A carefully designed preoperative handout is essential for an elective procedure which will change a patients face, body image and will also risk complications. There are several available, however below is the one to be considered as a useful model.
Orthognathic surgery corrects the relationship of the jaws to give improved jaw function and facial appearance.
Orthodontics
In almost all cases orthodontic treatment is required before the operation for about 18 months in order to ensure that the teeth are in the ideal relationship afterwards. This dental correction also helps to give the best possible appearance, function and stability following the operation.
Fixed braces are the standard means of orthodontic treatment and they are also invaluable during the operation to achieve the correct relationship of the jaws.
The Operation
This is carried out under a general anaesthetic and carries no risk in a fit young adult. In most cases the patient needs to be in hospital from 1-3 days after the operation.
Today, the bones are fixed during the procedure by miniature titanium plates and screws which are left in place without any harm or inconvenience. Occasionally a plate or screw may need to be removed if it is causing discomfort or gets infected. There are rare situations where the jaws need to be fixed together with wire or elastics after the procedure for up 4 weeks.
It is helpful to bring a small, soft tooth brush into hospital to help keep the teeth and wires clean. An antiseptic mouth wash (for example, chlorhexidene — Corsodyl) is important after your last daily meal.
Problems
Postoperative swelling is to be expected, which may give way to bruising over a period of 2 weeks. In most cases, pain is not a problem and can be controlled with mild painkillers. Most patients need to be away from work for 10 days to 2 weeks depending on their job and how they feel.
Numbness of the lower lip, upper lip and palate is possible depending on the operation. More than half of patients have some degree of short term numbness which in most cases gradually recovers. Small persistent areas tend to diminish in time are and generally not noticeable. There is no disturbance in muscle function.
Diet
It is important to keep the teeth free of decay throughout the treatment procedure and a careful choice of diet is essential. You must avoid sweet sticky foods, soft drinks and an excess of fruit juice. Hard foods must be cut up before chewing as they may damage the brace. Tooth brushing twice a day with a fluoride tooth paste is essential. The postoperative diet is initially liquid and then liquidised for 2-3 weeks. The dietician will advise you or a diet sheet will be given with this handout.
Postoperative Orthodontics
After the operation there is usually a short period of orthodontic fine tuning for about 6 months before the braces are removed.
This combination of orthodontics and surgery will improve your appearance, The details will depend on the procedure and must be discussed with the orthodontist and surgeon so that you do not have any unrealistic expectations of improvement.
Most cases take 2-3 years overall for completion. During this time regular appointments with be required to adjust the brace and review progress.
It is also essential that you have regular dental checkups to avoid serious dental decay.