A combined treatment is required if not only teeth and molars have to be moved, but the jaw itself is also changed in shape by means of surgery.
For example if:
- There is a lot of gums visible above your upper teeth when you smile;
- You just don't see any teeth when you smile;
- You think your lower jaw is too far forward;
- You risk losing your teeth because your jaws are wrong in relation to each other.
You may have thought for years about taking the step for this treatment, not surprisingly, it is a major step, even though it is "only" about a few millimeters of jaw shift. Practice has shown that surgery on your face is always literally "radical". Nowadays it is therefore not uncommon for psychological counseling to be offered during jaw operations. With changing your face you partly change your current way of life, especially if the operation takes place in adulthood. Children with dental and jaw problems nowadays automatically end up at the age of twelve at an orthodontist. If a jaw operation is necessary or desirable in their case, they are already "in the mill". For you as an adult, it will be your own request to your dentist to be referred to the orthodontist, or your dentist has advised you. You may not have had the opportunity to go to an orthodontist in the past or you may have had braces and the result is still disappointing, that does not matter for your choice.
What are the preparations for treatment?
The preparations for this treatment are extensive. The orthodontist and dental surgeon look together at the options for your teeth during the combined consultation, sometimes also with your own dentist. X-rays and face photos will be made, you will have to bite for making plaster models. Most likely a letter will also be drawn up for your insurer with a request for reimbursement of the costs of treatment. Moreover, it is well discussed with you that your face will change as a result of the operation. Usually that is exactly what you want and you will be happy with it, but it doesn't hurt to prepare for it. The treatment proposal that follows from this intake can be very different from what you had expected. Perhaps you "just want the large lower jaw to be a little smaller" and the treatment proposal is precisely to move the upper jaw forward. The orthodontist and dental surgeon are very experienced in viewing facial profiles, let them explain well why they propose a certain procedure and what end result they have in mind. They have "before and after" photos available for many operations, which can also help you make the decision.
Is the treatment painful?
Before the operation you will be admitted to the hospital and you will go under anesthesia. You will therefore not notice the treatment itself.
How often do I have to come to the practice?
For the entire process you first get appointments during the combined consultation hours for the intake and the discussion of the treatment. Usually two or three appointments.
This is followed by the procedure at the orthodontist, you will have to come for a consultation every four to six weeks. After an initial period of a few months, your teeth will look good enough to start the operation. You will then receive an appointment for the jaw operation. Your wishes can be taken into account, maybe you want to plan the operation during a holiday? You will be admitted to the hospital for the jaw operation for approximately three days. You can count on it that you still need a week after the operation to recover. Your jaw heals in about six weeks. It is possible that small corrections with elastics will still be made during the healing period. After the healing period you continue with the orthodontic treatment. Your dental check-ups will continue during this period. All in all, you will spend about two to two and a half years on the total treatment.
What inconveniences can I expect during treatment?
- The inconvenience of wearing braces;
- Hospitalization for the jaw operation;
- The healing period afterwards, about a week long, you will not feel well. Your face is still thick, you can't eat easily and you may still have bruises. After the operation you must rinse with chlorhexidine to provide extra protection for your teeth. Your teeth will turn brown. Your dentist can polish this away afterwards.
The orthodontist will start treatment.
During the operation, the dental surgeon will saw through your lower jaw and / or upper jaw in certain places and move them to a different position. The new position is fixed with small titanium screws. The screws disappear invisibly under your gums. You don't notice anything about the screws in the jawbone, these screws remain in the jaw and no longer need to be removed.
Which additional objections can I expect?
The post-operative objections are mainly caused by the swelling.
After the jaw operation your face will be swollen, you will immediately receive cold packs and medication to prevent swelling as much as possible. Some have bruises on the face after surgery. The bruising and swelling disappear automatically in the week after the operation.
Remarkably little is complained about after pain, often not even painkillers are needed after the procedure. You leave the hospital after a day or two. On the outside of your mouth there is, apart from the swelling and sometimes a single bruise, not much to see.
The lower jaw nerve runs in your lower jaw, which, among other things, provides the feeling in the lower lip and chin. This nerve can be damaged during the operation, which can lead to a decreased feeling in the lower lip. This almost always recovers spontaneously within a few months.
What can go wrong?
An operation always involves risks, such as after bleeding or a wound infection. After the jaw operation you will receive antibiotics to prevent the latter. Bleeding during or after the procedure is rare, but must be reported for completeness. Occasionally the feeling in the lower lip does not fully recover.