Orthognathic Information Sheet

Your dentist has referred you to see us for specialist information.

 

Now that we have examined you and listened to your concerns, we would recommend a combination or orthodontic treatment and surgery to correct you tooth irregularities and jaw position.

 

Why is it necessary to have surgery to correct my teeth?

The distance between your top and bottom teeth is too great to correct by simply moving your teeth.

 

Why do I have to have my teeth straightened before surgery?

The teeth and the jaws are rather like the cogs of a clockwork mechanism— if they fit together properly then the machine runs smoothly. It is important that the teeth are moved to their ideal positions before surgery so that following surgery the teeth mesh together. The correct dental relationship also helps to stabilise the jaw position after surgery and gives the greatest improvement in facial appearance.

 

How long do I have to wear fixed orthodontic appliances before and after surgery?

The orthodontic appliances are worn for about 18 months before surgery and about 3—9 months after surgery.

 

How often will I need to come for adjustments?

We see you for adjustment of the appliance approximately every 6 weeks.

 

About 10 days before your operation we arrange an extra appointment to take study casts and add hooks to the orthodontic appliance. From the study casts, our orthodontic technicians make a plastic wafer fit between your teeth. This helps the surgeons to accurately reposition your jaws. The hooks on the wires are also for use by the surgeon to help localise your new jaw position.

 

Will I have any teeth removed?

It is sometimes necessary to remove teeth to provide space to line up your remaining teeth.

 

The need for this depends entirely on your particular requirements and will be discussed with you by your Orthodontist. It is often necessary, particularly if a lower jaw operation is required, for you to have your wisdom teeth removed. The position of these teeth can interfere with the operation.

 

We normally recommend this to be done at least 6 weeks before your operation so that the area is completely healed before you jaw surgery.

 

What does the surgery involve?

The technical aspect of the surgery will be explained to you in detail by the surgeon.

 

How long will the operation take?

The operation will be carried out under general anaesthesia and will take approximately 2—5 hours to complete. The timing will vary depending on your particular type of operation and again, more detail will be discussed with you by the surgical staff.

 

How long will I be in hospital?

You will be admitted as an in-patient and will be in hospital for 4—5 days.

 

Will I have my jaws wired together?

Very rarely it is necessary for this to be done. Usually the jaws are fixed inside using small plates made of titanium (similar in appearance to mechano).

 

This allows you to open your mouth almost straight away after the operation.

 

The titanium plates are normally left in place and only removed if problems occur, e.g. discomfort.

 

Very occasionally it may be necessary to use elastic bands to hold the jaws together, but we will let you know about the likelihood of this unusual possibility prior to the operation.

 

Will there be any scars on my face?

Usually the operation is carried out entirely from inside the mouth.

 

The surgeon will discuss with you any likelihood of approaching the operation site from outside the mouth.

 

Will the operation change my appearance?

As you know, the operation is to be carried out to correct the position of your teeth and to change the relationship between your jaws. Movement of your jaws will change your facial appearance. We will try to describe and show you the changes we expect as a result of surgery. A change in appearance is sometimes quite difficult to accept, particularly for your friends and family. We will be very happy to discuss any anxieties you or your family / friends may have and will arrange counselling if this is something you or your family / friends would find helpful.

 

Will the operation be painful?

All operations result in some degree of discomfort and swelling. This varies tremendously from person to person, but most patients who have jaw surgery do not find it very painful. Obviously we try to control any pain and swelling with the appropriate drugs.

 

Please discuss any anxieties regarding pain and swelling with your surgeon.

 

Will, and what, will I be able to eat?

A soft diet will be recommended for you. Gradually you will be able to eat harder food and approximately 6 weeks after your operation you will be eating as you did before surgery. During this period of recovery you will find you lose weight. Most patients lose approximately 7lbs.

 

Are there any risks?

All operations involve a degree of risk related to the general anaesthetic. However, this is a very rare occurrence. Following your operation you will experience a numbness related to the operation site. This numbness lasts for approximately 6 weeks to 6 months. It is very rare that nerve damage is permanent.

 

Risks vary depending on your operation and should be discussed in detail with your surgeon.

 

How long will I have to be away from work/school?

You will normally be away from work/school for approximately 3 weeks. Again, this varies from patient to patient and depends on your type of operation and general robustness.

 

Why is it necessary to wait until I have stopped growing?

The jaws follow the growth rate of the rest of the body. Early surgery may mean that the operation has to be repeated when growth has been completed due to continuing change in the jaw relationship. The earliest age at which surgery is normally considered is in the late teens.

 

Does the operation work?

All the operations performed result in substantial improvement in the function and appearance of the jaws and face. The stability of the final result depends on the type of operation and an individual’s response to the operation.

 

Details of your particular operation should be discussed with your surgeon.

 

We hope this information leaflet has answered many of your questions.

This leaflet has been designed for you to improve your understanding of your forthcoming operation and contains many commonly asked questions. If you have any questions or would like further explanation please discuss this with your doctor or attending nurse.