difficulty swallowing, chewing, or biting food
• Chronic jaw or jaw joint (TMJ) pain and headache
• Unbalanced facial appearance from the front or side
• Inability to make the lips meet without straining
• Chronic mouth breathing and dry mouth
• Facial trauma

What are the Different Types of Jaw Surgery ?

Jaw surgery corrects problems that make your jaws stick out too much or too little, making your facial features appear unbalanced. There are three types of jaw surgery:

• Maxillary osteotomy. This surgery is done when your upper jaw sticks out too much or too little. Maxillary osteotomy also treats an open bite and cross bite.
• Mandibular osteotomy. This surgery is done when your lower jaw sticks out too much or too little.
• If you have a problem that affects both jaws, the surgery is called bilateral osteotomy or double-jaw surgery.

What Happens Before this Procedure ?

There’s a lot of pre-work that goes into jaw surgery. Your healthcare provider needs certain information to plan your surgery. Here are some tests and steps they might take to obtain that information:

• X-rays.
• Computed tomography (CT) scans.
• Photographs of your teeth and jaw.
• Impressions of your teeth to create a dental model.
• They might also scan your teeth.

What Happens After Jaw Surgery ?

You may need to stay in the hospital for one to four days after your surgery so your healthcare providers can monitor your progress. Here’s what you might experience while you’re in the hospital and throughout your recovery:

• You’ll have a plastic splint in your mouth that your healthcare provider placed during surgery. The splint will help train your mouth muscles to work with your new jaw position. You’ll need to wear your splint except when you eat or clean your teeth.
• Your face will probably be pretty swollen. You’ll sleep with your head raised and take medication to help with swelling.
• our healthcare provider will prescribe medication to help with pain and protect against infections.
• You’ll need to keep ice packs on your face throughout the first 24 hours, using the ice pack for 20 minutes on, 10 minutes off.
• You’ll start the liquid diet you’ll be on for the next several weeks.
• The swelling and the splint in your mouth might make it hard for people to understand you. That can be frustrating. Let your healthcare provider know if you’re really struggling. They’ll suggest things you can do to communicate.
• Your healthcare provider will remove the plastic splint about eight months after surgery.
• If you have braces, you’ll continue wearing them for six to nine months after surgery.
• After your braces are removed, you’ll need to wear removable retainers to keep your teeth in their new position. Your healthcare provider will let you know how often you need to wear your retainers, but most people wear them continuously for a full year. After that, you might need to wear your retainers a few nights a week.