Download A Guide for Patients Undergoing Orthognathic Surgery

Maxillo-Facial Out Patient Department
A Guide for Patients Undergoing Orthognathic
Surgery
What is Orthognathic Surgery?
This is the surgical repositioning of one or both jaws to achieve a stable and balanced working
occlusion (bite). It is carried out in cases where orthodontics alone cannot provide a suitable or
stable occlusion at end of treatment. Surgery can also improve patient profile and give them
greater self-confidence.
When surgery has been recommended along side orthodontic treatment, you will find a highly
motivated team doing their best to make the treatment outcome a successful one. The team
includes:
The Orthodontist - aligning your teeth
The Maxillofacial surgeon - carrying out the surgery
The Technician - carrying out model planning & constructing appliances
The Orthodontic nurse – assisting the orthodontist and providing oral health instructions
Your general dentist - looking after your oral health
A typical treatment plan, for example, would be as follows:
1.
Removal of the wisdom teeth. This is especially important in the lower jaw, as the wisdom
teeth lie where the mandible (lower jaw) is split to set it forwards or backwards.
2.
Fixed orthodontic appliances (braces). These are fitted and checked by the orthodontist.
They are adjusted approximately every six weeks until ready for surgery, usually after
about twelve to eighteen months.
3.
Up to date x-rays and impressions are taken of your newly aligned teeth shortly before
surgery. Jaw movements are planned and acrylic (plastic) wafers are made to ensure
correct jaw positioning in surgery.
If you need this information in another format or language 01536 492510
Further information about the Trust is available on the following websites:
KGH - www.kgh.nhs.uk | NHS Choices - www.nhs.uk
Ref: PI.640 February 2013
Review: November 2014
4.
The surgery is carried out by the Maxillofacial surgeon, at either Kettering General Hospital
or Northampton General Hospital
5.
After surgery, orthodontic treatment is continued for up to four months, to ensure accurate
interlocking of the upper and lower teeth. During the first six weeks after surgery weekly
visits are necessary to settle the bite.
6.
The fixed orthodontic braces are removed and removable retainers are fitted. Then annual
appointments are made for a period of two years after surgery.
Questions and Answers
Is surgery really necessary?
If you have been given this option then the chances are that it is. You probably have an
underlying jaw discrepancy, which although it could be masked or camouflaged by orthodontics
alone, would in the long run turn out to be unstable and could exaggerate certain aspects of
your facial appearance such as a big chin or a small upper jaw.
Is having no treatment at all an option?
Yes it is an option. At best you will remain the same. However if left your bite may deteriorate
and cause problems later.
Am I the right age for this treatment?
Surgery is usually carried out once growth of the face is completed. This is from late
adolescence on, but then can be carried out at any age. However, in mature adults, tooth
movement in the orthodontic stage may take slightly longer.
How long will my operation take?
A single jaw procedure takes about two hours.
A two - jaw procedure lasts about three and a half hours.
How long will I be in hospital?
Approximately two to three days, depending on your progress and how well you are feeding.
Although feeding will be difficult at first, good nutrition is vital to optimise the healing process. It
is advisable to eat very well the week before you come in to hospital, as you may lose weight in
the first few weeks after surgery.
When will I be able to eat solid food?
For a period of up to ten days after the surgery you will be wearing a thin plastic wafer between
your teeth to hold your jaws in the planned position. You will continue to wear elastics between
your upper and lower braces until the braces are removed approximately three months after the
surgery.
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For the first three to four weeks, the elastics cannot be removed and you will be on a liquid diet.
After this, you will be shown how to remove the elastics for eating and cleaning your teeth, but
you will need to eat only soft food until six to eight weeks after surgery. Following that, you can
eat a normal diet, although the braces will be in place for a few more weeks.
Is breathing a problem while my jaws are held together?
For the first couple of days after surgery your nose may feel blocked and there may be some
irritation of your throat, but it will pass quickly. Even though your teeth will be held together, you
will still be able to part your lips and breathe through your mouth.
Will my speech be affected?
After the operation and particularly while the wafer is in place during the first ten days, speech is
affected and you may be difficult to understand. Once the wafer is removed, your speech will
improve.
Will I be swollen after the operation?
Yes, but some people swell much more than others. Any swelling will appear and increase
during the first forty-eight hours after the operation. However after this time you should see an
improvement and a reduction in swelling.
Some bruising may occur, and some people bruise more than others. The bruising can last for a
few weeks and can extend down to the upper chest area.
Will I have a scar?
All the jaw surgery is done from inside the mouth, so there are no facial scars. However, a small
incision may be made at the angle of your lower jaw which usually heals without leaving a
significant mark.
Are there any adverse side effects from surgery?
There is a possibility that the nerve running through your lower jaw may be bruised during
surgery. If it is then you may experience some numbness around your chin and your lower lip.
In most cases this is temporary and feeling will return. In approximately 4 – 5% of cases full
sensation does not return, but this does not affect the lip movement, function or appearance in
any way.
How long will I be off work / away from college?
You can resume normal light activities after about a week. You should be able to return to work
or college / university approximately four weeks after surgery. You will, however, need to return
to have your braces and elastics adjusted during this time.
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Once I have my braces off, what happens?
Once the braces are removed there will be a period of “retention”. This is to allow the teeth to
settle and become firm in their new positions. You will be given a set of removable retainers to
wear every evening and night for a period of six months, and then a minimum of two nights per
week indefinitely. You will also be seen for review at one year and two years after your surgery.
Contact Information
If you have any concerns or queries, please contact:
The Maxillofacial Department
Monday – Friday, 9am to 5pm
 01536 492360
Outside of these hours please ring Northampton General Hospital
and ask for the Maxillofacial Senior House Officer on-call
 01604 634700
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