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Frequently Asked Questions

What are the benefits of corrective jaw surgery?

Chewing – People with jaw and bite problems often avoid certain foods that they are unable to incise or chew completely. Correction of these problems may allow these individuals to enjoy a more healthy and varied diet.

Digestion- The digestive process begins in the mouth, where food is incised and crushed so that it can be properly digested once swallowed. A poor bite that doesn't efficiently process food in the mouth may lead to problems with digestion. Treatment that improves chewing function may improve digestion.

Jaw and Jaw Joint Pain- People with certain jaw and bite problems, particularly a small lower jaw, may experience discomfort in their jaws or jaw joints. Often it is because they have developed a habit of protruding their jaw forward to form a better bite, or to hide the appearance of a weak chin. This may cause tension in the jaw muscles and joints, eventually leading to jaw discomfort and/or headaches. Although it cannot be guaranteed, correction of these jaw and bite problems often reduces or eliminates jaw and jaw joint pain.

Tooth wear- Teeth that do not meet properly may eventually lead to excessive tooth wear. This is especially a concern for anterior open bite problems, where only the back teeth make contact. Correction of the dental malocclusion will help to protect the teeth from excessive wear.

Mouth breathing- Certain jaw problems that lead to difficulty bringing the lips together result in mouth breathing. While the jaw problem may not be the cause of mouth breathing (theories assert that mouth breathing from chronic nasal obstruction is the root cause of the jaw problem), the effect is often dry mouth and inflammation of the gum tissues. Corrective jaw surgery that allows the lips to come together without straining helps to reduce the inflammation caused by a chronically dry mouth.

OSA (obstructive sleep apnea) - OSA is a problem of upper airway collapse during sleep. Not only does this condition impair good restful sleep leading to daytime sleepiness, it has other serious health consequences, including high blood pressure, heart disease, and depression. While corrective jaw surgery is not a first-line treatment for OSA, it may be an alternative when other treatments have failed or are poorly tolerated. While this is especially true of individuals with recessed jaws, it may also be an option for those with OSA who have normal jaw development.

What is the recommended age for corrective jaw surgery?

Unless there are exceptional circumstances, we do not proceed with orthognathic surgery on patients who have not completed skeletal growth, especially those with an underbite. This is because they may grow out of the correction and additional surgery would be necessary. There is really no upper age limit, as long as the patient is healthy.

I have impacted wisdom teeth. Do they need to come out ahead of time, or can they be taken out during my corrective jaw surgery?

Opinions differ regarding impacted wisdom teeth. It is our routine to have impacted lower wisdom teeth removed in young adult patients at least six months prior to orthognathic surgery involving the lower jaw, but longer is preferred. This is because wisdom tooth removal is generally uncomplicated at this age, and the most common orthognathic surgery procedure on the lower jaw is easier without the presence of wisdom teeth. In older adults, wisdom tooth removal can be more complicated. In these instances, we may recommend removing the wisdom teeth when the corrective jaw surgery is done.

Can I have corrective jaw surgery without orthodontic treatment?

Orthodontic treatment is almost always needed. When the jaws are misaligned, the teeth naturally compensate somewhat for the skeletal problem. That is to say, the teeth will naturally crowd or tilt in a way that lessens the true extent of the skeletal misalignment. Prior to surgery, the orthodontist needs to move teeth into a position that allows for a correct bite when the jaws are surgically aligned. After surgery, the orthodontist must usually fine-tune the bite in order to create the best possible dental occlusion.

Can I have lingual braces or Invisalign instead of regular braces?

In certain instances it is possible to do orthognathic surgery on patients who desire or require concealed braces. This treatment may necessitate a temporary fixed set of braces just for surgery and for a short time afterward, or alternatively, temporary anchor devices (TADs) may be placed above and between the teeth for the necessary "handles" for the jaws. Your surgeon would need to confer with your orthodontist to determine if this treatment is possible.

How long will my orthodontic treatment take before I am ready for corrective jaw surgery?

That all depends upon how much preparation your orthodontist must do to prepare you for surgery. This process may take as little as a few months if the teeth are not overly crowded or misaligned, or it may take up to a year, especially if the plan calls for removal of certain teeth and orthodontic closure of the resulting spaces.

Will I wear my braces during corrective jaw surgery?

Yes, your braces provide the necessary "handles" for the jaws during the procedure. Although it is seldom necessary to wire the jaws together after surgery, the jaws must be fixed together during certain parts of the operation. The braces facilitate this process.

I read that screws and plates are used in corrective jaw surgery. Are these eventually removed?

Screws and plates are inserted to fix the jaws in their corrected alignment. Even though a healed jaw does not require this hardware for strength, it is not routinely removed. The screws and plates have the same titanium composition as dental implants, a biomaterial that has been studied extensively and has no ill effect on the body. Due to the small size of the hardware, most patients have no awareness that it is present. On infrequent occasions when a plate or screw must be removed, it can often be done in the office.

How long will the surgery take?

The length of surgery depends upon the complexity of the case. Routine surgery on one jaw generally takes sixty minutes to two hours. Surgery that involves multiple procedures may take as long as three to five hours.

Is there a lot of pain after corrective jaw surgery?

While pain is an expected side effect of most surgery, many corrective jaw surgery patients tell us that their post-surgical discomfort was much less than they anticipated. We of course prescribe the pain medications you may need to transition through the recovery process with the least amount of pain as possible.

Is there a lot of swelling and bruising after corrective jaw surgery?

Swelling and bruising varies and may not be relative to the extent or complexity of surgery. In general, younger patients tend to swell more and bruise less, while older adult patients tend to bruise more and swell less. Much of the swelling and bruising resolves within the first few weeks, but it may take up to a year for the swelling to completely resolve. Ice packs, elevation of the head while sleeping, and use of the facial muscles will help the swelling to resolve more quickly.

Are there ever complications from corrective jaw surgery?

As with any surgery, corrective jaw surgery carries certain risks that must be weighed against the benefits of treatment. These risks include, but are not limited to pain, infection, decreased sensation or numbness, bleeding that could be potentially serious, jaw joint problems, and damage to normal structures such as the teeth, gums, and bone. There could be healing problems that may require more surgery, and there are certain risks associated with the general anesthesia that is necessary for corrective jaw surgery. These risks are discussed in detail at your first visit.

Will the surgery change my appearance?

Problems with the bite often go hand in hand with an imbalance in facial proportions, such as a weak or strong chin, or a "gummy" smile. Depending upon the severity of the condition, appearance changes may range from subtle to significant. These changes may at first be masked by swelling, but in time the result will become apparent. We always plan the surgery for a result that appears natural and non-surgical. The Case Studies illustrate some aesthetic changes that occur as a result of treatment.

How long should I expect to stay at the hospital?

Patients having uncomplicated surgery on one jaw often go home on the day of surgery. Patients having more comprehensive surgery can expect to stay in the hospital overnight. If desired, a family member can generally stay with the patient overnight, but this must first be approved by the Charge Nurse.

How long will it take for me to get completely back to normal?

Most corrective jaw surgery patients will resume regular activity within a few weeks, but it will take a few months before you are ready to engage in contact sports and strenuous physical activities.

Will my insurance cover the surgery?

We begin to determine the answer to this question at your very first office visit. As we are not contracted with any insurance companies, if your insurance plan only provides benefits for treatment by in-network doctors, then with few exceptions the surgery would not be covered. If your plan permits you to see any doctor, then all or part of your surgery may be covered. We are familiar with the terms of coverage for most of the major insurance plans, and we will assist you throughout the insurance process by submitting the necessary preauthorization and claim paperwork. When benefits are denied (corrective jaw surgery excluded from coverage or no benefits for out-of-network providers) we can discuss potentially affordable options.