The term orthognathic comes from the Greek words “orthos” meaning straighten and “gnathic” meaning of or related to the jaw. So orthognathic surgery is a surgery that “straightens or realigns the jaw.” Orthognathic surgery restores normal jaw function, enhances the quality of life, and provides a boost to one’s self esteem. With dental alignment problems, orthodontic treatments are simply not enough. This is when surgery may be required to correct the problem.  The upper and lower jaws are bases upon which teeth are aligned. Jaw abnormalities may be inherited or acquired from developmental or traumatic events, and may affect not only your facial appearance but also your bite, speech, and/or chewing.  Braces correct dental abnormalities like crooked teeth and poor bites (malocclusion). However, irregularities of jaw size or position can only be corrected surgically.  Corrective jaw (orthognathic) surgery may be needed when some of these conditions are present:

  • Birth defects such as Cleft Lip & Palate
  • Chronic jaw or jaw joint pain (TMJ) and headache
  • Chronic mouth breathing, airway defects
  • Difficulty chewing, or biting food
  • Difficulty swallowing
  • Excessive show of gums (i.e. Gummy smiles)
  • Excessive wear of the teeth
  • Facial asymmetry
  • Inability to make the lips meet without straining
  • Open bite (space between upper and lower teeth when the mouth is closed)
  • Protruding or receding lower jaw and chin
  • Sleep apnea (breathing problems when sleeping, including snoring)
  • Speech impairment
  • Trauma to head and face
  • Unbalanced facial appearance from the front, or side
Generally this involves more than one specialty: the dentist, orthodontist, and OMS (oral and maxillofacial surgeon), and at times the restorative prosthodontist — all working together to determine if you are a candidate for corrective jaw surgery. The OMS will determine which surgical procedure is appropriate and will perform the actual surgery. It has been estimated that nearly 5% of the population in the UK or USA are suffering with dental or facial deformities that cannot be easily corrected with orthodontic treatment, and will need orthognathic surgery to correct their condition.  However braces may be needed before and after surgery to stabilize the teeth and jaw, and perhaps retainers after braces are removed.  Orthodontics are continued after surgery to achieve final alignment of the teeth and to retain them in their new position. Some of the main goals of orthognathic surgery are to achieve a correct bite, improve facial appearance, and alleviate breathing problems by enlarging the airway. Correcting sleep apnea is one of the most effective treatments with orthognathic surgery, showing a 90–100% success rate. Orthognathic surgeries are meticulously planned using computer imaging, skeletal analyses, sketches, and even mock up surgeries on plaster models. This provides the surgeon with details to create precise templates used during surgery to position the jaws. Before surgery, X-rays and photos are usually taken to facilitate effective planning. Computer software can be used to visualize how the patient’s face will look after surgery, which is useful both for planning and for explaining the surgery to patients and their families. The surgery is usually done in a hospital, with one post-op night included.  Because of the miracles offered by modern technology, the procedures most frequently used today are accomplished by operating completely inside the mouth, and the length of the surgery has been reduced from ten hours to three or four. In earlier times it was fairly normal to have one’s teeth wired shut for up to seven weeks. Back in the 70′s and 80′s patients reported the greatest discomfort came from having their teeth wired shut. With today’s methods that is hardly ever necessary and the patient can usually resume jaw movements like speaking, yawning and coughing, almost immediately. Most patients are asked to maintain a liquid or soft diet (the consistency of mashed potatoes or scrambled eggs) for four to six weeks following the surgery to allow sufficient time for the bone to heal. While there is minimal pain following the procedure, there will be swelling (peaking in three to five days, most of it subsiding within ten days), nasal and sinus congestion (resolving in five to seven days), and some difficulty eating and chewing food.  The convalescence period is short, usually around ten days, before returning to school or work. If you are interested in orthognathic surgery in Costa Rica, fill out the “Find a Dentist” form on this page.  One of our patient advocates will reply to your needs.