Jaw Surgery (Orthognathic Surgery)

The orthodontist is the key provider of care, preparing teeth for upcoming surgery, commonly by using braces to reposition the teeth. Orthodontist and surgeon communication is key duringthis phase, as the surgeon will guide the orthodontist on how to maneuver the teeth prior to jaw surgery, and the orthodontist will guide the surgeon as to how to move the jaw bones to achieve the absolute best occlusion (bite relationship) for you. 

Duration is anywhere from 6-18 months, depending on the severity of the bite/jaw abnormality. A consultation with a surgeon and an orthodontist is essential early, and you should anticipate a prolonged course of therapy prior to surgery. During this phase, your surgeon will outline to you the surgical plan, developed by the careful analysis of your digital photography, x-rays and dental casts.

If you do not have an orthodontist involved in your care, please ask your surgeon for a referral. At UChicago Medicine, we have an expert orthodontist who specializes in this type of diagnosis.

Surgery, as outlined by the surgical plan, is typically performed for about 3-5 hours, depending on the type. Double-jaw surgeries typically take longer than single jaw surgeries. Once again, the surgical plan requires that your surgeon has the following:

• Digital photography -- performed in the surgeon’s studio
• X-rays (panorex, AP/lateral cephalogram, submental vertex view)— provided by the orthodontist
• Dental casts and acrylic splint(s)—provided by the orthodontist

Most surgeries require a 1-2 day hospital stay. In the first 12-24 hours, you are monitored carefully in an ICU/step-down setting. Your diet will be established and a nutritionist will provide you with a customized diet plan tailored to your caloric needs. You will be discharged with appropriate prescription medications to minimize discomfort and prevent infection. Your surgeon will contact you to see how you are doing the day after discharge.

You will be checked by the surgeon to ensure proper healing after surgery and to make sure that the facial and dental relationships are acceptable.

Follow-up visits proceed approximately every 2 weeks until the bones are almost healed (6 weeks). Standard protocol for elastic wear is for the first 2 weeks after surgery in a continuous fashion; after these 2 weeks have passed, you will be placed on a regimen of “guiding elastics,” where the dental elastics are kept on for most of the day and just removed for meals. After the first 2 weeks post-surgery, you will also be switched from a full liquid/pureed diet to a soft diet.

4 weeks after surgery, the dental elastics will be removed and discontinued from the post-surgical regimen. 6 weeks after surgery, you will be referred back to your orthodontist, who will begin the “finishing touches” on the teeth.