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Your jaw has two parts, including the upper jaw (maxilla) and lower jaw (mandible). Sometimes, children develop misaligned jaws, which can result in crooked teeth and a bad bite.
Orthognathic surgery, also called corrective jaw surgery, may be necessary if a child's jaws are severely misaligned. Also, children who need surgery often receive orthodontic treatment (such as braces and headgear) before and after surgery.
Jaw irregularities are usually genetic but can also be influenced by long-term childhood habits (e.g., thumb sucking or mouth breathing).
Other indicators for orthognathic surgery include:
Children are typically the best candidates for surgery because their jaws are not fully developed.
Once the jaw fully develops in adulthood, treatment options for severe misalignment are limited. An orthodontist may recommend orthognathic surgery at this stage of life.
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There are a few different types of orthognathic surgeries available, depending on the severity of misalignment and your jaw positioning. Five common types of jaw surgery include:
Maxillary osteotomy surgery corrects a severely receded upper jaw. During the procedure, an oral surgeon makes an incision in the gums above the teeth in the upper jaw.
The surgeon cuts, breaks, and moves the upper jaw into the correct position. Then, they attach a small plastic wafer to the teeth to help align the upper jaw. The jaw is fixed in place with titanium screws and metal plates.
Mandibular osteotomy surgery corrects a severely receded lower jaw. During the procedure, an oral surgeon moves the lower jawbone forward or backward, depending on the patient’s bite alignment. Lower jaw surgery commonly treats underbites.
Similar to mandibular osteotomies, genioplasties also correct severely receded lower jaws. During this procedure, an oral surgeon restructures the jaw and chin. Often times, an oral surgeon combines lower jaw surgery and chin surgery into the same operation.
Temporomandibular joint dysfunction (TMD) causes severe pain in the jaw and muscles that control jaw movement. An arthroplasty or arthrocentesis surgery may be used to correct TMD:
The most common operation to correct temporomandibular joint dysfunction is an open-joint arthroplasty (keyhole surgery). During the procedure, an arthroscope (small camera) is inserted into a small incision the surgeon makes in front of the ear. Then the surgeon removes any scar tissue surrounding the joint to relieve pain.
Arthrocentesis uses sterile fluid to wash out the TMJ (temporomandibular joint). During the procedure, an oral surgeon repositions the patient’s jaw, realigns the cartilage disc, and then administers a steroid drug into the joint. The goal of the surgery is to return the cartilage disc to its correct location and remove any debris inside the joint.
The cost of jaw surgery typically ranges between $20,000-$40,000. However, surgery to correct temporomandibular joint dysfunction can cost up to $50,000.
If you have health insurance, orthognathic surgery may be covered in some cases. For example, some insurance companies (e.g. Aetna) consider jaw surgeries to be “medically necessary” if the skeletal irregularities cause sleep apnea disorder, breathing issues, and/or severe speech impediments.
Orthognathic surgery is “cosmetic” if the procedure is elective and only improves your facial appearance.
Before the procedure, general anesthesia is administered. This ensures you will not feel anything during the operation. You cannot drive a car for 48 hours post-op.
When you wake up, the upper lip, gums, and jaw will be numb for a few hours. Although, some people experience numbness for months following surgery. This is because an oral surgeon cuts the nerves during the procedure, which requires time to re-grow.
After orthognathic surgery, most patients can return home the following day. Although, it takes about six to eight weeks for the bones to fully heal. During this time period, it is important to take it easy and not disrupt the healing.
The recovery timeline for jaw surgery is as follows:
For the first six to eight weeks after surgery, your diet should consist of liquids only. This includes soups, smoothies, mashed potatoes, and ice cream, among others. After your jaw heals completely, normal eating patterns can return.
“Jaw Surgery.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 Jan. 2018, https://www.mayoclinic.org/tests-procedures/jaw-surgery/about/pac-20384990.
Khechoyan, David. “Orthognathic Surgery: General Considerations.” Seminars in Plastic Surgery, vol. 27, no. 03, 2013, pp. 133–136., doi:10.1055/s-0033-1357109.
“TMJ (Temporomandibular Joint and Muscle Disorders).” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/health-info/tmj/more-info.
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