Info about Corrective Jaw Surgery

I never knew anything about the world of jaw surgery so I thought I would post some info about it.  It is awesome and crazy all that surgeons can do to fix someones jaw.   I made this post for friends and family that didn't understand why I was even doing this surgery since they thought I looked fine and don't understand how neccesary this surgery is for me.  I actually have almost all the conditions listed below.  ugh.

 The info below is from http://www.aaoms.org/jaw_surgery.php

Corrective Jaw Surgery

Corrective jaw, or orthognathic, surgery is performed by Oral and Maxillofacial Surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.
Following are some of the conditions that may indicate the need for corrective jaw surgery:

• difficulty chewing, or biting food
• difficulty swallowing
• chronic jaw or jaw joint (TMJ) pain and headache
• excessive wear of the teeth
• open bite (space between the upper and lower teeth when the mouth is closed)
• unbalanced facial appearance from the front, or side
• facial injury or birth defects
• receding chin
• protruding jaw
• inability to make the lips meet without straining
• chronic mouth breathing and dry mouth
• sleep apnea (breathing problems when sleeping, including snoring)

Who Needs Corrective Jaw Surgery?

People who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or "occlusion," problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws.

Evaluating Your Need for Corrective Jaw Surgery

Your dentist, orthodontist and Oral and Maxillofacial Surgeon will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. The Oral and Maxillofacial Surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your Oral and Maxillofacial Surgeon and orthodontist understand that this is a long-term commitment for you and your family.They will try to realistically estimate the time required for your treatment.
Corrective jaw surgery may reposition all or part of the upper jaw, lower jaw and chin. When you are fully informed about your case and your treatment options, you and your dental team will determine the course of treatment that is best for you.

Correction of Common Dentofacial Deformities

Correcting an Open Bite: Some of the bone in the upper tooth-bearing portion of the jaw is removed. The upper jaw is then secured in position with plates and screws.

Correcting a Protruding Lower Jaw: The bone in the rear portion of the jaw is separated from the front portion and modified so that the tooth-bearing portion of the lower jaw can be moved back for proper alignment.

Correcting a Receding Lower Jaw or "Weak Chin": The bone in the lower portion of the jaw is separated from its base and modified. The tooth-bearing portion of the lower jaw and a portion of the chin are repositioned forward.

What Is Involved in Corrective Jaw Surgery?
Before your surgery, orthodontic braces move the teeth into a new position. Because your teeth are being moved into a position that will fit together after surgery, you may at first think your bite is getting worse rather than better. When your Oral and Maxillofacial Surgeon repositions your jaws during surgery, however, your teeth should fit together properly.
As your pre-surgical orthodontic treatment nears completion, additional or updated records, including x-rays, pictures and models of your teeth, may be taken to help guide your surgery.
Depending on the procedure, corrective jaw surgery may be performed under general anesthesia in a hospital, an ambulatory surgical center or in the oral and maxillofacial surgery office. Surgery may take from one to several hours to complete.
Your Oral and Maxillofacial Surgeon will reposition the jawbones in accordance with your specific needs. In some cases, bone may be added, taken away or reshaped. Surgical plates, screws, wires and rubber bands may be used to hold your jaws in their new positions. Incisions are usually made inside the mouth to reduce visible scarring; however, some cases do require small incisions outside of the mouth. When this is necessary, care is taken to minimize their appearance.
After surgery, your surgeon will provide instructions for a modified diet, which may include solids and liquids, as well as a schedule for transitioning to a normal diet. You may also be asked to refrain from using tobacco products and avoid strenuous physical activity.
Pain following corrective jaw surgery is easily controlled with medication and patients are generally able to return to work or school from one to three weeks after surgery, depending on how they are feeling. While the initial healing phase is about six weeks, complete healing of the jaws takes between nine and 12 months.

Enjoy the Benefits

Corrective jaw surgery moves your teeth and jaws into positions that are more balanced, functional and healthy. Although the goal of this surgery is to improve your bite and function, some patients also experience enhancements to their appearance and speech. The results of corrective jaw surgery can have a dramatic and positive effect on many aspects of your life. So make the most of the new you!

ORAL AND MAXILLOFACIAL SURGEONS: AN IMPORTANT LINK

Oral and maxillofacial surgery is the specialty of dentistry that includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
An oral and maxillofacial surgeon is a graduate of an accredited dental school who has completed an additional four or more years of training in an accredited, hospital-based oral and maxillofacial surgery residency program.
Oral and maxillofacial surgeons are an important link in the referral network for primary care providers. Through appropriate referrals, patients can be provided with expedient and cost-effective health care for conditions relating to the specialty of oral and maxillofacial surgery.

Before pics

8-19-2008 Before braces
You can see the baby tooth that was a shell on top of the adult tooth.

12-9-09

3-3-11
Adult tooth is now completely up but there is a huge permanent gap next to it.

The pictures below are very embarrassing.  They show everything I dislike about my jaw and always try to hide.  When my orthodontist started taking these pics for my records I honestly hated that they even existed.  I never planned on anyone other than my ortho and surgeon ever seeing them.  I finally decided that I was ok that I had them when I saw how much my mouth was changing and getting better because of my braces.  I'm still embarassed that my teeth looked like this and I can't wait until this is all a distant memory.  These pictures show my jaw and smile at its worst and not how it looks to people in everyday life.  I will later add some pictures of me "posturing" my jaw to make it look normal. 

8-19-08

3-26-09

3-3-11

7-27-11

9-20-11

Iit looks like my jaws tilt down on my left now because of my rubberband.

11 mm overjet :(

with upside down V rubberband

resting expression (lips don't touch)

My "good smile" that I try to do for all pics. 
I used to be able to do it more naturally but my smile has changed a lot
 because of the way my braces have moved my jaw.

Big gummy smile I usually try to hide. 
Can't wait until my gummy smile is a distant memory.

From the beginning

I'm not sure when I started developing an overjet but I remember being very aware of it when I was a teenager.  As I got older I would have to do my "good smile" for me to like any pictures of myself.  If I was genuinely happy when a picture was taken of me I would have a huge gummy smile with lots of teeth showing.  Not cool. 

In my 20s I noticed that my jaw would pop in and out of place most of the time and I would have a lot of pain.  Sometimes my jaw would hurt so much and lock.  Sometimes my jaw would lock so tight I couldn't get a spoonful of cereal in my mouth.  I never told my dentist because I was afraid of what he would say.  How do you fix a jaw other than surgery?  I honestly didn't even know that surgery was the answer but I hoped it wasn't.  If I knew the results of this surgery sooner I would have asked for it years ago.  Amazing.  I hope I'm not the exception to that.

Summer of 2008 I finally told my dentist about my jaw pain and he told me to see an Orthodontist.  I made an appointment with a local Ortho and he scared me to death.  I can't believe I didn't run out in tears.  He looked in my mouth for a long time and said he didn't know how I could even eat.  He explained that my upper jaw was too narrow and too far forward, my lower jaw was too far back and none of my teeth touched at all.  Apparently I move my jaw in a funny, unnatural way to get my teeth to touch enough to eat.  All my chewing was done on my back right side of my mouth and I was overworking that side of my face and causing the jaw pain.  The look on his face as he explained all of this was total shock and he didn't understand how I didn't know all of this yet.  I was not happy when he said the only solution was breaking both of my jaws with surgery.  I felt horrible that I didn't know that I was totally jacked up and not one dentist had ever told me that my jaw was severly not normal.  He actully used the word "deformity."  Awesome.

After the shock wore off I called a ton of dentists for 2nd options.  One of the dentists I called gave me some answers.  He told me he had the surgery and that I definatly would benefit from it.  He gave me the info about the ortho and oral surgeon he used and I called them right away.  I met with both of them and they explained their plans for my jaws and made me feel at ease with this whole world I didn't know existed.  I also shared with them that my husband and I were planning on getting pregnant with our last baby soon and I asked if I could fit my new jaw plans around our plans.  They said I could but it would extend things a little.  That was fine with me. 

My ortho explained that my bottom jaw was going to take longer than my top jaw because of a baby tooth I still I had.  A baby tooth!  I was 29, how did I still have a baby tooth?  When I was a kid I cracked my first molar and swallowed half of it.  I went to a dentist and they removed the other half but never put a spacer in, thinking my tooth below would just fill in the spot soon.  Well, it wasn't ready and the tooth in front of it slowly started tilting and blocking it.  I could see the tooth below it and just thought it was not a big deal and just cosmetic.  My ortho explained that the trapped tooth was actually a second baby tooth with an adult tooth deep in my gums.  I also needed my wisdom teeth pulled to make more room for the movement they needed before surgery.  December 2008 I got my lower braces on at 29.  I felt too old for braces and silly sitting in the room with all the teenagers. 

I had 3 wisdom teeth and the baby tooth pulled in January 2009 by my oral surgeon while completly knocked out and he put a thin gold chain anchored around my adult tooth deep in my gums.  He attached the chain to my lower wire.  At my adjustments my ortho cut links off my chain to slowly pull my tooth up from my gums.  tI was shortened every 6-10 weeks and took forever to come up.  I don't remember how long but it was forever and hurt a lot. The worst part was the adjustments when they couldn't slide the wire though the chain loop because it wouldn't reach.  They would have to tie elastic thread through the loop and knot it repeatly around the wire.  The elastic thread would rub on the inside of my cheek and rip it apart.  Wax couldn't stick on the thread so I had to just wait until my cheek stopped being raw and just got used to it.   I remember waking up one night feeling like someone was trying to pull my tooth out of my mouth because the pressure on my tooth was too much. 

I had to wait until my wisdom teeth were pulled to try to get pregnant and was finally cleared by my surgeon and ortho.  I got pregnant in March and had my son in November and was thrilled that I was able to have our baby all while staying on track with my jaw.  My lower tooth was taking forever on its own, like my ortho thought it would, so the baby didn't end up extending my timeline.  I was scheduled to get my upper braces on December 2009 and my ortho was anticipating me being ready for surgery 6 mos later.  My son would only be 7 mos old at my surgery time and I wanted him to be at least 1 year so I decided to postpone my upper braces for 7 more months and goet them on July 2010.   We were all expecting my jaw to be ready for surgery around December 2010 but my jaws were not cooperating.  That problem tooth ended up causing more problems.  As it came up it made my lower jaw do funny things.  It dipped down really bad over the months it came up.  My whole left lower side of my jaw dipped drastically lower than my right side.  By the time my tooth came all the way up my jaw looked like a rollar coaster on one side.  I was happy that it wasn't noticeable to anyone else because my lower teeth were hidden behind my lower lip.  December 2010 my ortho added a fun rubberband in the shape of an upside down V from my upper jaw to my lower jaw on my left side of my face.  I was not a fan.  I had to wear one rubberband during the day and double it up at night.  It was also very painful.  I finally got rid of my chain pulling on my tooth and now I had pain from the rubberband.  Night again was the worst.  I would wake up in the early morning hours and unhook it and throw them on the floor because it was so painful.  Most of the time I didn't know I took them off because I would do it in my sleep.

My possible surgery dates kept getting brought up at my appointments with my ortho.  He kept giving me approximate times he thought I would be ready and it was such a tease.  December 2010 he said I might be ready in March.  In March he said I might be ready in June or July.  July he said I might be ready in August or September and he told me that I was ready to see my surgeon.  I was so excited that I was finally close.  Saw the surgeon end of August and he said I needed one more adjustment in September and I could get my final molds in October and possibly surgery at the end of October or beginning of November.  Woo hoo!  Saw him early October and he told me I needed to go back to my ortho to make my mouth passive and come back end of October.  I was so disappointed and in shock when he told me that.  He gave me an appointment for final molds October 24th and said I should have surgery about 4-6 weeks after that date.  It really seemed like it was never going to happen.  My braces are passive now and I'm hoping and praying that my appointment tomorrow really is the last one before I finally get my official surgery date.  I'm so ready for this long journey of getting to surgery to be done so I can start the journey of healing after surgery.