Surgical Orthodontics

Surgical FAQs

• What is surgical orthodontics?

  Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient´s ability to chew, speak, and breathe and for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps make sure teeth are in their proper positions after surgery.

• Who needs surgical orthodontics?

  Your orthodontist will consider surgical orthodontic treatment for patients with improper bites and those with facial aesthetic concerns. Jaw growth is usually completed by age 16 for girls and 18 for boys. All growth must be completed before jaw surgery can be performed. However the pre-surgical tooth movements can begin one to two years prior to these ages.

• How does it work?

  During your orthodontic treatment, which usually lasts 18-24 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 with an oral 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/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.

• Wisdom teeth removal

  Did you spend years in braces so that you could get a straighter smile? Do you want to maintain the results of orthodontic treatment throughout the rest of your years?

  If so, you should schedule a consultation with an oral surgeon to learn more about wisdom teeth removal.

  The wisdom teeth are the largest in the mouth, which often means that people’s jaws aren’t big enough for them to erupt properly into the correct position. When this occurs, the wisdom teeth become impacted.

  Impacted wisdom teeth continue to try to push through the gums, though. This can force the other teeth out of alignment, eliminating the positive outcomes of orthodontic treatment.

  Wisdom teeth removal can help to prevent this scenario. Patients who are concerned with preserving a straight smile often choose to have impacted wisdom teeth extracted before those teeth push their neighboring teeth out of position.

  An oral surgeon typically performs the wisdom teeth removal procedure because it may be necessary to remove some bone prior to extracting the teeth. It’s a much more involved process than a simple extraction of another tooth might be.
  Impacted wisdom teeth are associated with other negative scenarios in addition to a crooked smile. Because of their location at the rear of the jaw, wisdom teeth are very hard to keep clean, regardless of whether they are impacted. Therefore, impacted wisdom teeth can be more susceptible to infection and abscesses.
  Additionally, impacted wisdom teeth are prone to developing cysts and tumors, and they can often cause discomfort as they continue to attempt to erupt.

  Having impacted wisdom teeth removed in a timely fashion can reduce your risk of undoing all of the good from any orthodontic treatment you had in your teens. You can reduce your risk of a number of other oral health problems by having your wisdom teeth extracted, too.

• During the procedure

  Your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:

  Local anesthesia: Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.

  Sedation anesthesia: Your dentist or oral surgeon gives you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don’t feel any pain and will have limited memory of the procedure. You’ll also receive local anesthesia to numb your gums.

  
  General anesthesia: In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You’ll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.

  During wisdom tooth extraction, your dentist or oral surgeon:

  – Makes an incision in the gum tissue to expose the tooth and bone

  – Removes bone that blocks access to the tooth root

  – Divides the tooth into sections if it’s easier to remove in pieces

  – Removes the tooth

  – Cleans the site of the removed tooth of any debris from the tooth or bone

  – Stitches the wound closed to promote healing, though this isn’t always necessary

  – Places gauze over the extraction site to control bleeding and to help a blood clot form

• After the procedure

  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.