Jaw Surgery Questions and Answers

Question:

I've been told I have a pretty severe over bite and should have oral surgery to correct it because it causes serious pain in my jaw and popping when I chew. The way the procedure was described to me is that there would be incisions made on either side of my lower jaw, then they would lengthen it and put screws in my jaw. Is there any way that this surgery can be done with out having to get braces as well?

Answer 1:

The standard of care leans towards orthognathic surgery (ie: corrective jaw surgery) involving atleast an oral & maxillofacial surgeon and an orthodontist. Proper tooth alignment can be critical for a stable and acceptable outcome.

David King, DDS
Wilmington, DE

Answer 2:

Yes, but the results are not as long lasting nor as surgically correct as they can be when done with the assistance of orthodontic therapy. It is considered below the standard of care to do the jaw surgery alone without braces.

Charles McNamara, DMD
Winter Park, FL

Question:

hi, i'm a 31 yr. old female and i believe i have "malocclusion"? an overbite.my top row of teeth almost completely overlaps my bottom row of teeth when i bite..my question is that i've been reading on the net that braces is recommmended for correcting this..does it matter who does this or is it like a plastic surgeon who will create his version of molding depending on his style, the reason why i'm asking is i would like to create a more wider smile since my teeth now which are straight are very narrow and i would like it to expand more outward and also my chin seems to be a little weak, would braces also fix that or do you think i would have to have jaw surgery to correct that. please let me know your opinion about finding a good doctor if it does make a difference on how my outcome of appearance will be..thanks for your patience and time.

Answer:

Rachel, It sounds like you need an orthodontist. Find one who is certified by the American Board of Orthodontics. You may need jaw surgery if you have such a deep bite. If so the orthodintist will direct you to an Oral and Maxillofacial Surgeon.

Charles McNamara, DMD
Winter Park, FL

Question:

Doc, I am 24 yr old & finally have the $$ for braces. I was told that I need surgery as well to move my lower jaw out, since it is recessed. I was told my teeth are slanted far outward so they want to pull teeth in lieu of moving the teeth out. The dr. said without the surgery I could only hope for 50% improvement of my overbite. He said I would wear braces for under two yrs w/ surgery & 2 yrs w/out surgery. I asked how much this surgery would cost. He referred me to the oral surgeon. The oral surgeon told me he would have to see me (even though my orthodontist had lunch w/ him & took my records to discuss my case). Do you have any idea how much Im looking at? I dont want to spend the consultant fee of 250 if I cant afford the surgery. I mean is this 2000 or 5000 or over 10,000? Please help!!!

Answer:

I can't give you an answer without seeing your models, xrays, and doing an exam. Fees vary with the complexity of the surgery, and vary from region t region as well as practice to practice. Most major medical plans will cover jaw surgery if you can prove medical need.

Charles McNamara, DMD
Winter Park, FL

Question:

I have a bad underbite. I had a surgery consult, and had been planning on having the surgery at the end of June. They planned on moving my upper jaw forward and possibly moving the lower one back also. They were also going to shorten my upper jaw. Then I found out my insurance doensn't cover the surgery and it is likely to cost 30-35,000 dollars. I can't afford that! I'm really insecure about my smile, and I have a lot of problems eating. Is there any way to get my insurance company to cover it? Do you know of any companies that do cover that kind of surgery?

Answer:

Kelly, Unfortunate for many, insurance companies often apply the cosmetic surgery rules to orthognathic surgery. They feel the establishment of a functional bite is nothing more than cosmetic surgery, and most companies will not cover cosmetic surgery. It may take a number of appeal and review letters to get the company to assist you. You may need to make a number of calls to the company, and have both your doctor's office and your employee benefits rep make calls, too. If it can be a benefit to any medical problems you have, e.g.TMJ, gastric problems, air way problems you might get a favorable responce. Check also that your benefit handbook excludes or does not exclude corrective jaw surgery. It may mean changing docs, but if they do cover it it may mean you have to see a new provider. Good luck

Charles McNamara, DMD
Winter Park, FL

Question:

Hi. I am a candidate for upper and lower jaw surgery. My lower jaw sits back to far and my upper palete needs to be widened. I am a small framed women. I was wondering if you can give me an idea of what my chances are that a relapse may happen if I have these surgeries? I hear there is a good chance that a relapse will happen after having the lower jaw surgery. Would you be able to give me some more info. on the facts?

Answer:

You should discuss this with the doctor doing your surgery.

Charles McNamara, DMD
Winter Park, FL

Question:

I have tmj and I don't like my physical appearance because of this disorder. Is there anything that can be done to help without having a major jaw surgery?

Answer:

Have you tried wearing a veil? Seriously, your question is so vague I can't even begin to offer you an answer.

Charles McNamara, DMD
Winter Park, FL

Question:

The orthodontist refuses to continue with braces until my daughter has either orthognatic (sp?) surgery on her upper jaw or a partial glossectomy to reduce her tongue size. The surgeon insists on the jaw surgery while my daughter has chosen (only because there have not been alternatives offered) the tongue surgery. I feel like I am backed into a corner. She is 16 and small boned. She has an open bite and cross bite on the left side. Her front teeth are fractionally off center. She was in braces for four years. The first two years seemed to be effective. Unfortunately, we moved before treatment was complete. The second orthodontist, whom I assumed was to continue the treatement, insisted on re-doing everything. Each month he "re-tied" according to his records. We moved again and the third orthodontist (same org as the second) was to complete the treatment. He took off the braces after six months saying four years was long enough. He put her in a retainer. We moved back to our first home and immediately returned to her first orthodontist. He was quite concerned because, after excpanding her palate, one side had partially collapsed creating a crossbite and, she still had an anterior open bite. He said to think about it but we would likely have to start over. He wanted to extract upper and lower bicuspids. The new ortho (who is oushing for the surgery options) says her tongue will likely just push the teeth out again despite the extractions and braces. I hate that she has already gone through so much. It has already cost a lot more than I can afford as a single mom. I don't know what to do or who to contact. In the meantime, I have paid out even more to this orthodontist who claims he can do it once and do it right BUT with the surgery. It never should have come to this and I am extrememly concerned as well as confused. CAn someone help or advise? Thank you Jamey

Answer:

I am confused also! I cant recommend the glossectomy when orthognathics or distraction osteogenesis will do the job. Texas is filled with top notch oral surgeons. get another opinion.

David King, DDS
Wilmington, DE

Question:

Doctor, I am a 35yr old male with a severly receeding chin/lower jaw. This not only looks terrible, but I'm told it probably causes my severe snoring. Can this be corrected by surgery, is it safe procedure, are there risks, do I have to get my teeth realigned first, if I get the procedure would there be scarring?

Answer:

Jeff would be better off calling a local Oral Surgeon in your area to answer your questions. I cannot make an opinion on your case without the use of xrays, and a complete exam. The best I will say is yes,jaw surgery can correct a deficient jaw, and yes,there are risk which any patient must be aware of prior to starting treatment, and yes, often it is done in conjunction with orthodontic treatment, and no, often there are no external scars.

Charles McNamara, DMD
Winter Park, FL

Question:

I have a big lower jaw which I believe causes two problems. First, I experience brief pain at the temporomandibular joint after yawning. Almost always there is some silent cracking sound as I move my lower jaw. And second, I find it difficult to talk clear and loud; as it takes alot of effort to move my big lower jaw up and down. For aesthetic reasons, my daily face posture holds the big lower jaw so the chin is pointing down. But often, phlegm builds up at the back of my throat; which with my face posture, obstructs the air passage and my ability to talk. My question is: Can corective jaw surgery solve both of 'my' big lower jaw problems? Can it clear my air passage so that I can talk more loud and clear? Will it ease the temporomandibular joint pain and make it easier to move it up and down? Thank-you, Joe Yamada

Answer:

The answer to all your questions is yes. I would seek an initial consultation with an orthodontist that is familiar with jaw corective surgery. Good Luck

Question:

I have 2 questions: 1. My daughter who is nearly 7 years old, has inherited Class III, skeletal malocclusion. Two out of three orthos we've consulted recommend starting treatment right now. Treatment would consist of expanding the upper arch and the use of a chin cup with anterior traction to upper teeth. We've read studies that indicate that in the short-term results from this treatment are very effective but that long-term, growth of the lower jaw can resume, in adolescence. What is the success rate for permanent treatment of class III at an early age? Can early treatment lead to greater problems later on to correct additional growth at a later age? Do you recommend treatment at this age? 2. My other daughter who is nearly 9 has excessive overcrowding. Two orthos we've consulted recommend we wait until more adult teeth come out. One ortho recommends the extraction of 7 baby teeth and the use of a space maintainer to allow more room for the adult teeth. Do the baby teeth not already act as a space maintainer, therefore making this apparatus unnecessary? Is there a chance that her jaw will develop normally allowing room for all her adult teeth? What do you recommend? Any info. you can provide would be greatly appreciated, as we are a little confused given the differences of opinion. Thank You

Answer:

1) Class III malocclusions are very difficult to correct. If the discrepancy between the upper and lower jaw is too great, jaw surgery in combination with orthodontics is required to achieve a correction. Consequently, children in the 7 to 9 year range who demonstrate class III growth are frequently treated to re-direct this unfavorable growth. I treat each patient individually addressing their specific circumstances. Sometimes I do begin treatment at 7 years of age. 2) While I can't diagnose a patient without seeing him/her, generally the space for the permanent teeth in front of the first permanent molars has been determined as soon as these molars erupt. There are appliances available to expand the dental arches to some extent. Although all orthodontists have similar goals for the patient, the method of achieving those goals can vary from orthodontist to orthodontist. Sometimes there can be a significant variance in the treatment plan.

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