Specialty Orthodontics

Surgical Orthodontics

Surgical orthodontics, also known as orthognathic surgery, is a type of orthodontic treatment used to correct severe cases that include bad bites, jaw bone abnormalities, and malocclusion. Oral and maxillofacial surgery is one of the nine recognized dental specialties, and it focuses on treating complex craniofacial cases that involve the mouth, jaw, face, and skull. If you need surgical orthodontics, your orthodontist will work with an oral and maxillofacial surgeon to ensure that you receive the best care possible.

When might surgical orthodontics be needed?

Surgical orthodontics may be used to treat adults with improper bites or other aesthetic concerns. Typically, jaw growth stops by age 16 in females and 18 in males. In order to receive orthognathic surgery, the jaw must be done growing. The need for surgical orthodontics occurs when the jaws do not line up correctly, and a proper bite cannot be achieved with orthodontic treatment alone. Orthognathic surgery will help properly align the jaw, and orthodontic braces will then be used to move the teeth into their proper position.

How does orthognathic surgery work?

An oral and maxillofacial surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about a two-week rest period. Since orthognathic surgery is a major treatment, we recommend that you schedule some time away from work and school during the healing process. After your jaw has healed, your orthodontist will once again “fine-tune” your bite. After surgery, you will have to wear braces, and most braces are removed within six to 12 months following surgery. After your braces are removed, you will wear a retainer to help maintain your new smile.

Craniofacial Orthodontics – Cleft Lip & Palate

Craniofacial orthodontics is a sub-specialty of orthodontics that focuses on the treatment of patients with birth defects such as cleft lip and palate. The orthodontist will work with a team comprised of speech pathologists, oral surgeons, and craniofacial plastic surgeons in planning treatment to correct cleft lip and palate, as well as other jaw and face abnormalities. As a member of a craniofacial team, a craniofacial orthodontist evaluates tooth and jaw development and growth. He or she takes care of the non-surgical treatment of the position of the jaws, and is also responsible for the pre- and post-operative treatment of jaw surgery, monitoring growth by means of X-rays and models.

What is a Cleft Lip and Palate?

Cleft lip and cleft palate are facial malformations in which the parts of the face that form the upper lip and mouth remain split, instead of sealing together before birth. Similar splits can occur in the roof of the mouth, or palate. Clefting results when there is not enough tissue in the mouth or lip area, and the tissue that is available does not join together properly. While the defect occurs in early fetal development, in most cases, the cause is unknown. However, there appears to be a link with genetics and maternal environmental exposures during pregnancy.

While there are certainly aesthetic considerations associated with cleft lip and palate, having this birth defect can affect people in many more serious ways.

• Difficulty Eating – When there is a separation or opening in the palate, food and liquids can pass from the mouth back through the nose. While waiting for surgery, patients can use specially designed prosthetics to help keep fluids flowing downward towards the stomach, ensuring that they receive adequate nutrition.
• Speech Difficulties – Because the upper lip and palate are not properly formed, it may be difficult for children to speak clearly, and when they do, it may produce a nasal sound. As speech may be hard to understand, a speech pathologist may be used to resolve these issues.
• Ear Infections – Cleft lip and palate can lead to a buildup of fluid in the middle ear, leaving children at a higher risk for ear infections, and if not properly treated, even deafness. To prevent infections, small tubes may be placed in the eardrums to facilitate fluid drainage.
• Dental Problems – Children who suffer from cleft lip and palate also often have missing, malformed, or displaced teeth, leading to a higher number of cavities and other dental and orthodontic issues.

Treatment

The treatment for cleft lip and palate is most likely surgery, and this is where your craniofacial orthodontist and team of specialists come in. Depending on the severity of the case, more than one surgery may be necessary. In children, surgery usually takes place between three and six months of age.