When might combined orthodontic/surgery treatment be needed?
Orthodontists treat poor alignment of teeth (spacing or crowding) as well as bite issues (malocclusions). Sometimes these malocclusions are not just because the teeth are in the wrong positions, but because the jaws are misaligned. Examples would be a lower jaw that is too small or too large or asymmetric jaw growth that causes a skew to the bite and smile. When jaw growth issues are caught at a young age, Dr. Robison can often implement dentofacial orthopedic methods to correct or reduce the amount of jaw discrepancy by guiding jaw growth. Once growth is complete, the correction becomes more difficult.
Thankfully, because of advances in orthodontics over the past several years including advances in the Damon Smile System coupled with the use of TAD’s (Temporary Anchorage Devices), the need for Combined Orthodontic/Surgery Treatment has significantly reduced even in adults. Mild to moderate jaw discrepancies can now often be camouflaged with tooth movements that would have been impossible a decade ago. However, if the jaw discrepancies are too severe, then a combined orthodontic/surgery treatment should be considered.
If you have been told that you needed jaw surgery, consider getting a second opinion from Dr. Robison. He will do a thorough evaluation and let you know what your surgical and non-surgical options are.
Note from Dr. Robison:
“Many people feel that having jaw surgery is “extreme” and “excessive”. However, if a person has a severe skeletal abnormality that impairs their function, then trying to treat it without surgery is what is “extreme” and “excessive”. The most appropriate, and conservative treatment in such cases is orthodontics combined with jaw surgery. The improvement in a patients’ quality of life is dramatic.”
How does orthognathic surgery work?
Dr. Robison will start with braces or Invisalign to move your teeth so that they will fit together during the surgery. This involves removing a lot of what are known as dental compensations – poor tooth positioning because of the bad bite. These preparatory tooth movements are made within approximately 12 months, and once complete, you are ready for surgery.
An oral and maxillofacial surgeon or plastic surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital or in a surgical center – depending on the complexity of the surgery. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about six weeks of a “no chew” diet. Thankfully, because of advances in surgical techniques, most often the jaws are not “wired shut” as they used to do years ago.
Since orthognathic surgery is a major treatment, we recommend that you schedule some time away from work and school during the healing process. Two weeks is typical, but the surgeon will have the best advice for you and your specific needs. After your jaw has healed, your orthodontist will "fine-tune” your bite. Your orthodontic treatment will typically take an additional 6 to 12 months following surgery. After your braces are removed or Invisalign complete, you will wear retainers to help maintain your new smile.
What are the risks associated with orthognathic surgery?
As with any major medical surgery, there are risks associated with orthognathic surgery. However, the process of orthognathic surgery is not new, and it has been performed for many years in practices and hospitals. You should consult a surgeon shortly after your consultation with Dr. Robison. He or she will be able to give you more information about the risks of surgery as it relates to your specific surgical procedure.
What are the rewards of having orthognathic surgery?
For many patients, the most important reward of having orthognathic surgery is achieving a functional bite that they can use to bite into things and chew normally. The fact that orthognathic surgery also tends to improve facial and smile esthetics is a bonus but is secondary to function. Dr. Robison often tells patients that it is impossible to do anything in the mouth to improve function that does not also improve esthetics. This is particularly true with combined orthodontic/surgery treatment because the improvement in function is so dramatic, the esthetic improvement is equally dramatic.