About five percent of the U.S. population will benefit from corrective jaw surgery. Many of these patients will have a malocclusion or an abnormal bite that cannot be corrected from an orthodontic standpoint. This is an elective surgery that requires that the patient have a period of pre-surgical orthodontics surgery itself and then post-surgical orthodontics. They have to personally be invested in the process of having a good outcome in regards to moving forward through all these different steps to complete the procedure and the whole process. Usually, we try to move forward with orthotic surgery or corrective jaw surgery when a patient reaches skeletal maturity. For females, we often say they reach skeletal maturity around 15 to 16 years of life, whereas males more frequently reach skeletal maturity a little bit later, often around 18 to 19 years of life. Now that being said, the actual deformity that the patient has is very important for determining when surgical intervention is needed. Corrective jaw surgery is really a team approach, and it requires excellent orthodontic care both before surgery and after surgery. To coordinate the jaws to get the teeth in appropriate alignment to optimize the surgical outcome.
Frequently, during the pre-surgical phase of orthodontics, I’ll be in close coordination with the orthodontist to discuss the progress that the patient is making and when he or she may be ready for surgery, which is ultimately an orthodontic decision. Virtual surgical planning really allows us to not only educate our patients using three-dimensional images, but it also allows me as the surgeon to explore different treatment options. In doing so, I can have a much better understanding as to what the outcome will be if I do x procedure versus y procedure. And that information is incredibly powerful for both me as a surgeon and the patient as well in regards to making decisions as to what treatment they want to pursue.
Healing from jaw surgery usually takes approximately six weeks, and so for that six-week period, patients do have activity and dietary restrictions that they must adhere to. And one of the biggest challenges with jaw surgery is not actually the pain itself associated with surgery, but really it’s the diet I put patients on after surgery, and that can be very challenging. The good news is I spend a lot of time with families pre-operatively talking about what to expect and exploring options for how to manage that, and patients ultimately do great with it. But being on a restricted diet for six weeks can be very challenging. For most patients, the first two weeks tend to be the hardest. After the first two weeks, the swelling really improves pretty significantly such that by three to four weeks, somebody can go to the grocery store, and of course, their family knows they had surgery, but the clerk checking them out doesn’t necessarily know that. By weeks five and six, patients feel really excellent. Yes, they are still swollen. They’re still healing, but overall they look really good, and most people can’t even tell that they had surgery that recently.