When is Orthognathic Surgery Medically Necessary? Understanding the Indications

Are you having difficulties chewing or swallowing food? Is your speech impaired or are you experiencing chronic jaw pain? These symptoms may indicate the need for orthognathic surgery, a procedure that corrects abnormalities in the jaw bone. While our society often associates jaw surgery with cosmetic enhancement, it is medically necessary for those suffering from severe jaw misalignment that cannot be corrected with braces or other non-surgical methods.

Orthognathic surgery is not a quick fix or an option for minor jaw discrepancies. Rather, it is a major surgical procedure that requires careful consideration by a team of specialists, including an oral surgeon, an orthodontist, and a maxillofacial surgeon. The surgery involves repositioning the jawbone to correct misalignment and improve function. Ultimately, the goal of orthognathic surgery is to improve the patient’s ability to speak, eat, and breathe while reducing any discomfort or pain that they may be experiencing.

While undergoing orthognathic surgery is a significant decision, it is often medically necessary for those experiencing severe jaw misalignment. If you are having trouble with basic functions such as eating, speaking, or breathing, it may be time to consult with a specialist and explore your options. Orthognathic surgery could significantly improve your quality of life and open up new opportunities for a more fulfilling and pain-free future.

Definition of Orthognathic Surgery

Orthognathic surgery, also known as corrective jaw surgery, is a complex surgical procedure that aims to correct severe jaw deformities and improve the overall function and appearance of the patient’s face. This type of surgery is performed by oral and maxillofacial surgeons who specialize in the diagnosis, treatment and management of various diseases and conditions affecting the hard and soft tissues of the face, mouth and jaws.

Orthognathic surgery is typically performed on patients who have jaw-related problems that cannot be corrected through non-surgical procedures such as braces or orthodontic treatments. These problems may be congenital or acquired, and can have a major impact on the patient’s ability to chew, speak, and breathe properly, as well as affect their facial appearance and self-esteem.

  • Common reasons for orthognathic surgery include:
  • Malocclusion (misaligned bite)
  • Facial asymmetry
  • Cleft palate and lip
  • Growth abnormalities of the jaws
  • TMJ disorders
  • Chronic jaw pain and headaches
  • Sleep apnea and breathing difficulties

Before undergoing orthognathic surgery, patients usually undergo extensive evaluation and planning by their oral and maxillofacial surgeon, which may include 3D imaging, dental impressions, and other tests to determine the nature and extent of the deformity and how best to correct it.

Dentofacial Deformities

Dentofacial deformities are malformations of the face, jaws, and teeth, and can be caused by a variety of genetic and environmental factors. These deformities affect not only the appearance of the face, but also the function of the mouth, making it difficult to perform basic activities such as eating, speaking, and breathing. They can also lead to other health problems, such as chronic headaches and sleep apnea.

  • Malocclusion: This refers to when the teeth and jaws do not fit together properly
  • Class 2 Malocclusion: This is a malocclusion where the upper teeth are overlapping the lower teeth too much or the lower teeth are too far back
  • Class 3 Malocclusion: This is a malocclusion where the lower teeth are overlapping the upper teeth too much or the upper teeth are too far back

Orthognathic surgery is medically necessary in cases where these dentofacial deformities are severe enough to impact a person’s quality of life. The surgery involves realigning the jaw and teeth to correct the deformity and improve function. The following are common dentofacial deformities that can require orthognathic surgery:

Open bite: This occurs when there is a gap between the upper and lower teeth even when the mouth is closed

Underbite: This occurs when the lower jaw protrudes or the upper jaw recedes, causing the lower teeth to overlap the upper teeth

Overbite: This occurs when the upper jaw protrudes or the lower jaw recedes, causing the upper teeth to overlap the lower teeth

Dentofacial DeformityOrthognathic Surgery Procedure
Open BiteMaxillary impaction and mandibular setback
UnderbiteMaxillary advancement and mandibular setback
OverbiteMaxillary impaction and mandibular advancement

Orthognathic surgery can be a life-changing procedure for those with dentofacial deformities, improving both appearance and function. It is important to consult with a qualified oral and maxillofacial surgeon to determine if this surgery is medically necessary and appropriate for you.

Risks associated with Orthognathic Surgery

Orthognathic surgery is a complex surgical procedure that involves moving the jaw bones to improve an individual’s bite, speech, and overall oral health. Although the surgery has been proven to be safe and effective, like all surgical procedures, it is not without risks. Here are some of the commonly associated risks with orthognathic surgery.

  • Bleeding: Any surgery comes with the risk of bleeding. During orthognathic surgery, the surgeon will make incisions in the gums, which can lead to bleeding. The bleeding is usually minimal and can be controlled by applying pressure to the area. However, in rare cases, excessive bleeding can occur, which may require blood transfusions or additional surgery.
  • Infection: Infections can occur after any surgical procedure. In some cases, the surgeon will prescribe antibiotics to prevent infections. However, in other cases, infections can occur despite precautions. The signs of infection include fever, redness, swelling and tenderness around the surgical site. If you notice any of these symptoms, it’s important to contact your surgeon immediately.
  • Nerve Damage: During orthognathic surgery, the nerves that control the mouth and face can be at risk. Nerve damage can cause a wide range of symptoms, including numbness, tingling, weakness, and paralysis. In most cases, the damage is temporary, and the nerves will heal within a few weeks to several months. In rare cases, however, the damage can be permanent, leading to long-term sensory and motor deficits.

Other risks: There are other risks associated with orthognathic surgery as well, including:

  • Difficulty opening your mouth wide
  • Difficulty speaking or swallowing
  • Misaligned bite
  • Jawbone fracture
  • It’s important to understand that these risks are rare, and most individuals who undergo orthognathic surgery experience positive outcomes. Working with a qualified and experienced surgeon, following pre- and post-operative instructions, and ensuring adequate aftercare can help minimize the risks and improve the chances of a successful outcome.

    Recovery Period after Orthognathic Surgery

    Orthognathic surgery is a complex and invasive procedure that involves the realignment of the jaws to correct conditions such as a malocclusion or a misaligned bite. One of the most important aspects of this surgery is the recovery period. Here are some important things you need to know about the recovery period after orthognathic surgery.

    • The length of the recovery period varies from person to person and depends on the extent of the surgery. Typically, patients require 2-4 weeks off from work or school to allow their bodies to heal and recover.
    • The first week after surgery is the most difficult, and patients should expect some discomfort and pain. Pain medication will be prescribed to help manage this during the initial stages of recovery.
    • During the first week, patients will also experience swelling and limited mobility of the jaws. They will be required to adhere to a strict liquid or soft food diet and use ice packs to help manage swelling.

    It’s essential to follow the post-operative instructions provided by your surgeon to ensure a smooth and successful recovery. These instructions may include:

    • Avoiding strenuous physical activity and limiting movement for several weeks
    • Applying ice packs to the face to reduce swelling
    • Taking prescribed pain medication as directed
    • Eating a soft or liquid diet for a specified period of time
    • Maintaining good oral hygiene, including brushing with a soft toothbrush and using mouthwash to prevent infection

    It’s also essential to attend all follow-up appointments with your surgeon and bring any concerns or questions you may have to their attention. The following table provides a general timeline for the recovery period after orthognathic surgery:

    Time frameActivities
    First weekStrict liquid or soft food diet, limited mobility, ice packs, pain medication, and rest
    Weeks 2-4Gradual return to normal activities, soft food diet, continued pain medication, and follow-up appointments with your surgeon
    Months 1-3Continued follow-up appointments with your surgeon, soft food diet, and gradual return to normal activities
    Months 4-6Braces and orthodontic treatment to complete the realignment of the teeth

    The recovery period after orthognathic surgery is an essential time for allowing your body to heal and for ensuring the success of the procedure. By following your surgeon’s post-operative instructions and attending all follow-up appointments, you can expect a smooth and successful recovery.

    Alternatives to Orthognathic Surgery

    Orthognathic surgery is a complex procedure that requires careful consideration by the patient and oral surgeon. It involves the repositioning of the jaw, and is typically carried out to correct a significant jaw discrepancy that can cause issues with speaking, eating, and even breathing.

    However, orthognathic surgery is not always the only option for those with jaw discrepancies. For some individuals, alternative treatments may be effective in resolving their issues without the need for surgery. Here are some alternatives to orthognathic surgery:

    • Braces or clear aligners: For individuals with mild to moderate jaw discrepancies, orthodontic treatment may be effective in correcting the issue. By using braces or clear aligners, the teeth can be moved into a more optimal position, which can in turn help to correct the jaw alignment.
    • Functional appliances: These are custom-made dental devices that help to reposition the jaw by changing the way the muscles and bones interact. They can be used to treat certain types of jaw discrepancies, such as overbites and underbites.
    • Jaw exercises: For some individuals, practicing specific jaw exercises may be effective in strengthening the muscles and improving the alignment of the jaw. These exercises can be recommended by an oral surgeon or physical therapist.

    Of course, it’s important to note that none of these alternatives will be effective for everyone. The best course of action for someone with a jaw discrepancy is to speak with an oral surgeon who can evaluate their specific situation and recommend the most appropriate treatment option. In some cases, orthognathic surgery may still be necessary.

    The Risks of Avoiding Orthognathic Surgery

    While alternative treatments may work for some individuals, it’s important to consider the risks of avoiding orthognathic surgery. Depending on the severity of the jaw discrepancy, not addressing the issue could lead to long-term health problems.

    For example, a severe overbite or underbite can cause issues with chewing and swallowing, which could result in malnutrition. Additionally, some individuals may experience chronic jaw pain or difficulty breathing if their jaw is not properly aligned.

    If you’re considering an alternative treatment option for your jaw discrepancy, it’s important to speak with an oral surgeon who can provide you with an accurate assessment of the risks involved. In some cases, orthognathic surgery may be the safest and most effective option for achieving optimal jaw alignment and improving overall health and well-being.

    Advantages of Orthognathic SurgeryDisadvantages of Orthognathic Surgery
    Corrects significant jaw discrepanciesInvolves a long and complex recovery process
    Improves overall oral functionPotential for complications, such as infection or nerve damage
    Can improve the appearance of the faceRequires general anesthesia
    Can improve breathing and reduce snoringCan result in temporary numbness and swelling in the face and lips

    Overall, it’s important for individuals with jaw discrepancies to carefully consider all of their treatment options in order to determine the best course of action. While orthognathic surgery may be the most appropriate option for some, others may benefit from alternative treatments such as braces or functional appliances.

    Addressing Sleep Apnea through Orthognathic Surgery

    Sleep apnea is a serious condition that can result in significant health problems if left untreated. It is characterized by interruptions in breathing during sleep that can last for up to a minute or more. These interruptions can occur hundreds of times throughout the night and can lead to a range of issues, from headaches and fatigue to heart disease and stroke.

    While there are several treatments available for sleep apnea, orthognathic surgery is often recommended in cases where the condition is caused by structural issues with the jaw and/or airway. This type of surgery can help to reposition the jaw and open up the airway, allowing for more consistent breathing during sleep. Here are some benefits of addressing sleep apnea through orthognathic surgery:

    • Improved quality of sleep
    • Reduced risk of health complications associated with sleep apnea
    • Reduced snoring

    Before deciding on orthognathic surgery for sleep apnea, it is important to have a full evaluation by a qualified healthcare professional. This evaluation will help to determine the underlying causes of the condition and whether or not surgery is the right option. In some cases, other treatments may be recommended instead.

    If surgery is recommended, patients will typically undergo a series of imaging tests to evaluate their jaw and airway structure. From there, a surgical plan will be developed that takes into account the patient’s individual needs and goals. The surgery itself is typically performed under general anesthesia and involves repositioning the jaw to open up the airway.

    While recovery time can vary depending on the individual case and the extent of the surgery, most patients are able to return to normal activities within several weeks. Following surgery, patients will typically be monitored closely to ensure that their breathing and other vital signs are stable.

    ProsCons
    Effective in addressing sleep apnea caused by structural issuesMay require a significant recovery period
    Can improve overall quality of life for patientsMay not be covered by insurance
    Can reduce the risk of health complications associated with sleep apneaCan be expensive

    Overall, orthognathic surgery can be an effective option for addressing sleep apnea caused by structural issues. While there are some potential downsides to the procedure, many patients find that the benefits outweigh the risks and are able to enjoy improved quality of life as a result.

    Orthognathic Surgery and TMJ Dysfunction

    Orthognathic surgery is a corrective procedure that is used to address issues with the alignment of the jaws and teeth. It is a treatment option that is typically recommended for individuals who have problems with their bite or jaw alignment that cannot be corrected through orthodontic treatment alone.

    One of the conditions that orthognathic surgery may be medically necessary for is TMJ dysfunction. TMJ, or Temporomandibular Joint Dysfunction, occurs when there is pain or discomfort in the jaw joint and surrounding muscles. This can cause difficulty with normal jaw movement, including chewing and speaking.

    • When conservative treatments, such as physical therapy and pain-management medications, fail to provide relief, orthognathic surgery may be necessary to improve the alignment of the jaw and reduce pressure on the TMJ.
    • Orthognathic surgery can also be used to address issues with muscle tension and overuse that contribute to TMJ dysfunction.
    • By realigning the jaw and reducing tension on the TMJ, orthognathic surgery can improve symptoms of TMJ dysfunction, including pain, stiffness, and difficulty with jaw movement.

    In addition to addressing TMJ dysfunction, orthognathic surgery may also be necessary for individuals who have experienced trauma to the jaw, have a congenital jaw deformity, or have breathing difficulties that are caused by a misaligned jaw.

    Overall, orthognathic surgery is an effective treatment option for individuals who have malocclusion or jaw alignment issues that cannot be corrected through orthodontic treatment alone. It can also be an effective solution for individuals who are experiencing TMJ dysfunction and have not found relief through conservative treatments.

    ProsCons
    Can improve alignment of jaws and biteMay require extensive recovery time
    May improve breathing difficultiesMay involve risks associated with anesthesia and surgery
    May improve TMJ dysfunctionMay require multiple procedures

    Before considering orthognathic surgery, it is important to discuss the risks and benefits of the procedure with a qualified oral and maxillofacial surgeon and orthodontist. They can provide guidance on whether orthognathic surgery is medically necessary and what the best treatment options are for individual cases.

    FAQs: When is Orthognathic Surgery Medically Necessary?

    1. What is orthognathic surgery?
    Orthognathic surgery, also known as corrective jaw surgery, is a procedure used to correct various abnormalities of the jaw and face.

    2. When is orthognathic surgery medically necessary?
    Orthognathic surgery is medically necessary when a person’s jaw or facial structure causes problems speaking, eating, or breathing.

    3. What conditions can benefit from orthognathic surgery?
    Orthognathic surgery can benefit individuals with conditions such as sleep apnea, an overbite, or an underbite.

    4. How do I know if I need orthognathic surgery?
    If you are experiencing trouble speaking, eating, or breathing due to abnormal jaw or facial structure, consult with your doctor or an orthodontist to see if orthognathic surgery is an appropriate treatment.

    5. What are the risks of orthognathic surgery?
    As with any surgery, there are risks associated with orthognathic surgery. These risks include bleeding, infection, and damage to nerves or surrounding tissue.

    6. How long is the recovery period after orthognathic surgery?
    The recovery period after orthognathic surgery can vary, but typically takes several weeks to a few months for complete healing.

    7. Will insurance cover the cost of orthognathic surgery?
    Whether or not insurance will cover the cost of orthognathic surgery depends on the individual’s specific insurance plan. It is important to check with your insurance company prior to undergoing surgery.

    Thanks for Reading!

    If you think you may need orthognathic surgery, consult with your doctor or orthodontist to determine if it is an appropriate treatment. Remember to check with your insurance plan about coverage, and be aware of the potential risks associated with any surgery. Thanks for reading and visit us again for more helpful health information!