Orthognathic Surgery (Jaw Surgery)

Orthognathic surgery is needed when the top and bottom jaws don’t meet correctly and/or teeth don’t adequately fit within the jaw. Teeth are straightened with orthodontics, and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those with an improper bite, or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that may affect chewing function, speech, or long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required for the jaws when repositioning is necessary.

Difficulty in the following areas should be evaluated:

  • Difficulty in chewing, biting, or swallowing
  • Speech problems
  • Chronic jaw or TMJ pain
  • Open bite
  • Protruding jaw
  • Breathing problems

Any of these symptoms can exist at birth, be acquired after birth as a result of hereditary or environmental influences, or as a result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team can make the decision to proceed with treatment together.

Orthognathic Surgery Presentation

To provide you with a better understanding of orthognathic surgery, we have provided the following multimedia presentation. Many common questions pertaining to orthognathic surgery are discussed.

Orthognathic Surgery Presentation

Technology & Orthognathic Surgery

Our doctors use modern computer-aided techniques and three-dimensional models to show you exactly how your surgery will be performed. Using comprehensive facial x-rays and computer video imaging, we can show you how your bite will be improved and even give you an idea of how you’ll look after surgery. This helps you understand the surgical process and the extent of the proposed treatment. Our goal is to help you understand the benefits of orthognathic surgery.

If you are a candidate for corrective jaw surgery, our doctors will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.

Orthognathic Surgery Overview

For a brief narrated overview of the orthognathic surgery process, please click the image below. It will launch our educational MiniModule in a separate window that may answer some of your questions about orthognathic surgery.

Orthognathic Surgery Overview

Post-Operative Instructions

What you may need at home

  • Saline (Dissolve 1 teaspoon of salt in 8 ounces of water)
  • Child size toothbrush/Waterpik
  • Scissors/wire cutter (for cutting elastics or wires depending on what is holding the jaw closed)
  • Vaseline or lip balm
  • Blender

Medications

You will be prescribed a pain medication and antibiotic upon discharge. These medications may be in liquid or pill form. If given a liquid medication then use the syringe provided by the pharmacy to measure and administer. If given a pill then you may crush the pill and mix it with a small amount of water or juice. Please take medications as prescribed by the doctor.

We recommend that you take an over the counter non-steroidal anti-inflammatory such as Ibuprofen, Motrin or Advil. Take 600 mg every 6 hours for the first week to help reduce pain and swelling. Please remember that most narcotic pain medication already have Tylenol in it, so do not take any extra Tylenol as this may cause serious issues.

For patients that have had an upper jaw surgery nasal decongestants, expectorants or nasal sprays may be used to help with any difficulty breathing through your nostrils. A humidifier or frequent warm showers may also help aid in congestion.

Swelling

Expect significant swelling. Swelling will maximize during the first week then should start to diminish. It is beneficial to use ice/ice packs/frozen peas wrapped in a towel and applied to the cheeks for a period of 20-30 minutes at a time. Ice should be used for the first 48-72 hours.

It takes approximately two weeks for the majority of swelling to disappear. If any there is an increase in swelling and pain after 10-14 days then that could indicate an infection, which may require treatment. Should this happen, please contact the doctor.

Bruising may also occur with swelling. The bruising should dissipate as swelling subsides. The bruising may travel in the skin and change in color. This is normal and will resolve in 2 weeks.

Bleeding

Minor oozing from the incisions made inside the mouth should be expected for the first 72 hours. Upper jaw surgeries usually experience some minor trickling of blood through the nose. Nasal sprays and decongestants will help with this. Dark blood clots may be coughed up or expressed through the nose

toward the end of the first week for upper jaw surgeries. If in any case there is a gush of bright red blood from any incisions or the nose then contact the doctor.

Numbness

Numbness to the face and jaw depending on the surgery that was done is normal. This may persist for weeks, sometimes months. This will be monitored by your doctor during your office visits.

Oral Hygiene

It is very important to keep your mouth and teeth clean following surgery. Gentle rinsing and spiting with salt water or prescribed Peridex oral rinse should be done the first week. Then a Waterpik can be used to aid in cleaning. Use a child toothbrush to brush the outsides of your teeth. If you are wired or have elastics then you will not be able to brush the tongue side of your teeth.

Nausea

Avoid any foods that may cause your stomach to become upset. If you do that you are going to vomit then you should:

  • Bend forward
  • Put your finger inside your cheek alongside the teeth and gently pull your cheek outward.
  • Remember that everything that you are ingesting is liquid, therefore if anything comes out it will also be liquid. Vomit can escape around the teeth and out the side of the cheek. Try not to cut the wires or elastics if at all possible.
  • Anti-nausea medication can be prescribed if necessary.

Diet

It is essential that your body receives adequate fluids and nourishment in order to promote healing. You will be limited to a liquid diet for 4-6 weeks. Suggestions for a full liquid diet include: milk shakes, smoothies, Je11-0, blended foods, ensure and protein shakes. The doctor will instruct you as to when you can resume a soft diet. Avoid alcohol, sugary and carbonated drinks.