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Your jaw has two parts: the upper jaw (maxilla) and the lower jaw (mandible).
Jaws often become misaligned during childhood, which can result in crooked teeth and an 'off bite.'
Orthognathic surgery, also called corrective jaw surgery, may be necessary if the jaws are severely misaligned.
Children might undergo orthodontic treatment before and/or after jaw surgery. This depends on the type of jaw misalignment they have.
Jaw irregularities are usually genetic. They can also be influenced by childhood habits like thumb sucking and mouth breathing.
Some examples of bite issues that may require surgery include:
Other indicators for jaw surgery include:
Children are typically the best candidates for surgery because their jaws aren't fully developed. Caught early, jaw discrepancies might be fixable with just orthodontic treatment.
Once the jaw fully develops in adulthood, treatment options for severe misalignment are limited. An orthodontist may recommend jaw surgery at this stage.
There are a few types of jaw surgery available, depending on the severity of misalignment and jaw positioning:
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.
Upper jaw surgery can correct an overbite, crossbite, and open bite.
Mandibular osteotomy surgery, or lower jaw surgery, corrects a severely receded lower jaw. It's commonly used to fix an underbite.
During the procedure, an oral surgeon moves the lower jawbone forward or backward, depending on the patient’s bite alignment.
Genioplasties correct severely receded lower jaws. The chin is also restructured.
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).
An arthroscope (small camera) is inserted into a small incision in front of the ear. Then scar tissue surrounding the joint is removed to relieve pain.
Arthrocentesis uses sterile fluid to wash out the TMJ (temporomandibular joint).
During the procedure, an oral surgeon repositions the jaw, realigns the cartilage disc, and administers a steroid drug into the joint.
The goal is to return the cartilage disc to its correct position and remove any debris inside the joint.
The cost of jaw surgery ranges from $20,000 to $40,000.
Surgery to correct temporomandibular joint dysfunction can cost up to $50,000.
Orthognathic surgery may be covered by health insurance.
Some insurance companies like Aetna consider them medically necessary when the skeletal irregularities cause:
Jaw surgery is considered cosmetic if it's elective and only improves your facial appearance.
Jaw surgery is generally safe. But all invasive surgeries come with risks.
Some possible jaw surgery complications include:
After the surgery, most people can return home the following day. It takes about 6 to 8 weeks for the bones to fully heal.
The recovery timeline for jaw surgery is as follows:
General anesthesia is administered before the procedure. This ensures you won't feel anything during the operation.
After you wake up, your upper lip, gums, and jaw will be numb for a few hours. You also can't drive a car for 48 hours post-op.
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.
For the first few weeks after surgery, your diet should consist of soft foods only. This includes soup, smoothies, mashed potatoes, and scrambled eggs.
You can eat normally once your jaw heals completely. Your surgeon will let you know when it's time.
If your dentist recommends jaw surgery, it's essential to follow their instruction.