Orthognathic Surgery is the medical term for Jaw Surgery. It is a surgery to reposition the jaws to correct alignment. This realignment allows teeth to fit when misalignment cannot be solved by orthodontics alone.
We think it is reasonable to consider going through jaw surgery for a few reasons. Most frequently, the upper and lower teeth fit in a way that makes chewing and biting difficult. This match between the upper and lower teeth is referred to as your bite (occlusion.)
If the occlusion is incorrect, you will hear the term malocclusion (bad bite.) Common malocclusions are referred to as overbites, underbites, crossbites, and open bites. These conditions are frequently related to the underlying structure of the bone being mismatched to the opposing bone. Those two bones are the maxilla (upper jaw) and mandible (lower jaw). When the lower jaw is too far forward (mandibular hyperplasia), or the upper jaw is too far back (maxillary hypoplasia), an underbite is present. When the lower jaw is too far back (mandibular hypoplasia), or the upper jaw is too far forward (maxillary hyperplasia) there is an overbite. the front teeth don’t touch (anterior open bite), the back teeth don’t touch (posterior open bite)
While malocclusions can lead to difficulty with biting and chewing, the cause of the malocclusion can cause other functional problems. Small lower and upper jaws are associated with difficulty breathing during the day and night. This is because there is less space for the tongue and soft palate to live. You are good at compensating for this and the most common compensation is head position. People come in with neck pain and postural concerns because the are chronically adapting to their poor jaw position.
Underbites and open bites are associated with speech difficulty. The tongue forms many sounds by touching the roof of the mouth behind the front teeth. If the front teeth are far away from the tongue, it can be difficult to speak. Air escape can happen as well with front teeth that don’t touch.
Jaw joint (TMJ) issues are complex but with severe malocclusions, people often find fatigue with chewing. This is because only a few teeth work to chew. Many chewing cycles can wear out the joint.
Upper and lower jaws are mismatched for variable reasons. Common causes are TMJ arthritis, trauma, congenital issues, growth abnormalities, open mouth breathing, low muscle tone, jaw tumors or systemic issues.
Jaw surgery is completed under general anesthesia as an outpatient surgery. It is used to treat several conditions including a severe underbite or overbite, open bite, jaw or facial asymmetry, sleep apnea and others.
Typically, patients find themselves in our office after seeing an orthodontist. The orthodontist will make the recommendation based on your jaw alignment. Surgery may be needed in addition to orthodontic treatment to correct your bite. They would refer you to discuss orthognathic surgery with a maxillofacial surgeon.
Your initial consult in our clinic will consist of one of our surgeons taking a history, doing an examination, reviewing your clinical photos and any available imaging. They will then discuss what is involved with jaw surgery and anticipated surgical intervention. You will also be shown a cartoon demonstration video of how jaw surgery is used to reposition the jaws. After this consult you return to your orthodontist to begin orthodontic treatment.
The traditional timeline for jaw surgery patients is to be in braces for a period of time, on average this is about 6-18 months to straighten and align the teeth prior to surgery. Then the orthodontist will tell the patient when they are close to being ready for surgery. It is then that you follow up in clinic for a recall visit. One of our maxillofacial surgeons will do another exam and we will take updated photos. The surgeon will then have a better idea of what surgical treatment they recommend. At this recall if you are ready for surgery you will meet with one of our care coordinators to schedule a surgery date.
You return to clinic to obtain presurgical records. These records include an updated CT scan and an optical scan of your teeth. These are used by the surgeons to complete your virtual surgical planning (VSP). This is a way to customize the surgery to each individual patient. At your preoperative visit we will discuss the process of surgery at the hospital, review your specific plan for surgery, and review instructions for recovery after surgery.
Surgery takes place at the hospital; you spend one night in the hospital after surgery and are discharged the following day. We see you in clinic for your post operative visits at 1, 3, and 6 weeks after surgery and then 6 months after surgery.
Jaw Surgery
Did you know?
Though only an oral surgeon can let you know if jaw surgery is right for you, there are some signs and symptoms that the procedure could be right for you:
- Your lips do not meet in your natural bite
- Your jaw protrudes noticeably forward
- Your chin is receded backward
- Your face seems unbalanced
- You have open space between your upper and lower arches when your mouth is closed
- You have breathing difficulties during sleep
- You find yourself breathing primarily through your mouth
- You have difficulty chewing and/or swallowing food
- You have excessive wear on your teeth
- You have ongoing jaw joint pain
- You suffer with chronic headaches
You may be a candidate for corrective jaw surgery if you have a malocclusion (bad bite) that is caused by poorly aligned jaws. Only a complete consultation with an oral surgeon can help you determine whether jaw surgery is right for you.
At Seattle Jaw Surgery, you will be evaluated by Dr. Bobek to determine if surgery is right for you. If you can avoid surgery he will be honest with you! If you could benefit from surgery, he will discuss the pros and cons.
The decision to recommend surgery is based off of the individual. Functional troubles, clinical examination, radiographs (xrays), history, orthodontic exam and dental impressions are all considered when recommending for or against surgery.
On the day of your operation, you’ll be placed under general anesthesia. An incision will be made on the inside of your mouth, through which your surgeon will reposition your jaws. Some jaw surgeries involve bone shaping, which may include shaving some bone away or grafting new bone into the jaw. A combination of plates, screws or wires may be used to hold the jaw in place before your incision is closed.
Please view our jaw surgery techniques on our videos page.
Yes. The initial healing phase is usually a few weeks long. During this time, you’ll be placed on a modified diet and instructed to avoid certain activities. It is important to take all medications as prescribed and to keep the incision site clean and free of debris. Your jaw may be swollen and sore for several days after surgery. Be sure to contact your doctor if you experience fever or any discomfort that worsens with time. Keep in mind that your jaw will continue to heal over the course of several months – a process that can take up to one year to complete.
