Corrective Jaw Surgery Waterloo
Orthognathic surgery refers to the surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area.
Orthognathic surgery is generally performed by an Oral and Maxillofacial Surgeon to correct malocclusion (bad bite) in cases where routine orthodontic treatment has not or will not be effective. Orthognathic surgeries include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy.
There are several classifications of malocclusion (the improper coming together of teeth) which may require orthognathic surgery:
Class I Occlusion –This malocclusion means that the lower anterior incisors sit directly behind the upper anterior incisors when the patient bites down. This is considered less destructive than Class II and Class III malocclusions.
Class II Malocclusion – This is identified when the lower anterior incisors lie significantly behind the upper anterior incisors during the biting process; in some cases hitting the soft tissue behind the upper incisors. This is commonly referred to as an overbite and can cause discomfort, bone damage, excessive wear of the front teeth, and tooth loss.
Class III Malocclusion – This is commonly known as an underbite and occurs when the lower anterior incisors and lower jaw are positioned beyond the upper teeth, making the lower jaw much more prominent than the upper jaw.
Reasons for Orthognathic Surgery
The malocclusion of the teeth can create greatly destructive forces among the five powerful muscles that control the closing and opening of the jaw. These muscles generate a tremendous force when clenching, grinding or chewing. Misalignment can seriously damage the function and aesthetic appearance of the teeth in many ways if left untreated, such as:
- Tooth Wear – In the case of an overbite, the pressure and wear on the teeth is not spread evenly. This can also lead to TMJ, migraine headaches, and tooth loss.
- Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth alters the way the facial muscles interact. In some cases, the meniscus cartilage which acts as a buffer between the jawbones can be painfully damaged.
- Loose Teeth – When uneven pressure is continually exerted in unintended places or soft tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain and reduces proper function.
- Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods are eaten.
- Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor alignment of the upper and lower jaws.
What Does Orthognathic Surgery Involve?
When the dentist identifies a patient as a candidate for orthognathic surgery, a complete photographic analysis is initially undertaken. This includes panorex x-rays, cephalometric x-rays, models, impressions, and radiographs. Your oral & maxillofacial surgeon, your orthodontist and your dentist will work together and consider how the corrective surgery will impact both proper jaw function and the aesthetic appearance of the entire face.
Generally, orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You may also be provided with a modified diet (if required).
Corrective Jaw Surgery in Waterloo – Book Your Consultation
If you’re experiencing jaw pain, bite issues, or difficulty chewing, corrective jaw surgery may help restore proper function and comfort. Call Trillium Dental Centre at 519-746-4000 to schedule your consultation and discuss your treatment options.
What to Expect During Orthognathic Treatment
Corrective jaw surgery (orthognathic surgery) repositions the upper jaw (maxilla), lower jaw (mandible), or both to correct skeletal discrepancies that orthodontics alone can't address. It's coordinated care: an orthodontist and an oral and maxillofacial surgeon work together over 18-36 months, with orthodontic preparation, surgical correction, and post-surgical orthodontic finishing.
Trillium Dental Centre provides the general dental coordination, the comprehensive consultation, and the post-surgical dental care; the surgical phase itself is performed by an RCDSO-certified oral and maxillofacial surgeon in a hospital or accredited surgical facility. We refer to and coordinate closely with the surgeon and the orthodontist throughout the case.
The pre-surgical orthodontic phase (12-18 months) prepares the teeth so they fit together correctly after the jaw is moved. Surgery itself is typically inpatient with a 1-3 day hospital stay; recovery at home runs 2 to 6 weeks for return to most activities, with full healing over several months. Post-surgical orthodontics (6-12 months) finalizes the bite. Total treatment timeline is generally 2-3 years from consultation to final retention.
Who Is a Candidate for Corrective Jaw Surgery
Orthognathic surgery is considered when:
- Severe skeletal underbite (lower jaw significantly forward of upper)
- Severe skeletal overbite (upper jaw significantly forward of lower)
- Open bite — front teeth don't touch when back teeth meet
- Significant facial asymmetry of skeletal origin
- Obstructive sleep apnea that has not responded to other treatments
- Major chewing or speech impairment from jaw position
- TMJ problems linked to severe bite discrepancy
Surgery is reserved for skeletal issues — bite problems that orthodontics alone can't correct because the bones themselves are misaligned. Most orthodontic cases don't need surgery; the consultation determines whether your specific situation is one that would benefit. Patients must have completed jaw growth (typically late teens for women, early twenties for men) before surgery.
What Recovery Looks Like
The initial hospital stay is 1 to 3 days. Immediately after surgery you'll have significant facial swelling, soreness, and difficulty opening the mouth widely. Pain is managed with prescribed medication; most patients describe the discomfort as substantial but well-controlled. Numbness in parts of the lip, chin, or cheek is common in the first weeks and gradually resolves over months — sometimes leaving small areas with permanent altered sensation.
Diet starts with liquids for the first week, soft foods for several weeks, and gradual return to normal eating over 6-8 weeks as healing progresses. Speaking and singing return progressively. Most patients return to office work at 2-4 weeks and to physical activity around 6-8 weeks. Full bone healing takes about three months.
Post-surgical orthodontic appointments resume around two to four weeks after surgery to begin fine-tuning the bite. Follow-up with the surgeon continues for 6-12 months. Functional and cosmetic improvements are typically appreciated by patients across the first six months as swelling resolves and the new alignment becomes natural.
Cost and Insurance Coverage
Orthognathic surgery is a complex multi-provider case with separate fees for the orthodontist, the oral and maxillofacial surgeon, the hospital or surgical facility, and any general dental work needed before or after. We help coordinate the financial side and provide written estimates from each provider. Fees follow the current Ontario Dental Association (ODA) Suggested Fee Guide for the dental portions; surgical fees follow the appropriate medical/dental fee schedules.
Coverage varies. Orthognathic surgery for medical indications (severe functional issues, obstructive sleep apnea) is often partially covered by OHIP for the hospital and surgeon portions. Orthodontic phases are usually covered by extended dental insurance to standard orthodontic levels. Purely cosmetic cases are typically not OHIP-covered. We work through coverage details with the patient, the surgeon's office, and your insurer.
Corrective Jaw Surgery — Frequently Asked Questions
Do you perform the surgery at Trillium?
No. Orthognathic surgery is performed by an RCDSO-certified oral and maxillofacial surgeon at a hospital or accredited surgical facility. We coordinate the general dental aspects of the case and work with the surgeon and orthodontist throughout. None of our dentists hold an RCDSO specialty certificate in oral and maxillofacial surgery.
How long is the whole treatment?
Most cases run 2-3 years from initial consultation to final retention: 12-18 months of pre-surgical orthodontics, the surgical procedure with 6-8 weeks of major recovery, then 6-12 months of finishing orthodontics.
Will my face look different afterward?
Yes, but typically in ways most patients welcome. The face is rebalanced to a more harmonious proportion as a side effect of correcting the underlying bite. Before-and-after planning includes 3D imaging and computer simulation so you have a realistic sense of facial changes before committing.
Is the surgery covered by OHIP?
For medical indications (severe functional issues, sleep apnea), often partially yes — the hospital stay and surgical fee are typically covered. For purely cosmetic cases, no. The orthodontic portions are usually billed to extended dental insurance, not OHIP. We work through the details case by case.
How painful is the recovery?
Most patients describe the first week as substantial discomfort, well-controlled with prescribed medication. Discomfort tapers from there. Numbness in the lip/chin/cheek area is common for weeks to months and is usually more bothersome than the pain itself.
Will I be able to chew normally again?
Yes — better than before, typically. The whole point of the surgery is to put the jaws into a position where they function correctly. Chewing returns gradually over 6-8 weeks; full function is usually established within three months.