Orthognathic Surgery

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Sometimes braces cannot treat problems within the mouth, and this might mean you have to undergo some form of orthognathic surgery to treat oral conditions.  In Greek ‘Orthos’ means straight, and ‘gnathos’ means jaw, so literally speaking the surgery is a jaw straightening exercise.  During this surgery the jaw can be manipulated in any direction, up down, forwards or backwards in order to create a straight line and a good occlusion.  A misaligned jaw might affect the structure or growth of the mouth, as well as affecting the jaw and face in appearance.  Orthognathic surgery can also be used in the treatment of a cleft palate.

Reasons for having Orthognathic Surgery

Orthognathic surgery is normally used to treat extreme problems in the jaw and mouth that cannot be fixed through the use of braces.  Having orthognathic surgery can help to improve:

  • Occlusion (bite).  Not having a correct bite can mean that you don’t chew your food properly, limiting the amount of nutrition that you can gain.  Depending on the severity of the occlusion and the amount of crowding of the teeth you could also find that you have problems with oral hygiene and a shorter tooth lifespan.
  • Snoringand sleep problems.  Having a small lower jaw can affect your sleeping which in turn can lead to other health problems. 
  • Breathing concerns.  If you have a short upper lip and overshot upper jaw then your lips are harder to close, making you breathe through your mouth more often than your nose.  This can deteriorate the severity of occlusion within your mouth, leading to impeded speech and possibly pain in the jaw. 
  • Facial aesthetics.  Your profile is defined by the positioning of your jaw.  Any problems with overshot or undershot jaws can be treated using orthognathic surgery. 

Orthognathic Procedure

Before you have any form of surgery you will be given a complete consultation to assess your health and to discuss the surgery in detail.  It is also likely that during this consultation your dentist or surgeon will recommend some lifestyle changes such as dietary supplements or reducing smoking with you.  The actual surgery is only a part of a longer process of treatment.  Usually it will take two years or so for the full treatment to be given so you need to ensure that you are committed before you begin the process. 

Before the surgery is undertaken you will have any unnecessary teeth removed to avoid overcrowding, including your wisdom teeth.  If you are missing teeth then these will be restored to ensure that the process will allow you better occlusion and aesthetic appeal.  You are likely to be fitted with a brace to start tooth realignment so that the surgery can be done with better knowledge of the mouths shape and that after surgery the teeth are more stable.

The next step in the process is to have the surgery.  You are very likely to be placed under a general anaesthetic before having orthognathic surgery.  This ensures that you won’t feel any pain and will be unconscious throughout the procedure.  The time it will take to complete your surgery will depend on the procedure being undertaken and the extent to which things are being changed.  It is quite a major surgery and will take at least an hour to complete, possibly more.

It is likely that your surgeon will disconnect your lower jaw.  This allows greater access to the mouth and means that your surgeon can adjust it more fully.  This generally applies if either the lower or the upper jaw is being targeted.  After the surgery you will have to wear a brace for up to six months, during which time the teeth are re-set in line with your jaw.  The whole process can last between 18 and 24 months to complete.

Orthognathic Surgery Aftercare

Often you will have to stay in hospital following orthognathic surgery so that pain-killers and medication can be monitored and administered effectively.  You will experience discomfort and it is likely that you will have swelling around the lips, cheeks and jaw areas.  Over time this swelling will dissipate.

You will have some form of wiring attached to your jaw after the surgery to keep it as still as possible.  This means that you will have to have a liquid diet while the jaw heals and it might take a few months before you can eat as normal. After the surgery your surgeon will require many follow up visits to ensure that you are happy and that the surgery was successful.  Any wiring or screws can be removed as you recover.

You will need to maintain a high standard of oral hygiene while you are recovering from orthognastic surgery as you are at a heightened risk throughout your recovery.

Smoking can seriously affect your recovery speed and ought to be avoided at all times. 

For about 6 weeks after the surgery you will need to refrain from any strenuous exercise.  After this time the initial recovery will be completed.

After 8 weeks you will be fitted with braces in order to completely perfect your occlusion.  These will need to be worn for some months, how many depends on your individual circumstance. 

Orthognastic Surgery Risks

All surgery contains an element of risk and Orthognastic is no different. 

  • Swelling.  This is a common response to surgery and ought to dissipate within a few days.  Some people encounter prolonged periods of swelling which can be uncomfortable and may require further visits to doctors.
  • Infection.  Infections can be highly dangerous and need to be treated with antibiotics as soon as possible.  To minimise the risk of infection it is important to follow your surgeons’ aftercare advice. 
  • Sinus problems.  Very rarely can this occur but if you do encounter problems with your sinuses then you may need further surgery to correct it. 
  • Numbness in lower lip.  This is something that tends to disappear after 6 months but can be permanent if the nerves have been damaged. 

Cost of Orthognathic Surgery

Exact prices cannot be given as each individual will have unique needs from the surgery.  You will be given a price for surgery that is tailor made for you, calculated from the treatment cost, surgery preparation and hospital charges.  There is a possibility that insurance will help to cover your costs, and that the NHS will pay for medical cases. 

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