Do I still need to see my regular dentist?
Yes. It will be important that you still have regular check-ups with your usual dentist throughout your treatment.
Your orthodontist will not be checking your teeth for decay.
Archives: FAQs
Why do I need orthodontic treatment as well as an operation?
If your jaws are to be moved into an improved position, it is important that your teeth are also moved so that they will meet better after the operation.
Fixed “train track” type braces are fitted about 18 months before surgery (but it may take longer). They are worn for up to six months after surgery, until the teeth are finely adjusted and stabilised.
Lastly, there will be a period where a removable retainer brace is worn at night that holds the teeth in their new position.
Why is surgery needed?
We only perform jaw surgery if it is appropriate, if the patient wants it to be done and the patient is keen to undergo treatment.
It is not always possible to change your teeth and bite using only braces (orthodontics). This is because the bones of your face and jaws, in which the teeth sit, may be out of balance with one another.
Orthognathic surgery is able to improve large gaps between the jaws and balance the shape of your face.
Who will be treating me?
Your treatment is carried out within Sheffield Teaching Hospitals, and is led by a team made up of consultants: a maxillofacial surgeon and an orthodontist
Our consultant orthodontists are qualified orthodontists who have undergone specialist hospital training to enable them to treat your complex problems.
Our consultant maxillofacial surgeons have undergone a full surgical training coupled with dental expertise.
All surgeons are on the General Medical Council Specialist List for Oral and Maxillofacial Surgery.
Sometimes other health professionals may need to be involved in your care. This might include dietitians, speech and language therapists, clinical psychologists and psychiatrists.
Jaw surgery procedures
Double jaw surgery (Bimaxillary osteotomy)
During this surgery the upper and lower jaws are cut precisely, to avoid damaging important structures like the teeth and the nerves which give feeling to the upper and lower lips, gums and roof of the mouth. The upper and lower jaws are then repositioned to correct the bite of the teeth.
The jaw bones are then fixed using plates and/or screws, which allow the bone to knit together and to heal in the correct position. These are very small titanium plates and screws, which normally stay in place indefinitely.
Braces are then used to settle the bite over a period of at least six months.
Surgery aims to produce a well balanced facial appearance and a good functioning bite.
Lower jaw surgery (Mandibular osteotomy)
During this surgery the lower jaw is cut precisely, to avoid damaging important structures like the teeth and the nerves which give feeling to the lower lip. The lower jaw can then be repositioned to correct the bite of the teeth, and to improve the position of the chin.
The jaw bone is fixed by plates and/or screws, which allow the bone to knit together and heal in the correct position. These are very small titanium plates and screws, which normally stay in place indefinitely.
Braces are then used to settle the bite over a period of at least six months.
The aim is to produce a well balanced facial appearance and a good, functioning bite.
Upper jaw surgery (Maxillary osteotomy)
During this surgery the upper jaw is cut precisely, dividing the top jaw and repositioning it in a new position, correcting the bite of the teeth.
The jaw bone is fixed by plates and/or screws, which allow the bone to knit together and heal in the correct position. These are very small titanium plates and screws, which normally stay in place indefinitely.
Braces are then used to settle the bite over a period of at least six months.
The aim of the operation is to produce a well balanced facial appearance and a good, functioning bite.
Chin surgery (Genioplasty)
During this surgery the chin is divided and repositioned in its new position.
The chin bone is fixed by small titanium plates, which allow the bone to knit together and heal in the correct position. These plates normally stay in place indefinitely.
The aim of this surgery is to produce a well balanced facial appearance.
Upper jaw widening surgery (SARPE)
During this surgery the roof of your mouth is surgically divided.
After a period of 3 – 5 days’ healing, you will be instructed to turn the screw in your upper brace appliance to gently widen the top jaw in very small amounts. You will carry on turning the screw, twice every day, for a number of days, until the desired widening is achieved.
This will produce a large gap between your upper central incisors, which will gradually start to close as your teeth drift towards each other over the next few months. New bone forms in the gap, and fixed braces are then used to straighten your teeth and further close the gap.
What does the operation involve?
The operation is carried out inside the mouth, so there are no external scars.
Occasionally, tiny incisions, less than 4 mm in length, are made on the face on the bridge of the nose or under the jaw line, but these are usually virtually invisible a few weeks after surgery.
What is orthognathic surgery?
Orthognathic surgery is an operation to reposition the jaws within the face.
The operation aims to improve the gap between the lower and upper jaws, which will enable the teeth to bite together better. This also has the benefit of balancing your facial appearance.
Most patients are delighted with the results, and although there may be some difficult times during the treatment, once it is over the benefits are often significant.
Should I worry about jaw joint problems?
It is important to realise that the jaw joint problems, although a
nuisance, are not sinister, and usually respond to relatively simple
measures over time. Patients themselves can manage most of these
treatments.
Occasionally, jaw joint problems may return after several weeks.
It is very rare for jaw joint problems to progress to arthritis.
What happens if these methods don’t improve things?
Surgery is carried out in only a very small number of cases. This can
involve manipulation or washing out of the joint space whilst you are asleep.
In extreme cases, it may be necessary to open the joint and operate on the bones, cartilages and ligaments.
What are the treatments?
Treatment varies, depending on whether you are suffering from
myofacial pain dysfunction, internal derangement of the temporomandibular joint, or a combination of both.
On the whole, treatment is aimed at trying to reduce the workload of the muscles, to align the disc of cartilage to return to a normal position in the joint.
Some of these treatments are:
- A soft diet that requires little chewing; this allows overworked
muscles to rest. - Painkillers and anti-inflammatory medications (e.g. Nurofen) are good and can be either taken as tablets or applied as gel on the outside of the joint.
- Heat, e.g. warm water in a hot water bottle (avoid boiling water) wrapped in a towel and applied to the side of the face.
- Identifying and stopping any habits, such as chewing or grinding. Remember that these may be subconscious, i.e. you may not be aware of them.
- Relaxation therapy and learning techniques to control tension and stress.
- Jaw joint exercises. The exercises that are best for you, will have been discussed by the doctor seeing you. Please remember to carry them out as instructed.
- Resting the joint as much as possible, e.g. avoiding yawning
widely. - Providing a clear plastic splint that fits over the teeth and is worn mainly at night. This helps support the joint and the surrounding muscles.
- Physiotherapy
- Replacing missing teeth to balance the bite. If this is appropriate, it will have been discussed with you.
