Surgical orthodontics, also known as orthognathic surgery, is a type of orthodontic treatment used to correct severe cases that include bad bites, jaw bone abnormalities, and malocclusion. Oral and maxillofacial surgery is one of the nine recognized dental specialties, and it focuses on treating complex craniofacial cases that involve the mouth, jaw, face, and skull. If you need surgical orthodontics, your orthodontist will work with an oral and maxillofacial surgeon to ensure that you receive the best care possible.
When might surgical orthodontics be needed?
Surgical orthodontics may be used to treat adults with improper bites or other aesthetic concerns. Typically, jaw growth stops by age 16 in females and 18 in males. In order to receive orthognathic surgery, the jaw must be done growing. The need for surgical orthodontics occurs when the jaws do not line up correctly, and a proper bite cannot be achieved with orthodontic treatment alone. Orthognathic surgery will help properly align the jaw, and orthodontic braces will then be used to move the teeth into their proper position.
How do I know if I need orthognathic surgery?
Your orthodontist can tell you if orthognathic surgery is needed as part of your treatment. Depending on the severity of your case and the alignment of your jaw, you may or may not need surgery.
How does orthognathic surgery work?
An oral and maxillofacial surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about a two-week rest period. Since orthognathic surgery is a major treatment, we recommend that you schedule some time away from work and school during the healing process. After your jaw has healed, your orthodontist will once again “fine-tune” your bite. After surgery, you will have to wear braces, and most braces are removed within six to 12 months following surgery. After your braces are removed, you will wear a retainer to help maintain your new smile.
What are the risks associated with orthognathic surgery?
As with any major medical surgery, there may be certain risks of having orthognathic surgery. However, the process of orthognathic surgery is not new, and it has been performed for many years in practices and hospitals. If you're concerned about an upcoming treatment with orthognathic surgery, please contact our practice and let us know. We are happy to answer any questions that you may have, and provide you with any additional information. Your comfort is important to us.
What are the rewards of having orthognathic surgery?
For many patients, the most important reward of having orthognathic surgery is achieving a beautiful, healthy smile that lasts a lifetime. Whether you need orthodontic treatment to correct a bad bite, malocclusion, or jaw abnormality, orthognathic surgery can help restore your confidence and leave you smiling with confidence for many years to come.
Oral and Maxillofacial Surgery
Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international surgical specialty, and it is one of the nine specialties of dentistry recognized by the American Dental Association.
Oral Surgeons: Changing Lives with a Smile
Oral and maxillofacial surgeons are the only recognized dental specialists who, after completing dental school, are surgically trained in an American Dental Association-accredited hospital-based residency program for a minimum of four years. They train alongside medical residents in internal medicine, general surgery and anesthesiology, and also spend time in otolaryngology (ear, nose, and throat), plastic surgery, emergency medicine, and other specialty areas. Their training focuses almost exclusively on the hard and soft tissue of the face, mouth, and jaws, and their knowledge and surgical expertise uniquely qualify them to diagnose and treat the functional and aesthetic conditions in this part of the body.
Conditions and Treatments
Your oral and maxillofacial surgeon has many years of education and hands-on training to provide treatment for a wide range of conditions.
Corrective Jaw Surgery
Corrective jaw or orthognathic surgery is performed in which the upper jaw, lower jaw, and chin may be repositioned to correct minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth which can improve chewing, speaking, and breathing. Difficulty chewing or biting food, excessive wear of teeth, a receding chin, a protruding jaw, or sleep apnea may indicate the need for corrective jaw surgery.
Wisdom teeth are the last set of teeth to develop. Sometimes they emerge from the gum line, and the jaw is large enough to allow room for them, but more often than not, they fail to emerge and become impacted. When a wisdom tooth is impacted, it may need to be removed. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease. The American Association of Oral and Maxillofacial Surgeons strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.
Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip or a split in the opening in the roof of the mouth. Until it is treated with surgery, a cleft palate can cause problems with feeding, speech, and hearing. Oral and maxillofacial surgeons work as part of a team of health care specialists to correct these problems through a series of treatments and surgical procedures over many years.
Maxillofacial injuries or facial trauma encompass any injury to the mouth, face, and jaw. One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets, or combinations of these bones. These injuries can affect sight and the ability to breathe, speak, and swallow. Because of this, the expertise of the oral and maxillofacial surgeon is indispensable. Avoiding injury is always best, so it is extremely important to use seat belts, protective mouthguards, and appropriate masks and helmets for everyone who participates in athletic pursuits at any level.
Temporomandibular Joint Surgery
The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet and allows the lower jaw to move and function. If you experience jaw pain, earaches, headaches, a limited ability to open or close your mouth, clicking, or grating sounds, you may have Temporomandibular Disorder (TMD). TMJ treatment may range from conservative dental and medical care to complex surgery. If non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated which can involve either arthroscopy or repair of damaged tissue by a direct surgical approach.
Oral and maxillofacial surgeons recommend that everyone perform an oral cancer self-exam each month. If you notice white or red patches, an abnormal lump, chronic sore throat or hoarseness, or difficulty chewing or swallowing, you should contact your oral and maxillofacial surgeon. They will remove a section of tissue to perform a biopsy and accurately diagnose the problem.
Dental implants are long-term replacements for missing teeth that your oral and maxillofacial surgeon surgically places in the jawbone. Composed of titanium metal that fuses with the jawbone through a process called osseointegration, dental implants never slip and never decay. Because dental implants fuse with the jawbone, bone loss is generally not a problem.
Oral and maxillofacial surgeons have the ability to provide patients with safe, effective outpatient anesthesia including local anesthesia, nitrous oxide, IV sedation, and general anesthesia. During their surgical residency, residents must complete a rotation on the medical anesthesiology service where they become competent in evaluating patients for anesthesia, delivering the anesthetic, and monitoring post-anesthetic patients.
You may have noticed that our doctor specializes in “Orthodontics and Dentofacial Orthopedics.” While most people have heard of orthodontics, many are confused by the dentofacial orthopedics part of the title.
Every orthodontist starts out in dental school. Upon completion of dental school, some graduates immediately go into practice as dentists. Others choose to pursue a specialty, which requires additional schooling during a two- to three-year residency program. There are nine specialties sanctioned by the American Dental Association. Some you are likely familiar with: pediatric dentistry (dentistry for children), periodontics (dentistry focusing on the gums), and oral surgery.
“Orthodontics and Dentofacial Orthopedics” is one of the nine specialties. Essentially, while orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. Appliances are frequently used — the more familiar braces for orthodontics, and other specialized appliances like headgear and expanders depending on what facial abnormalities are present. Sometimes orthopedic treatment may precede conventional braces, but often the two are used at the same time. So if your child gets braces and headgear, he's actually undergoing orthodontics and dentofacial orthopedics.
Being skilled in both areas, our doctor is able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.