327 Central Park West (Suite 1A), New York, NY 10025
Surgical Precision for Perfect Alignment
Surgical orthodontics, also known as orthognathic surgery, is a specialized field that combines orthodontic treatment with corrective jaw surgery to address complex dental and skeletal issues. This approach is typically recommended when conventional orthodontic methods, such as braces or aligners, are insufficient to correct significant jaw discrepancies. The primary goals are to enhance facial aesthetics, improve bite functionality, and alleviate difficulties related to chewing, speaking, or breathing.
Frequently Asked Questions
Surgical orthodontics involves the realignment of the jaws to correct irregularities that affect a patient’s ability to chew, speak, and breathe, as well as to improve facial appearance. This process is a collaborative effort between an orthodontist and an oral and maxillofacial surgeon. Braces are typically applied before and after the surgery to ensure that the teeth are properly aligned in the newly positioned jaws.
Candidates for surgical orthodontics often include individuals with:
- Severe bite problems (malocclusions) that cannot be corrected with braces alone
- Jaw growth discrepancies leading to facial asymmetry
- Obstructive sleep apnea due to jaw positioning
- Chronic jaw pain or temporomandibular joint (TMJ) disorders
- Difficulty chewing, biting, or swallowing
- Speech impediments related to jaw alignment
Jaw growth typically completes by age 16 for females and 18 for males. Surgical intervention is considered only after growth cessation, although orthodontic preparation can begin earlier.
During orthodontic treatment, typically lasting 18 to 24 months, braces gradually move the teeth into place. However, if there are significant jaw alignment issues, surgery may be recommended as part of your treatment plan. As the teeth shift during this phase, the bite may temporarily feel worse before it improves. Once the jaws are correctly positioned through surgery, the teeth align as intended.
Orthognathic surgery is performed in a hospital setting by an oral and maxillofacial surgeon. The procedure can take several hours, depending on the complexity and specific needs of your case.
Common types of jaw surgery include:
- Lower Jaw Surgery (Mandibular Surgery): The bone behind the teeth is repositioned to move the lower jaw forward or backward.
- Upper Jaw Surgery (Maxillary Surgery): The upper jaw may be moved in any direction—forward, backward, up, or down. Sometimes bone is added or removed to achieve ideal alignment.
- Comprehensive Jaw Adjustments: In certain cases, additional facial bones may be repositioned or reshaped to support better symmetry and function.
Recovery and continued orthodontic care
After surgery, most patients return to school or work within two weeks. Healing takes approximately 4 to 8 weeks, during which time your orthodontist will monitor your progress closely.
Once the jaw has healed:
- Braces stay on for another 6 to 12 months to fine-tune your bite and ensure long-term results.
- After the braces are removed, you’ll wear a retainer to help maintain your new smile.
If you’ve had braces or any other form of orthodontic treatment, keeping your teeth in their new, straight position is a top priority. One common reason smiles shift over time is the growth of wisdom teeth, the third molars that typically appear between ages 17 and 25.
Because wisdom teeth are large and located at the back of the mouth, there often isn’t enough room for them to grow properly. When this happens, the teeth may become impacted, stuck under the gums or pushing in at an angle. As they try to erupt, they can apply pressure on nearby teeth and disrupt the alignment that orthodontic treatment worked so hard to achieve.
- Removing impacted wisdom teeth helps prevent:
- Crowding or shifting of teeth after braces
- Pain and pressure in the jaw
- Infections or gum issues around partially erupted teeth
- Cysts or damage to nearby teeth and bone
- Trouble cleaning the area, which can lead to decay
Wisdom teeth removal is typically done by an oral surgeon. If the teeth are impacted, the procedure may involve removing a small amount of bone to safely extract them. The surgery is performed under local or general anesthesia, depending on your needs, and recovery usually takes about a week.
In short, removing your wisdom teeth can help protect the long-term results of your orthodontic care and support your overall oral health. If you or your teen are approaching the age when wisdom teeth typically come in, it’s a good idea to schedule an evaluation.
Surgical orthodontic procedures are carefully planned to ensure your safety and comfort throughout. Depending on the complexity of your case and your comfort level, your oral surgeon or dentist may recommend one of the following types of anesthesia:
Anesthesia options
- Local Anesthesia: For simpler extractions, local anesthesia is commonly used. A numbing agent is first applied to your gums, followed by an injection near the extraction site. You’ll stay awake during the procedure and may feel some pressure or movement, but you won’t feel pain.
- Sedation Anesthesia: This method involves an IV sedative administered through your arm to help you relax and reduce awareness during the procedure. You’ll remain conscious at a minimal level but won’t remember much. Local anesthesia is also used to numb the treatment area for added comfort.
- General Anesthesia: In more complex or sensitive cases, general anesthesia may be used. You’ll receive medication through an IV or by inhaling it through your nose. This puts you into a deep sleep, and you won’t experience any pain or have memory of the procedure. Your vital signs are closely monitored throughout, and local anesthesia is also applied to reduce post-op discomfort.
Steps of the Procedure
- A small incision is made in the gum to access the tooth and surrounding bone
- If needed, bone is removed to better reach the tooth root
- In some cases, the tooth is divided into smaller sections to make removal easier
- The tooth is extracted carefully from the socket
- The area is thoroughly cleaned of any bone or tooth debris
- Stitches may be placed to help close the wound and promote healing (though not always necessary)
- A piece of gauze is applied to the extraction site to control bleeding and help a clot form
If you receive sedation anesthesia or general anesthesia, you’re taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair. 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.
Schedule Your Consultation for Surgical Orthodontics in NY
Think surgical orthodontics might be right for you? Contact Central Park West Orthodontics to schedule a consultation and discuss your needs. We are located at 327 Central Park West (Suite 1A), New York, NY 10025. Call us at (212) 280 1700 to learn more about our services.
