Orthognathic (Jaw Surgery)

In order to achieve an ideal tooth to tooth fit the position of the teeth and jaws must also be ideal.  Some patients have a lower jaw that has grown too much in others the jaw can grow too little.  This can cause the teeth to bite the wrong way around or can cause the upper teeth to stick out.  For these patients, orthodontics alone will not correct the bite.  Surgery will be required to move the jaws into the proper position so the teeth will then meet correctly. For some patients orthodontic treatment and jaw surgery may be advised.

LSK1-filtered
LSK5-filtered

Here is an X-ray taken before and after jaw surgery.You can see in the first X-ray that the lower jaw is too far forward and the top jaw is too far back.  As a result the teeth do not meet properly.
After jaw surgery the teeth meet correctly.  You can also see the small screws and plates that are used to hold the jaws in the new correct position

If you have any further questions that you feel you would like to ask, then please write them down and bring them with you to your next appointment. It is important you fully understand what is involved in having orthodontic treatment before you decide to go ahead.

If I need jaw surgery, why do I also require orthodontics?

If the jaws are to be moved into the correct position, it is important your teeth are moved so that they will meet properly after surgery.

What type of brace will I need to wear?

Patients having jaw surgery used to have their teeth wired together for 6 – 8 weeks. However, this is now fairly unusual, as small metal plates are used to hold the fracture sites together.  These plates are on the surface of the bone but invisible beneath the skin, and generally remain in place forever.  Very occasionally they are removed at a later date.

How will the operation be done?

The operation will usually be done from inside your mouth.

How long will I be in hospital?

This varies, but in general between 2 – 4 days.

Are there any after effects?

You will have some swelling and bruising after the operation.  This will rapidly begin to subside over the first 2 – 3 weeks.  For operations on the lower jaw it is fairly common to have some numbness of the lower lip for some weeks or months afterwards.  In a small number of cases a residual area of numbness will remain permanently.  This numbness will not affect movement of your lip, only the feeling in it, in a similar way to an injection at the dentist as it starts to wear away.  You should generally expect to be off college/ work for at least 2 weeks.  As with any treatment, you will have to decide if the risks of treatment outweigh the proposed benefits.

Will I look very different after the operation?

You will look different to some degree, the amount depends on how much movement of the jaws is required.  You should discuss this with your orthodontist/surgeon.  One of the reasons patients choose to undergo this type of surgery is to change the way their face looks, the treatment plan aims to give an improved facial balance.

How long will the overall treatment take?

It usually takes 12 – 36 months and will vary according to how severe your case is.  Failed and cancelled appointments or repeated breakage of the brace will add to the overall treatment time.

How often will I need an appointment?

You will need frequent and regular appointments with the orthodontist during treatment for the brace to be adjusted.

Do I still need to see my regular dentist?

Yes. It will be important for you to have check-ups with your regular dentist throughout orthodontic treatment.  Your orthodontist will not be checking your teeth for decay.