Do you have trouble chewing, speaking, or breathing because of your jaw alignment? Do you feel self-conscious about your smile?

If you answered yes to any of these questions, jaw surgery might be able to provide a solution.

Orthodontia or jaw surgery is a surgical procedure that corrects the position and function of the upper and lower jaws. It can treat various conditions that affect the jaw and lower face, such as bite problems, facial imbalance, sleep apnea, TMJ disorder, or facial injury. Jaw surgery can improve how your teeth fit together, enhance your facial appearance and smile, ease your breathing and speech, and increase your quality of life.

However, this surgery is not a quick fix. It requires careful planning, preparation, and recovery. In this article, we will discuss everything you need to know about jaw surgery.

Types of Jaw Surgery

Jaw surgery can be of different types. The most common ones include:

Maxillary osteotomy

A maxillary osteotomy is performed by a surgeon when the upper jaw (maxilla) protrudes excessively or insufficiently. This surgery also addresses an open bite or a crossbite, in which the top and lower teeth come together but don’t meet adequately when the mouth is closed. During the procedure, the surgeon removes the bone above the teeth and repositions the upper jaw and teeth forward or backwards to align with the lower jaw and teeth. The surgeon adjusts the height or width of the upper jaw if necessary.

Mandibular osteotomy

When the lower jaw (mandible) protrudes too much or not enough, this surgery may be performed. It can correct an overbite or underbite, where the lower teeth sit too far behind or in front of the upper teeth. The surgeon cuts behind the molars and along the jawbone, then shifts the lower jaw and teeth forward or backwards to align with the upper jaw and teeth. If necessary, the surgeon also adjusts the angle or shape of the lower jaw. Plates or screws are used to secure the bone.

Bimaxillary osteotomy

Surgeons usually decide to perform this surgery to move the upper and lower jaws simultaneously. It merges maxillary and mandibular osteotomies to effectively correct complex jaw issues like facial asymmetry, sleep apnea, or facial trauma. During this procedure, the surgeon cuts and repositions the teeth’ lower and upper jaws to ensure they fit together and balance the facial proportions. To secure the bones, the surgeon employs plates or screws.

Genioplasty

Surgeons perform this surgery to change the shape or position of the chin, either as a standalone procedure or in conjunction with other jaw surgeries. This surgery aims to improve the chin’s appearance and function, mainly when it is too small, too large, or crooked. In this surgery, the surgeon cuts the chin bone and moves it forward, backwards, up, or down until it matches the rest of the face. They may also add or remove bone or implants to modify the chin’s size or form.

Temporomandibular joint (TMJ) surgery

This surgery treats TMJ disorder, which affects the joint joining the skull and lower jaw. It can cause pain, stiffness, clicking, or locking of the jaw. It can also affect the bite, chewing, and speaking. There are various types of TMJ surgery based on the cause and severity of the disorder. Some common types are arthrocentesis, arthroscopy, arthroplasty, and joint replacement. In these surgeries, the surgeon may remove or repair the damaged tissues, such as the cartilage, ligaments, or muscles, that affect joint function.

Preparing for Jaw Surgery

Let us now take a look at some of the steps one needs to follow to prepare for a jaw surgery:

• A thorough consultation and evaluation with the oral and maxillofacial surgeon and the orthodontist is the first step. They will examine your jaw, teeth, and facial structure and discuss your goals and expectations. They will also explain the surgery’s type, risks, and benefits and answer any questions.
• You may need to undergo preoperative tests and imaging, including blood tests, X-rays, CT scans, or 3D models of your jaw and teeth. The surgeon will use these tests to help plan the procedure and determine the best way to move your jaw and teeth.
• You may need braces or other appliances fitted to your teeth before and after the surgery to align and stabilise your jaw and teeth. The duration and type of orthodontic treatment will depend on your case and the complexity of the surgery.
• You will get detailed information on how to get ready for the surgery, such as what foods and beverages to consume, what drugs to take or not take, and how to clean your mouth. You will also need to take a break two weeks before the operation and abstain from smoking and consuming alcohol, as they may have an impact on the recovery period.

The Procedure of Jaw Surgery

The general steps of a jaw surgery include:

1. Anaesthesia: The anesthesiologist will give you general anaesthesia, which will make you unconscious and pain-free during the surgery. You may also receive local anaesthesia, which will numb the surgery area.
2. Incisions: To access the jaw bones, the surgeon will make minor cuts inside your mouth, near the gums or the cheeks. Sometimes, the surgeon may make minor cuts outside your mouth, near the chin or the ears, to access the jaw joints or the chin bone. He will try to avoid visible scars as much as possible.
3. Bone cuts:  The surgeon will use special instruments to cut the jaw bones according to the planned movement. He might remove a bone to change the jaw, chin size, or shape.
4. Fixation: The surgeon will use plates, screws, wires, or rubber bands to hold the jaw bones in their new position. The fixation devices will aid in the healing and fusion of the bones. After recovery, you can remove some devices while others stay permanently inside your mouth.
5. Closure:  The surgeon will use stitches or glue to seal the wounds. These stitches might dissolve independently or require removal later. The surgeon may also place a splint or a rubber band on your teeth to keep your jaw in place and prevent it from moving too much.

Recovery from Jaw Surgery

Following some general steps and guidelines can help you recover faster and better from jaw surgery. Here are a few of them:

• Hospital stay: You may need to stay at the hospital for one to three days after the surgery, depending on the complexity and length of the surgery. During this time, the medical staff will monitor you and administer pain medication, antibiotics, and fluids through an intravenous (IV) line. You may also have a splint or a rubber band on your teeth to keep your jaw in place and prevent it from moving too much.
• Postoperative care:  After you leave the hospital, you must follow the postoperative directions given by your surgeon and orthodontist. These instructions may include taking care of your incisions, cleaning your mouth, using ice packs or warm compresses, managing your pain and swelling, changing your dressings or gauze, and using your fixation devices.
• Pain management:  Pain and discomfort are possible following the surgery, especially in the first few days. You can take painkillers prescribed by your surgeon to relieve your pain. Aspirin and ibuprofen can raise the risk of bleeding; therefore, you should avoid using them. It would help if you also avoid alcohol and tobacco, as they can delay the healing process and cause infection.
• Wound healing: After the surgery, you may have wounds or incisions inside or outside your mouth. Keeping them clean and dry would prevent infection and promote healing. You can use saline water or antiseptic mouthwash to rinse your mouth several times daily, especially after eating or drinking. You should avoid touching or poking your wounds or incisions with your fingers or tongue.
• Swelling reduction: After the surgery, you may have some swelling or bruising around your face and neck. It is normal and will subside gradually over time. Cold compresses or ice packs can be beneficial in minimising swelling and inflammation within 48 hours after the surgery. Apply them for fifteen to twenty minutes several times a day. Avoid using heat or warm compresses, which can increase swelling and bleeding.
• Follow-up visits: You must see your surgeon and orthodontist for regular follow-up visits and adjustments after the surgery. They will track the course of your healing, take out any stitches or wires, and change or remove your splint or rubber band. They will also adjust your braces or other appliances to align your teeth and jaws.

Few Handy Tips for a Smooth Healing Process

To ensure a smooth healing process, you can follow these tips and guides:

• Follow postoperative instructions: You should carefully and faithfully follow the postoperative instructions given by your surgeon and orthodontist. They will provide specific information and advice on caring for yourself and your jaw after the surgery. Avoid deviating from their instructions or doing anything that may compromise your healing or outcome.
• Maintain oral hygiene: Following surgery, you should practise proper dental hygiene to prevent infection and promote healing. You should also brush your teeth gently and carefully, avoiding the surgical site until your surgeon tells you it is safe. You should also floss your teeth regularly, using a soft or waxed floss. You ought to refrain from using mouthwash with alcohol in it because it can irritate your mouth and slow down the healing process.
• Avoid strenuous activities: You may need to refrain from vigorous activities that may increase your blood pressure or heart rate, such as exercise or sports, for at least half a year after the surgery. These activities can cause bleeding, swelling, or pain in your jaw and face. For at least three months after the surgery, you should also avoid activities that may put pressure or stress on your jaw, such as chewing, yawning, or laughing too hard.
• Consume liquid or soft foods: You will be advised against taking solid foods for weeks after surgery, as the jaw will be swollen and sore. Eat soft or liquid food that is easy and healthy, like soups, smoothies, juices, milkshakes, yoghurt, mashed potatoes, and scrambled eggs. Avoid hard, crunchy, sticky, or spicy food, which can hurt or harm your teeth, gums, or the wound. Avoid hot or cold food, which may irritate the mouth and slow down the healing process. Drink water and avoid dryness in the mouth.
• Practice jaw exercises: You may need to do some jaw exercises to help restore your jaw function and mobility after the surgery. Your surgeon or orthodontist will give you some instructions and demonstrations on how to do the practices such as opening and shutting your mouth, moving your jaw from side to side, or sticking out your tongue. You should do the exercises as directed. Overdoing or forcing them may cause pain or damage.

Sources:

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