Jaw Surgery
There is a limit to how much teeth can be moved. While genetics will determine the size and shape of our jaws and the soft tissues of our lips cheeks and tongues will influence the position of our teeth. As orthodontists we have developed an understanding of how far one can push the teeth and we know that there are safe limits beyond which teeth can start to come out of bone. This leads to two types of problem, one type can be solved with just braces and the other may need help from a surgeon. If you have a problem that affects your facial appearance, such as a jaw which is set back or forwards, or asymmetric, the teeth can be moved to resolve some of problem. There does come a point though, where moving the jaws is the only way to deal with some problems.
Planning
At One Devonshire Place we have worked with surgeons over the years to facilitate these treatments. Recently we have been seeing more patients who have jaw problems and so we arrange to see people with a surgeon present to plan the treatment in more detail. We then fit braces to align the teeth in a way that the surgeon can then move the jaws. Often the position of the teeth at the start would limit the amount of jaw movement that the surgeons can make. This often means making the bite problem a little worse, so that the jaw movements can be enhanced and this gives a much better result when the surgery is done. Prior to the surgery we plan this with the surgeon and then arrange to see patients to finish the brace part of the treatment. The facial changes can be quite significant and so we do discuss this and how it could affect patients in their daily life, once the surgery is done and the braces removed.
Buried Teeth
The more common type of surgery that we get involved with is the uncovering of teeth. We can do simple surgical procedures at the practice but most often refer to a surgeon for this work to be carried out. The procedure involves uncovering the tooth, most often an upper canine, and attaching a chain to it. We then fit a brace which allows us to pull at the chain and bring the tooth down. Again there is a genetic link to some types of teeth that don’t come through but most often we are successful at bringing them through. We act as the main link between your dentist, the surgeon and us. If you have a jaw problem or a tooth which hasn’t come through, we can carry out an assessment to see which options might be available to you.
Sometimes we can carry out treatment without surgery while accepting some aspects of the bite. The important thing is that we are carrying out the treatment that resolves the issues that you want to be resolved at the start.
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