Learn About Surgical Orthodontics

Learn About Surgical OrthodonticsWhat is surgical orthodontics?

Sometimes, orthodontic treatment alone is not sufficient to correct serious bite problems, jaw growth abnormalities, and facial imbalances. In such cases, orthognathic surgery or surgical orthodontics may be required to reposition the jaw, thereby functionally improving the patient’s ability to chew, speak, and breathe and/or esthetically improving the facial appearance. Since moving the jaws also moves the teeth, braces are always placed in conjunction with this type of jaw surgery. This helps ensure that the teeth are in their proper positions after surgery.


How does it work?

During your orthodontic treatment, which usually lasts 12–24 months, you wear braces and will visit your orthodontist for scheduled adjustments to your braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.

Surgery is performed in the hospital by an oral and maxillofacial surgeon and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added or removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.

When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4–8 weeks), your orthodontist “fine-tunes” your bite. In most cases, braces are removed within 6–12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.


After orthognathic surgery, patients are often required to adhere to an all-liquid diet. After time, soft food can be introduced, and then hard food. Diet is very important after the surgery, to accelerate the healing process. Weight loss due to lack of appetite and the liquid diet is common, but should be avoided if possible. Normal recovery time can range from a few weeks for minor surgery, to up to a year for more complicated surgery.

For some surgeries, pain may be minimal due to minor nerve damage and lack of feeling. Doctors will prescribe pain medication and prophylactic antibiotics to the patient. There is often a large amount of swelling around the jaw area, and in some cases bruising. Most of the swelling will disappear in the first few weeks, but some may remain for a few months.

The surgeon will see the patient for check-ups frequently, to check on the healing, check for infection, and to make sure nothing has moved. The frequency of visits will decrease over time. If the surgeon is unsatisfied with the way the bone is mending, she/he may recommend additional surgery to rectify whatever may have shifted. It is very important to avoid any chewing until the surgeon is satisfied with the healing.


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