Jaw Surgery
Jaw surgery (orthognathic surgery) corrects misaligned jaws. It can treat conditions like TMJ disorders, malocclusion (“bad bites”) and obstructive sleep apnea. It’s a complex process that requires a lot of downtime. But it has a success rate of nearly 94%. Your dental provider might recommend jaw surgery when nonsurgical treatments aren’t enough.
Corrective jaw surgery (orthognathic surgery) changes the structure of your jawbone and brings your upper and lower jaws into proper alignment. Misaligned jaws can negatively impact your bite and make eating and speaking more difficult.
Jaw surgery isn’t a single event. It’s a two- to three-year process that combines surgery and orthodontics. Specifics vary for everyone, but here are the basics:
- Orthodontic treatment prepares your teeth for jaw surgery.
- Jaw surgery aligns your upper and lower jaws.
- Continued orthodontic treatment helps your teeth move into and stay in their final positions.
While there are some exceptions, most people can’t have jaw surgery until their jaws stop growing — usually in the late teenage years.
The three main types of corrective jaw surgery are:
- Maxilla surgery (maxillary osteotomy): Used when your upper jaw sticks out too much or too little.
- Mandible surgery (mandibular osteotomy): Necessary when your lower jaw sticks out too much or too little.
- Double jaw surgery (bimaxillary osteotomy): Recommended when you have a condition that affects both jaws.
Oral and maxillofacial surgeons or other head and neck surgeons use jaw surgery to treat:
- Broken jaws.
- Cleft lip and palate.
- Jaw cancer.
- Jaw cysts and tumors.
- Malocclusion (including overbite, overjet and underbite).
- Obstructive sleep apnea (OSA).
- Prognathism (when one or both of your jaws stick out).
- TMJ (temporomandibular joint) disorders.
- Undersized or oversized jaws.
You might need jaw reconstruction surgery after an accident or injury. This procedure may involve placing jaw implants to restore your appearance.
You’ll probably be on a liquid diet for about a month after your procedure. So, it’s a good idea to stock up on things like soups, smoothies, soft fruits and cooked vegetables you can liquefy using a blender.
Arrange for a trusted friend or family member to drive you to and from your appointment. You’ll be under anesthesia and will need someone to accompany you.
You can also make things easier on yourself if you get your medications filled at the pharmacy in advance. That way, when you come home from your jaw surgery, you’ll already have everything you need.
Before beginning your surgery, a healthcare provider will give you general anesthesia. That means you’ll be asleep and shouldn’t feel pain during the procedure.
What happens next varies depending on your unique situation. In general, during orthognathic surgery, your surgeon will:
- Make incisions (cuts) to access the affected area; they usually make the incisions inside your mouth, but they might need to make one or two small incisions on your outer jaw.
- Create small cuts in your jawbone.
- Place your jaw in the desired position.
- Remove, reshape or add bone as needed.
- Secure your jaw with surgical screws, wires or plates.
- Close your incisions.
- Dress the surgical wound.
- Place a splint over your teeth for stability.
Corrective jaw surgery is a complex procedure. It can take anywhere from one to four hours to complete.
You might go home the same day as your jaw surgery. But you’ll probably need to stay in the hospital for one to three days. During this time, your healthcare team will make sure that you’re healing as expected.
Following jaw surgery, it’s normal to develop side effects like:
- Bruising.
- Jaw swelling.
- Nasal congestion.
- Sore throat.
- Tenderness.
These side effects should ease up after a week or two. Most people can return to work or school after three to four weeks. If you have pain that doesn’t go away with medication, let your surgeon know.
Orthognathic surgery can correct conditions that nonsurgical treatments can’t. For example, braces can move your teeth into new positions. But they can’t move your jaw or change its shape.
Jaw surgery is a complex procedure. But it’s the only way to change the skeletal structure of your mouth.
Orthognathic surgery has a success rate of around 93.9%. Most people who have it report an improved quality of life.
Like any major surgery, corrective jaw surgery comes with risks and possible complications.
General risks after surgery are:
- Excessive bleeding.
- Infection.
- Reaction to anesthesia.
Complications specific to jaw surgery could include:
- Dental damage.
- Difficulty opening your mouth as wide as you’d like.
- Jaw pain.
- Lingering numbness around your mouth after surgery.
- Scarring.
Initial jaw surgery recovery should take about six weeks. But your jaw will continue to heal over the next several months. It might be a year before your jaw heals completely.
Every person’s recovery is different, but most people can resume light activity — like brief walks — after the first week or two. Talk to your healthcare provider before adding any exercise to your daily routine.
Here are some tips that can help during jaw surgery recovery:
- Don’t forget your splint. Your healthcare provider will give you a splint to help your mouth muscles adjust to your new jaw position.
- Elevate your head. Using pillows to prop up your head will help reduce facial swelling.
- Ice your jaw. You’ll need to keep ice packs on your outer jaw over the first 24 hours. Apply the ice pack for 20 minutes on, 10 minutes off, then repeat as needed.
- Keep your orthodontic appointments. If you have braces, you’ll continue wearing them for six to nine months after surgery. You’ll need regular follow-ups during this time.
- Stick with a soft diet. Balanced meals are especially important during recovery. Ask your surgeon how to include nutrient-rich foods in your diet.
- Take your meds as prescribed. Your healthcare provider will prescribe medication to reduce your risk of pain and infection.
- Wear your retainer. After your braces come off, you’ll need to wear a retainer to keep your teeth in their new positions.
When should I call my healthcare provider?
Call your surgeon right away if you develop:
- A fever higher than 100.4 degrees Fahrenheit (38.3 degrees Celsius).
- Pain that gets worse instead of better.
- Shortness of breath.
- Signs of infection (discharge, your skin feels hot to the touch).
- Vomiting or diarrhea that doesn’t go away.
References
- Al-Asfour A, Waheedi M, Koshy S. Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction (https://pubmed.ncbi.nlm.nih.gov/29373200/). Int J Oral Maxillofac Surg. 2018 Jun;47(6):726-731. Accessed 11/6/2024.
- American Academy of Oral and Maxillofacial Surgeons. Corrective Jaw Surgery (https://myoms.org/what-we-do/corrective-jaw-surgery/). Last updated 4/2021. Accessed 11/6/2024.
- American Society of Plastic Surgeons. Orthognathic Surgery (https://www.plasticsurgery.org/reconstructive-procedures/orthognathic-surgery/glossary). Accessed 11/6/2024.
- Yan A, Chen YR. Orthognathic Surgery to Enhance the Smile (https://pubmed.ncbi.nlm.nih.gov/36396264/). Clin Plast Surg. 2023 Jan;50(1):81-89. Accessed 11/6/2024.
- Zammit D, Ettinger RE, Sanati-Mehrizy P, Susarla SM. Current Trends in Orthognathic Surgery (https://pubmed.ncbi.nlm.nih.gov/38138203/). Medicina (Kaunas). 2023 Nov 30;59(12):2100. Accessed 11/6/2024.
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