Surgical Orthodontics FAQs

Surgical orthodontics, also known as orthognathic surgery, consists of a combination of orthodontic treatment (usually braces) and jaw surgery. This combination is often employed in cases of jaw problems – including bad bites and jawbone abnormalities – that are too severe to be solved by orthodontics alone. What are the benefits of surgical orthodontics? Depending on the particular jaw problem, patients can be relieved of biting and chewing difficulties, as well as breathing difficulties and sleep apnea. The treatment is used to improve both “gummy smiles” in which an excess of gums show above the teeth, and “toothless smiles” in which the lips cover the teeth. For patients with overbite, underbite, cleft palate, or facial injuries, the balance of the face is restored. Who is a candidate for surgical orthodontics? While the initial stage of orthodontic treatment may begin earlier, this type of jaw surgery is only appropriate in adults who have stopped growing. This group generally includes females 16 and older and males 18 and older. In younger patients, early intervention can often correct jaw problems and eliminate the need for future surgery. What results can be expected? When surgical orthodontic treatment is complete, overall dental health is improved, since a bad bite is eliminated and jaws are aligned properly. The treatment also results in a more stable, functional and healthy placement of the jaw. Patients enjoy easier speaking, breathing and eating. Frequently facial appearance is improved as well. Because surgical orthodontics is only employed in response to a significant problem, the improvement can be dramatic and have lasting positive effects. What does the process include? The process begins with orthodontic treatment. We'll use braces to move your teeth into the correct position prior to surgery. During this time, it may seem as if your bite is getting worse; this is because the jaws are still out of place. After the jaws are moved during surgery, you'll find your teeth fitting together better. Once surgery is complete, we will continue the orthodontic treatment to move all of your teeth into their final positions. What happens during surgery? The strategy varies according to the patient’s need. If the lower jaw is the source of the problem, it will be moved forward or backward. If the upper jaw is the issue, it can be moved forward, backward, up or down. In some cases bone will be removed or added to achieve the correct alignment and stability. Are there any risks involved? Surgical orthodontic procedures are performed routinely and carry only the usual risks associated with any type of surgery.

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Top 10 Tips for Cleaning Your Braces

Keeping your teeth clean is more important than ever when you have braces. Food bits have more spots than usual to hide in your mouth, so you must be diligent in order to avoid bad breath, swollen gums, discolored teeth and cavities. If you remove plaque regularly during treatment, you'll experience better results and shorter treatment time. Keep plaque at bay with these top ten tips:

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1. One tooth at a time. When you brush, take time with each individual tooth – at least 10 seconds each – and pay careful attention to the spots where your teeth touch your braces.
2. It’s all about the angles. Brush the tops of your teeth and braces with your brush angled down toward where they meet. Brush the bottoms of your teeth and braces with your brush angled up.
3. The tooth, the whole tooth, nothing but the tooth.  While the front surface of your teeth may seem like the most logical to clean, it’s equally important to clean the inner surface of your teeth (tongue side) as well as the chewing surface. And be sure to clean along your gum line – a key spot for plaque buildup.
4. Step 1: eat, step 2: clean. While you’re in treatment, it’s important to brush after every meal. Bits of food can easily get caught between braces and teeth, and these food bits interact with bacteria in your mouth to cause decay. The longer food is in contact with your teeth, the greater opportunity for plaque to form. If you are eating somewhere that you can’t brush, thoroughly rinse your mouth with water.
5. Like a Boy Scout, always be prepared. The easiest way to be sure you can brush after every meal is to get in the habit of taking a toothbrush, toothpaste and floss with you wherever you go. Designate a special container just for your teeth-cleaning tools and keep it in your purse, backpack, or laptop case.
6. Remove the moving parts. If you have elastic bands or headgear, remove these parts before you brush or floss.
7. Fluoride is your friend. Fluoride helps prevent cavities. Be sure to brush with fluoride toothpaste, and rinse with fluoride mouthwash.
8. Pointy brushes reach tiny places. Interproximal brushes (sometimes called proxa brushes or interdental brushes) are cone-shaped and come in very handy for reaching spots around your braces that standard brushes can’t.
9. Find the floss for you. Regular floss works for some patients, but others find it easier to work with a floss threader, which helps you get the floss into tight places. Other patients like an all-in-one product called Superfloss, which comes with a stiff end for easy threading, a spongy section for cleaning wide spaces, and regular floss for narrow spaces.
10. Make time for the pros. It’s your job to take care of the everyday cleaning. But make sure to visit your dentist regularly while in treatment, to get the deep, thorough cleaning that only a professional can provide.

Sincerely,
Dr. Miller & Staff

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The Right Time for an Orthodontic Evaluation: No Later Than Age 7

Even though most people think of pre-teens and teens when they think of orthodontics, there are good reasons your child should have an orthodontic evaluation much sooner. The American Association of Orthodontists (AAO), recommends a checkup with an orthodontist no later than age 7. At our office, we typically tell our parents: Third Grade. At this time, the incisors and molars are erupting and the orthodontist can evaluate your child's occlusion.

Early treatment may give your orthodontist the chance to: 1) guide proper jaw growth, (2) lower the risk of trauma to protruded teeth, (3) correct harmful habits or crossbite, (4) improve appearance, self-esteem, and speech, (5) eliminate crowding and avoid extractions. In essence, Phase I treatment lays down the proper foundation.
 
Please feel free to respond with any questions or requests for any future information.

Respectfully yours,
Dr. Miller