Why get corrective jaw surgery?
Corrective jaw surgery, or orthognathic surgery, is performed to correct bone problems that exist within someone's jaw that can't be corrected with only braces on the teeth.
Some people become aware that they need jaw surgery when they go to an orthodontist for braces.
Along with a dental problem, it might be discovered that you have a skeletal problem and need surgery to correct overgrowth or undergrowth of your jaw.
Before the surgery, you likely will have braces on your teeth to move them into a new position. These braces will stay on during your surgery and be adjusted about six weeks after you've had jaw surgery.
What happens during the surgery?
Corrective jaw surgery is generally performed in a hospital or surgery center. To begin the surgery, you will be placed under general anesthesia, where you fall asleep and generally won't feel pain during the procedure.
There's a misconception that, during jaw surgery, your surgeon will “break your jaw.” Rather, what happens is your surgeon will surgically separate your jaw.
There are various ways to perform the surgery, including segmentalism, in which your surgeon cuts your jaw into segments to move it into place, or through a single-piece method, in which there isn't as much sectioning of the jaw.
Generally, your surgeon will pull your cheeks back and begin making cuts inside your mouth. Most of the time, incisions are made inside your mouth, but occasionally your surgeon will make an incision in the cheek to correct issues in the lower jaw.
To correct your upper jaw, your surgeon will make cuts high in the upper lip at the base of the nose inside the mouth. Your surgeon will lift the gum tissue and make surgical cuts in the bones of the upper jaw, moving it where it needs to be. Your surgeon will place screws, plates or other devices inside your jaw to ensure it stays in position.
For your lower jaw, your surgeon will make cuts by your wisdom teeth, lift the gum tissue and make a surgical cut. Once this cut is made, your surgeon will be able to move the bottom of your mouth similar to how a dresser drawer moves, sliding it back or forward where it needs to be.
Does it hurt?
During the surgery, you shouldn't feel anything. After the surgery, some patients say it's about as bad as getting your wisdom teeth taken out, except the swelling is a bit more.
You likely will be sore and take prescription pain medication. The amount of time patients take pain medication varies on a case-by-case basis. You should be able to return to work or school within one to three weeks.
What are the risk factors?
With any surgery, there's a risk of bleeding and infection.
Specific to jaw surgery, there's a risk of losing feeling in your lower jaw because of possible damage to the nerve that goes through the lower jaw. It could be damaged during surgery, and also, there's a risk that the swelling from the surgery can put pressure on it.
In child patients, the feeling generally comes back, but it's less predictable in adult patients.
Other risks include permanent tingling in the lips or cheek, incorrect positioning of the jaw segments, joint problems and damage to your teeth.
What's the recovery time?
You'll be sent home on a liquid diet because it can be uncomfortable to chew with the soreness from the surgery. Usually, your mouth will not be wired shut, and you generally don't have gauze or drains in your mouth. Rather, you have sutures in your mouth. These should come out within 10 days to three weeks.
Your bones will grow back together, initially held together by plates or screws. Within about six weeks, you should be feeling back to normal. By three months, your bones should be fully healed.
What's the follow-up?
Your surgeon will see you again in about a week, three weeks and six weeks. You likely will return to your orthodontist within six weeks to adjust your braces.
After your bite is corrected, the “wear and tear” on your teeth should be more balanced. Also, it can improve your ability to chew.
Sources: Dr. Steven Sullivan, an oral and maxillofacial surgeon at the Oral and Facial Surgery Center in Oklahoma City; The Mayo Clinic; American Association of Oral and Maxillofacial Surgeons; Auckland Oral and Maxilofacial Surgery Group.