Oral Surgery Melbourne
There are two main questions to ask when deciding whether orthodontic treatment is necessary:
- Are the teeth in the right place?
- Are the jaws in the right place?
It is relatively easy to see when the teeth are crowded or protruding but perhaps not so easy to see if the jaws do not match in size or if one jaw is positioned either too far forward or too far back in comparison with the other one.
If there is not too much of a mismatch in jaw position, the orthodontics can largely camouflage the jaw discrepancy and this is what the orthodontist does for many patients. When there is a significant difference in jaw position, then the position of the jaws needs to be fixed before the teeth can be put in the best position for chewing. Another advantage of repositioning the jaws is that for many people it gives an enormous improvement in profile and appearance.
The Oral & Maxillofacial Surgeon
When it is desirable to position both the teeth and the jaws, the orthodontist works together with another dental specialist, the Oral and Maxillofacial Surgeon. Many of these surgeons are fully qualified medical practitioners as well as specialist dentists. The Oral and Maxillofacial Surgeon performs an operation for the patient in hospital which repositions either one or both jaws into an improved position. Jaws can be moved in any direction, just as teeth can.
In this way gummy smiles, which show too much gum above the upper incisors in smiling, can be corrected. So too can lower jaws which protrude and which take the lower front teeth ahead of the upper front teeth. Another example is where the lower jaw is very short and causes the lower front teeth to bite into the soft tissue of the palate behind the upper front teeth, making the palate quite sore. Sometimes the lower jaw is angled downwards giving the patient a very “horsey” or long face appearance to such an extent that the front teeth can not be brought together at all. Upper jaws can also be positioned too far back giving the patient a very sunken-in appearance around the base of the notes and a quite concave profile.
A Team Approach
As you can read here, the Oral and Maxillofacial Surgeon is very much a part of modern orthodontics. Orthognathic (jaw) surgery is not for everybody but for those who would benefit from its advantages, it is a very rewarding treatment option which a modern orthodontic team can offer.
Treatment is divided into three parts. Part 1 is the pre-surgical orthodontic phase when braces are fitted to the teeth in order to “de-compensate’ them, ie align and level the teeth and to place them in the correct angle in the supporting bone. Normally this takes 12-18 months of active tooth movement.
You should be aware that by the end of this phase your facial profile and the position of your teeth are liable to look worse rather than better. This is deliberate and unavoidable because your orthodontic treatment has been undoing nature’s attempt to mask the skeletal discrepancy of your jaws, in preparation for the surgical correction.
Part 2 is the surgical phase with the braces still fitted to the teeth, you will be admitted to hospital where your Oral and Maxillofacial Surgeon will make the necessary surgical corrections to the jaws.
Part 3 is the post-surgical orthodontic phase, usually lasting about six months, when the final orthodontic detailing and positioning of the occlusion is carried out.