Article reviewed by:
Dr Ho Kok-Sen • Oral and Maxillofacial Surgeon
Corrective jaw (orthognathic) surgery is a coordinated orthodontic and surgical treatment approach to correct severe jaw position or size discrepancies to improve your bite, speech, functionality and even breathing patterns. Typically, jaw surgery is suitable for those with complex jaw problems that orthodontics treatment alone cannot solve.
An oral-maxillofacial surgeon performs the jaw surgery while an orthodontist aligns the teeth and brings them to meet appropriately into a functional and healthy bite. Both specialists work closely to design and execute a plan customised to an individual’s needs while achieving an aesthetic facial appearance and stable bite.
In this post, here are eight commonly asked questions answered on corrective jaw surgery:
- Am I suitable for surgical orthodontics? Is there a minimum age?
- What is involved in jaw surgery? What can I expect?
- What are the benefits of jaw surgery?
- Are there risks involved for jaw surgery?
- Is it painful? How long is the down time?
- How to prepare for jaw surgery?
- Does medical insurance cover jaw surgery?
- I’m running on a tight work schedule. Can I perform surgery first?
Am I suitable for surgical orthodontics? Is there a minimum age?
Surgical orthodontics treats severe jaw size or jaw position discrepancies. As our jaws house our teeth, when the upper and lower teeth do not fit well, it results in difficulty with biting, chewing or speaking. This procedure may also benefit patients with obstructive sleep apnea or sleep-disordered breathing.
Generally, surgical orthodontics can be avoidable and rectified with orthodontic treatment (braces or clear aligners) if your jaw discrepancy is mild to moderate. While your smile and bite can be corrected alone without surgery, certain misalignments of jaws may still require surgical treatment. As jaw bones are still growing in children, seeking early treatment is beneficial to minimise the need for surgery.
What is involved in jaw surgery? What can I expect?
Generally, jaw surgery is carried out in 4 stages:
1. Treatment planning
During this initial phase of treatment, an oral surgeon will take radiographs and records to assess your dental condition. Your oral surgeon and orthodontist will then work hand in hand to plan the most suitable treatment for you. Treatment will only commence when the patient is agreeable to the treatment plan. Other dental specialists may also be involved should you require other treatment first, such as gum treatment, root fillings or implants.
2. Pre-surgical orthodontic treatment
In most cases, orthodontic treatment is performed before surgery to align the teeth and ensure the jaws and teeth meet correctly during the surgery. Not only does it help to improve your smile and create an optimal function in the new jaw positions, but it also enables you to bite and chew more effectively too. This phase usually takes an average of about 9 to 18 months. However, the total duration is subjective as every individual’s responsiveness differs. Other factors can include the patient’s age, cooperation, general health and compliance. A surgery-first approach may be possible depending on the individual’s dental conditions.
3. Jaw surgery
When your pre-surgical orthodontic treatment is complete, you see your oral surgeon for a review. This visit establishes a final plan before your surgical treatment. Depending on how your teeth have moved, it is possible to have some minor changes in the original treatment plan. Details on what to expect before, during, and post-surgery will also be rediscovered on the same visit to help you better understand and answer any questions that you may have about the procedure involved.
Your medical history will be recorded, and you need a blood test before the surgery. The surgery is done under general anaesthesia.
You will have a customised splint that determines the final position of your upper and lower teeth. Elastic bands are also placed between your braces to support your teeth in a stable position throughout the surgery. These will be placed in position generally for one week until your jaw is stable. Once your jaw is stable, your oral surgeon will teach you how to remove and put these bands back on after meals and during night time for another 5 to 6 weeks to prevent any early relapse.
Subsequently, your dental specialist will take x-rays to track your healing and alignment progress to check on the stability of the surgery.
4. Post-surgical orthodontic treatment
The final phase of orthodontic treatment begins on average six weeks after surgery to fine-tune the positions of your teeth for optimal function and an aesthetic smile. Your orthodontist will instruct you on retainer wear at the end of this treatment.
What are the benefits of jaw surgery?
For some patients with severe skeletal disproportions, orthodontic treatment alone cannot bring the teeth together for a functional and stable bite. Jaw surgery will help achieve a healthier, balanced and functional position of your teeth and jaws. It improves your daily functions with better bite, speech pronunciations, and sleeping patterns. With a better bite and straighter teeth, it is easier to maintain good oral hygiene. It can also significantly enhance your facial appearance and self-esteem. Jaw surgery may also address some patients’ obstructive sleep apnea or sleep-disordered breathing.
Are there risks involved for jaw surgery?
As with all surgical procedures, there will inevitably be some possible risks and complications. They include:
- Excessive bleeding during operation that may require a blood transfusion
- Potential wound breakdown and/or infection post-surgery
- Potential loss of vitality in adjacent teeth
- Temporary partial or complete numbness due to damaged nerves to nerves linked to lips, chin and tongue
- Discomfort at jaw joints
- Permanent change in sensation
Choosing the right and experienced oral and maxillofacial surgeon to perform your surgery will minimise the risks.
Is jaw surgery painful? How long is the down time?
Jaw surgery is done under general anaesthesia, reducing any discomfort felt during the procedure. After surgery, you will be hospitalised for observation for three days. Your oral surgeon will prescribe medications to manage your pain and elevate your healing experience.
Whilst in recovery, it is normal to experience movement constraints to your mouth due to facial swelling. Practicing some simple jaw exercises will improve mouth opening. Typically, patients can slowly transition from a liquid diet to solids (avoiding tough food) as the bones heal two weeks post-surgery. However, every individual’s rate of recovery varies. Thus, your surgeon will update your progress during your follow-up visits. Maintaining good oral hygiene throughout all stages, especially after surgery, is important to reduce post-operative infections.
Other things to avoid whilst in recovery include drinking alcohol and doing strenuous exercises. Avoid sports or activities that may put your jaw at risk for at least eight weeks. Reduce the intensity if you are experiencing any throbbing or pain with physical activity.
How to prepare for jaw surgery?
Months prior to your surgery, you may adopt these three tips to facilitate your treatment and recovery:
- Quit smoking
While smoking is not only health-damaging, it increases the risks of complications during surgery and decreases the healing process after surgery. Smoking may also cause gum disease. To minimize any complications, it is advisable to reduce or quit smoking.
- Plan sufficient time to recover
It is important to have proper and sufficient rest after your surgery to ensure your recovery goes well. Thus, planning your time well in advance is crucial to aid your absence from school or work. As every individual’s healing process differs, you may be able to return to work sooner than expected. Check with your oral surgeon on how long your home recovery will take.
- Understand your post-surgery recovery
In recovery, it is normal to experience movement constraints and pain due to facial swelling. Learn about your recommended diet, how to eat and stay comfortable during this period. Continue taking your prescribed medications upon discharge to ease your home recovery.
Does medical insurance cover jaw surgery?
Depending on your dental condition and insurance coverage, your insurance may cover the surgical portion of jaw surgery. A pre-authorisation request can be made for patients holding integrated shield plans under AIA, Great Eastern, and Prudential companies. When approved, the insurance company will issue a letter of guarantee for waiver of upfront payment. If you do not have insurance coverage, Medisave* may be utilised to cover the applicable fees partially.
*Medisave is only applicable for Singaporeans and Permanent Residents of Singapore
I’m running on a tight work schedule. Can I perform surgery first?
We do perform a “surgery-first approach” for some patients should their dental condition allows. As the name suggests, jaw surgery is performed before orthodontic treatment. Some benefits of adopting this approach include instantaneous improvement in oral function and shorter overall treatment duration due to quicker tooth movement.
Schedule a consult with our dental specialist team to determine if jaw surgery is suitable and which approach is most suitable for you.
Need some dental assistance?
Drop us a text via the WhatsApp icon on the bottom right corner, enquire or call us at (65) 6733 7883.