This option is suitable for patients when the underlying cause of the bite is not just to do with the position of the teeth but due to the position of the jaws. If the problem lies with the positions of the jaws themselves then the only way to fully correct the problem is to carry out surgical procedures to move the position of the jaws.
It is important to note that before any surgical treatment you will be thoroughly assessed and all of the individual risks and benefits will be explained to you by our multidisciplinary team prior to undertaking any treatment. The information given here is solely a guide and not all of it will be applicable to all patients.
This type of treatment is usually aimed at patients who have concerns about the positions of their teeth and jaws that cannot be resolved with braces alone. There are risks associated with the braces and the surgery and this treatment is only suitable for those for whom the benefits would outweigh the risks. Therefore, before any treatment is started all patients will undergo a thorough assessment and be seen by several members of our team to ensure the treatment is the best possible option for you.
Usually, the overall treatment takes between 2 ½ to 3 ½ years. Braces are used throughout the entirety of the treatment and the jaw operation happens approximately two thirds of the way through the treatment.
We use fixed braces to straighten the teeth and to move the teeth into the ideal position for the surgery. Sometimes, this can mean that we make the bite and the facial profile worse before we make it better.
The operation to the jaws will then correct the dental and the facial concerns. This will then be followed by a further 6-9 months of brace work to fully correct the bite.
This depends on your individual problem. Some people require surgery just to their top jaw, some to just their lower jaw and some to both jaws. You are brought into hospital on the day of your operation, will have your operation with a general anaesthetic (asleep) and usually stay for 1-3 nights afterwards depending on the operation and how you are recovering.
The operation itself involves making some cuts inside the mouth (so there are no scars on the face), the jaw bone (s) are moved into the correct position, small metal plates are used to fix the jaws in the correct position, finally the wounds are closed with some dissolving stitches.
As with any operation there are risks.
We will need to assess how medically fit you are prior to the operation to ensure you are healthy enough to have the operation, as you would for any general anaesthetic.
There are nerves that run through the top and lower jaws that get stretched during your operation. These nerves allow you to feel sensation in your lips, cheeks and in your mouth. Most patients suffer loss of this sensation immediately after the surgery. This usually recovers over the following weeks and months. However, some patients can be left with permanent numbness of their lips, cheeks and mouth after the surgery.
Although the reason for doing this surgery is to improve the position of your teeth and your bite, for many patients there will be beneficial changes to the facial appearance. All anticipated changes will be discussed with you before you decide to go ahead with this treatment.
The plates that are placed during the procedure usually are left in place for the remainder of your life and tend not to cause any problems. However, in some cases (about 10%) these can get infected and will need removing. It is often possible to remove the plates with simple numbing of the area before taking them out.
In addition to the surgical risks there are also the risks associated with having braces.
You will be required to come to lots of appointments during the length of the treatment. At first you will need to attend assessment clinics before any braces will be fitted. Once placed you will need to see the orthodontist approximately every 6-8 weeks.
When it is time for the operation you will usually need to take between 2-6 weeks off depending on your job and the type of surgery you have.
It is very rare for us to need to fix the top and bottom jaws together so you should be able to open the mouth to eat, drink and speak. However, as the plates that are placed in the jaw bones are not strong enough to withstand chewing forces you will need to be on a soft, diet for approximately 2 weeks after the surgery.
It is really important that after the surgery you try to consume as many calories as you can. It is difficult as you are limited to what you can eat but if you do not consume enough calories your healing will not be as good.
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