Orthognathic Surgery (Jaw Surgery)

Orthognathic surgery is needed when jaws don’t meet correctly and/or teeth don’t seem to fit with jaws. Teeth are straightened with orthodontics and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required for the jaws when repositioning is necessary.

Difficulty in the following areas should be evaluated:

• Difficulty in chewing, biting or swallowing
• Speech problems
• Open bite
• Protruding jaw
• Breathing problems

Any of these symptoms can exist at birth, be acquired after birth as a result of hereditary or environmental influences, or as a result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team can make the decision to proceed with treatment together.

Technology & Orthognathic Surgery

If you are a candidate for corrective jaw surgery, Dr. Morgan will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.

Orthognathic Surgery Post-Operative Instructions

Hospital Stay

• Immediately post op: you will likely recover from the anesthesia in the Post Anesthesia Care Unit (PACU). You will then be transferred to a room depending on hospital bed availability. Plan to spend one to two nights in the hospital.
• During your care in the PACU: a hospital nurse will monitor and assist you. They will provide you with medications for pain/antibiotics/nausea, etc. as instructed by your surgeon.
• While in your hospital room: A nurse will care for you as directed by the surgeon. Intravenous fluids and medications for pain, swelling, antibiotics, and nausea will be provided to you. You may be instructed to walk during this period to assist with your recovery.

What to expect in the first 24 Hours:

•     Medications: Medication will start through the IV fluids and will transition to oral to let you leave the hospital
•   Swelling increases over the first 3 days after surgery. In order to help reduce the swelling 
•  Keep your head elevated.
•    Apply ice to your face. Expect facial swelling during this period. Keep any dressings around your face intact until your surgeon visits you the next morning.

Diet:

• Your initial diet is clear liquids only (water, juice, broth, etc.).
• Take in as much fluid as is tolerable while awake. A full glass of water (8oz) every 3 hours is what’s needed to leave the hospital.

Bleeding:

• Expect minor bleeding and oozing of blood from your surgical wounds and nose for the first 24-48 hours.

Numbness:

• You can expect to feel some numbness of your lower lip, chin, cheeks, tongue, and teeth (for lower jaw surgery) and your upper lip, cheeks, nose and teeth (for upper jaw surgery.
• Expect limited jaw mobility after your surgery.
• You may be required to have an X-ray at the hospital, or later at the office.

Oral Hygiene:

• Rinse with Peridex solution twice a day and brush your teeth at the same time starting the day after surgery.
• If you are able, use a small (child sized) tooth brush to keep your teeth clean. Be careful around the incision sites, which will be in the upper vestibule of the mouth (for upper jaw surgery) or near the molar teeth along the back sides of the lower jaw (for lower jaw surgery).
• Depending on the type of surgery you may have a plastic splint wired to your upper teeth to help guide your bite into the right location. You may also be asked to use elastic bands around your braces to help guide your teeth into the correct bite.

Special Instructions for maxillary (upper jaw) surgery:

• Do not blow your nose or sneeze through your nose for the first 10 days (if you sneeze keep your mouth open). Take any additional antibiotics/medications (nasal decongestants, nasal sprays) as directed by your surgeon.

Upon discharge from the Hospital – At Home:

Swelling

• Expect swelling to worsen over the first 3-5 days. It will gradually resolve over the next few weeks. You can help this by continuing to ice the face. Give the skin a chance to recover by only using the ice packs for 20-30 minutes at a time.
• Keep your head elevated to help reduce the swelling. Sleep with extra pillows for at least the first 3 days after the procedure
• You may get a dose of steroid into your muscle before you leave the hospital to help reduce the swelling.

Bruising:

• Bruising may come with the swelling. The bruising should begin to resolve as the swelling subsides. The bruising may travel in the skin down the neck and into the upper chest.

Diet:

• A full liquid diet is all that is initially permitted. Take care in the first week to stay hydrated. Suggestions for the initial phases include milk shakes, smoothies, juices, jello. Avoid alcohol. You may remove the elastics to eat and replace them as you are able
• After the first week, begin to focus on adequate caloric intake. You can expect to eat 6-7 smaller meals rather than 3 large meals per day.

Numbness:

• The numbness to the face will persist for many weeks to months. As the numbness resolves there may be a tingling sensation in the affected areas.

Activity:

• Do no over exert yourself during the first 2 weeks after surgery. You may return to light house work or other daily activities after the first week.
• Light exercise is ok after 2 weeks. No contact sports for the first 6 weeks after the surgery.

Hygiene:

• You may remove the elastics for hygiene but replace them as instructed.
• Use Peridex mouth rinse 2-3 times a day for the first 14 days. Use a small tooth brush to keep the areas clean as well.
• You may also rinse the mouth with salt water throughout the day to sooth the wounds. You should not use a water pik for the first 14 days after surgery.

Follow up:

Be sure to return for your first weekly visit with your surgeon at day 5-7 after surgery.