Orthognathic Surgery

Corrective Jaw Surgery in the DFW Area

Orthognathic surgery is needed when jaws don’t meet correctly and/or teeth don’t seem to fit with jaws. 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 can affect chewing function, speech, 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

Having trouble? Please make sure you have the Adobe Flash Player plugin installed in order to correctly view this presentation. This software is available as a free download.

Technology & Orthognathic Surgery

Dr. Kao, Dr. Stella, Dr. Warner or Dr. Williams use modern computer techniques and three-dimensional models to show you exactly how your surgery will be approached. 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 treatment prescribed. Our goal is to help you understand the benefits of orthognathic surgery.

If you are a candidate for corrective jaw surgery, our surgeons 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.

Common Questions About Orthognathic Surgery

1. Will my insurance cover my surgery?

Most insurance companies will consider covering this type of surgery as long as it is deemed medically necessary. We will pre-authorize your surgery and let you know if it is approved through your insurance company.

2. How long is the surgery?

Your surgery time depends on the specifics of your case and can be up to six hours.

3. What if my insurance does not cover this surgery?

We have payment options that our Surgical Coordinator will be able to explain and assist you with the details. We offer Care Credit and Capital One. At your second consultation, we will be able to explain each option in detail and assist you in making the best choice for your care.

4. Will I be in pain?

You will be uncomfortable from being wired together after surgery. However, you will not be in pain.

5. Can I breathe through my mouth once I am wired together?

Yes, you can still breathe through your mouth even though you will be wired together.

6. How will I feel after my surgery?

The first week after your surgery you will be swollen with some bruising. Most patients are uncomfortable, but liquid pain relievers allow you to tolerate the unpleasantness. You should begin to feel normal after the second week.

7. How long will I be wired together?

You will be wired together for three weeks. Not all patients need to be wired together. Your surgeon will discuss this possibility prior to your surgery.

8. What if I become nauseous when I am wired together?

Importantly, nausea to the point of vomiting rarely occurs after the patient is discharged from the hospital. But remember, anything that goes through the wires can come back out through the wires. It may be messy but the event is not life threatening.

9. Will I need someone to be with me the entire time that I am recovering?

You will only need someone to be with you the first week; thereafter, you should be able to function on your own.

10. How long will I have to stay in the hospital after my surgery?

Usually 1-2 days.

Post Orthognathic Surgery Nutrition & Home Care

Remember the Rule of Twos:

  • 2000 calories a day
  • 2 liters of liquid a day
  • 2 hours suction rotation (Do not wake patient up in the middle of the night to suction. It’s hard enough to get any sleep!)
  • 2 weeks of no nose blowing (upper jaw surgery only)

Significant dehydration may occur silently over 1-2 days. Drinking should be strictly enforced by the care giver, whether or not the patient desires to drink. The only alternative is to place an intravenous line (IV) to replace lost fluids.

Intravenous fluids only temporarily hydrate a patient. You will incur a fee since your insurance does not reimburse this charge.

All patients benefit from proper nutrition which includes proteins, carbohydrates and fats (yes, even fats!). Supplements, such as Ensure, Boost, PowerAde and Gatorade add calories and help the healing process. Be CREATIVE!! Squeeze bags will reduce the frustration of fluid intake during the time your jaws are wired together. These may be purchased at our office.

You will be provided a suction machine after surgery. Instructions will be given to you by our staff regarding the proper operation of the suction machine. After you use the machine, do not discard the contents of the canister! The suction machine will fail to operate if the filter at the top becomes moist. Return the suction machine on the 3rd follow-up appointment. At that time, we will discard the canister contents, clean it and determine whether or not you will continue to benefit from the machine. Please return the machine on time as failure to do so will inconvenience other patients needing the device.

Afrin may be sprayed in each nostril every 4 hours, alternated with Saline spray every 4 hours. You may suction your nose every 2 hours. Afrin may be sprayed up to 5 days after surgery then switch to Saline only. Wire cutters are not routinely given to patients! Please call your surgeon immediately if you have a question or feel your breathing is compromised.

Nasal decongestants may be helpful. Over-the-counter liquid Benadryl in the evening and liquid Sudafed in the morning may be used; ask your doctor for correct dosage. Please note: Over usage of decongestants can cause more problems!

Proper oral hygiene is strongly encouraged since it prevents inflammation and speeds healing. Brush your teeth, not your gums; stay on the wires and plastic splint. You may use a bent spoon to retract the cheek to facilitate brushing in the back of your mouth. You may take a Navy shower until the doctor gives you the okay for a normal shower. (Navy showers-jump in, wet your body, turn shower off, soap up and then rinse.) Keep the facial tape dry so it stays in place. When instructed to remove the tape dressing, get in a warm, steamy shower to wet the tape. Slowly remove the tape in small sections.

Contact our office if you should have any questions or concerns.

Orthognathic Surgery Overview

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

Orthognathic Surgery Overview

Having trouble? Please make sure you have the Adobe Flash Player plugin installed in order to correctly view this presentation. This software is available as a free download.