In some cases, orthodontics alone cannot fix the underlying problems and Gippsland Orthodontics have to work with other speciality team members to obtain an ideal outcome. When the lower and upper jaws are not aligned properly, they can potentially impact a patient in many ways. These may include the ability to function and bite properly, the facial appearance and in some patients, the inability to breath correctly.
When our patients suffer from skeletal discrepancies, either from existing concerns or emergencies due to trauma suffered by the face, or breathing issues like sleep apnoea, at Gippsland Orthodontics, we will refer you to an Oral and Maxillofacial surgeon. In some scenarios, we may also refer you to an Ear, Nose and Throat (ENT) specialist.
An Oral and Maxillofacial surgeon is a dental specialist who treats a wide variety of issues regarding the jaw, face, neck, head and soft tissues inside the mouth.
For the most ideal orthodontic results, Gippsland Orthodontics will work as team with the local Oral and Maxillofacial surgeon to coordinate a treatment plan that is ideal for you. It may involve the jaws being properly positioned prior to beginning your orthodontic treatment. Alternatively, and in most cases, the surgery to correct the jaws may be completed during the orthodontic treatment.
There are several different types of surgeries that may be used to correct the above concerns with bites, jaws, facial appearance and sleeping problems. These may include:
Mandibular Advancement Surgery
When the upper and lower jaws need repositioning into the correct position relative to one another, the Mandibular Advancement Surgery can help. This surgery often involves moving the lower jaw forward to match the top jaw which, with orthodontic, aims to achieve a better bite and facial appearance.
Maxillary Advancement and/or Mandibular Set Back
This surgery is used to treat a Class III Malocclusion which is when the lower jaw sits forward to the top jaw (some may term it an ‘underbite’). It occurs more when there is limited upper jaw growth or trauma to the upper jaw, and also may occur when there is excessive lower jaw growth.
Common surgery to treat a Class III Malocclusion involves a maxillary advancement where the upper jaw is shifted forwards. Alongside this, the mandible is set back, or the lower jaw is moved back, to get the bottom and top jaws to fit together properly. People who have this surgery often find an improvement in their facial profile.
Maxillary Impaction (Gummy Smile)
Gummy smiles are quite often caused by the top jaw having excess vertical (up and down) growth, which causes a patient to have a ‘longer’ face. The surgery to reduce the gummy smile, is to remove a part of the upper jaw, and then move the upper jaw upwards to reduce the visible gum. There are other ways to potentially fix a gummy smile and all options must be discussed with Gippsland Orthodontics prior to deciding if surgery is the right option for you.
Surgically Assisted Maxillary Expansion (S.A.M.E)
Some people have an upper jaw that is too narrow and requires expansion to create room for teeth or orthodontic treatment. Ideally, orthodontists will aim to get expansion during the adolescent years, however, when a patient has finished growing it may require surgery to expand the upper jaw. Also referred to as upper jaw expansion surgery, the goal is to increase the size of the upper jaw.
Chin Advancement (Genioplasty)
The common reason for having a genioplasty is the feeling of a patient being unhappy with their chin’s appearance; however, this surgery is commonly paired with jaw surgery to improve the position of the lower and upper jaw. This surgery is also known as a chin augmentation and is intended to improve the appearance of the jaw and chin.
Sleep Apnoea Surgery
Sleep apnoea is a condition in which your breathing stops periodically during sleep. People who suffer sleep apnoea will often suffer from drowsiness, tiredness, difficulty in sleeping, snoring, headaches and falling asleep unintentionally during the day.
There are three categories of sleep apnoea; obstructive sleep apnoea (OSA) being the most common, the least common is central sleep apnoea (CSA), and lastly, a combination of both. Often a patient will require a sleep study prior to diagnosis and management of sleep apnoea.
A proper diagnosis is required prior to treating patients with sleep apnoea and if appropriate, in some cases a combined orthodontic and surgical approach to sleep apnoea may be appropriate. There are different types of surgery available to patients and each is specific to the position of the teeth and jaws. If you have any questions or suffer from any of the above jaw, health or medical issues, please reach out and book a consultation with the Gippsland Orthodontic team here.