When people think about braces, they don’t think about surgery. I understand that – I feel the same way. No orthodontist wants to suggest jaw surgery, unless it really makes sense and it can in some cases.
What Braces Can Do – and What They Can’t
Braces are a wonderful tool to align your teeth – finishing the job that nature started. Braces do more than line up your teeth. You also want the upper and lower teeth to fit together so they work together with a good bite. And you want your teeth to harmonize with your face for the best smile. Nature has the same goals. But the jaws don’t always match to give you the best harmony and balance.
The upper and lower jaw can be mismatched in their size and in their position. A small upper jaw could be combined with a larger lower jaw, or a lower jaw could be too far back compared to the upper jaw and the rest of the face. Nature and braces can fit the teeth together in a good way to make up for these jaw imbalances, but there’s a limit to how far the teeth can move.
We may need the teeth to move this much for a good fit and a great smile, but nature may only let the teeth move this much, even with the braces. In these cases, jaw surgery is going to give a better balance and harmony to your face and your teeth.
The fancy word for this jaw surgery is orthognathic surgery. The size and position of the upper and lower jaw affect the way the teeth fit together and on the structure of your face and smile. We’re all unique and our jaws can be in different positions with the teeth fitting together very nicely. Longer narrower faces, shorter wider faces, strong lower jaws, upper jaws more forward and everything in between can look very good and give you a good fit of the teeth with a beautiful smile.
For many, nature does a wonderful job of adapting the teeth to a person’s unique jaw structure to achieve a good fit and that beautiful smile. Braces come into the picture when nature needs some help. Braces work with your body to adapt the teeth to the jaws when nature can’t do enough. And when braces alone can’t give you what you want, surgery maybe something to consider.
Jaw Surgery Is Optional
No one is saying you have to have jaw surgery – it’s an option. It’s going to be up to you to decide if jaw surgery makes sense for you and your smile. It always comes back to you. I want you to feel good about yourself, not only about your teeth and smile, but about this whole process of guiding you to decide what’s best for you.
Some people will decide right at the beginning that jaw surgery isn’t for them. In that case, we’ll do our best with braces alone and that’s a lot. Other people will have family or friends who’ve had jaw surgery and they’re not surprised that we’re talking about it.
They may have a lower jaw that’s too far back and its always bothered them, so jaw surgery can make good sense. Others may not be sure. For those people, it can make sense for them to sit down with the surgeon to find out more and when they’ve gathered the information they need, and thought about it, they’ll know what they want to do. We’re here to support you in all this. Before deciding, some people will want to see how much braces alone can do and I’m happy with that option as well.
What to Expect with Jaw Surgery
So how does jaw surgery work? To begin with, jaw surgery is performed with the braces in place. We spend the first 12 to 18 months lining up your teeth in preparation for surgery and then you’re ready. You’re asleep and it’s done in the hospital. The procedure may involve just one jaw or sometimes both jaws. Everything is done on the inside of your mouth so there will be no visible scars. Small screws and plates are used to attach the bones giving you a better fit of the jaws. Healing is normally uneventful and you now have a better fit of your teeth, a better smile and a better harmony of the upper and lower jaws.
The change in your appearance can be quite dramatic, but often subtle. I know that sounds kind of strange, but it’s the best way to describe it for most people. We’re aiming to give you the smile, facial balance and harmony that nature intended for you. People will tell you that you look great but they will have no idea you had the procedure. Your lower jaw may have come forward to produce a better fit of your teeth, but all people see is the better balance and smile.
The surgery can also provide more room for your tongue and breathing. That can be a real benefit to your health and wellbeing in the future, beyond all the advantages to your teeth and smile. When the lower jaw’s too far back, people will often hold their lower jaw more forward naturally to improve their appearance, and that gives more room for the tongue, which feels better and it’s easier for breathing. Jaw surgery gives you that balance for your health, your teeth and your smile. In other cases, the lower jaw is moved back and that can give your face a younger look, that ages well, with a better smile and a more comfortable fit of your teeth.
Jaw Surgery & Wisdom Tooth Removal
Many people get jaw surgery to remove their wisdom teeth. Not everyone needs this done but for many of us there’s not enough room for the wisdom teeth to come in to become useful and healthy. This can lead to problems, so many people have their wisdom taken out and that’s a kind of jaw surgery too. Jaw surgery can include getting your wisdom teeth out, so you’d have a single procedure and healing and discomfort is comparable when both are done.
But again, if you’re not comfortable with jaw surgery we can do a lot for you with braces alone. And it’s not unusual for us to be talking about surgery for a person in their teens. Parents can, understandably, be uncomfortable with surgery for their child, so we may proceed with braces and then re-evaluate if surgery is required.
Surgery would still be an option in the future of course. We can do the best we can with braces alone and later, if the person wants to consider jaw surgery as an adult, it could be done then. You’d need braces again, but you will have less tooth movement to do.
Discussing surgery is never easy, but I think it’s my job to bring it up if it’s an option for you and your smile. We’re here to help you make the right decision for you. Whatever you decide, we’re here to support and inform you.