My Journey Through Orthognathic Surgery

I’ve always been a firm believer of the philosophy “You either learn to love it, or you do something about it”. Okay, perhaps it’s not exactly a philosophy, but they’re some very wise words to live by.

Like almost every child, I had a very “unique” smile: adult teeth growing in at different speeds, and a gap between my front teeth that I would proudly proclaim in the manner of a circus ringmaster that they could hold the weight of a 30cm ruler if I jammed it in hard enough, much to the amusement of my fellow 8 year old classmates.

Unfortunately, unlike almost every child, I was unable to receive orthodontic treatment before the age of 18 (where in the UK, it’s free), despite having a dentist’s assurance that I’d be put on a waiting list. Since I couldn’t afford the treatment, I decided that the next best thing to do would be just to accept it and move on. This is somewhat difficult when your teeth cause issues with not only eating, but speaking and, very embarrassingly, the occasional dribbling incident.

I have what is referred to lovingly as a ‘slight overbite’ (or unlovingly as ‘buck teeth’). Its correct term is ‘anterior overbite’. This occurs when the upper teeth are misaligned and jut out further than they should.

A few months ago, while visiting my (lovely new) dentist, I happened to ask if there were any options for me, such as adult braces. Cost would still be a concern, but I thought if I had a good payment plan, then surely it would be worth it? I had really and truly tried accepting them for how they were, but it just wasn’t getting any easier with age, and the slight speech impediment certainly wasn’t helping. The dentist put me in touch with an orthodontist a few towns away who would be able to offer orthodontic treatment for a quarter of the price (normally around £2000). Finally! I thought to myself. Although I couldn’t help thinking it all too good to be true (but that’s just my Daria-esque realism).

I was seen by the orthodontist surprisingly quickly a few weeks later, and of course here it was, the dream shattering “Braces won’t be able to fix your bite completely, and your teeth may push back into their original position”. Before I was able to break out my candelabra and roam the halls of the orthodontic surgery weeping, he advised me of the possibility of orthognathic surgery, or jaw surgery, which when combined with braces, has a much higher success rate in adults.

A few months later, I was seen by an orthodontist at the School of Dentistry at the Royal Victoria Hospital. Here I went through a range of teeth impressions (not the most pleasant experience, your upper and lower teeth are separately encased with a piece of plastic filled with green goop curved to the shape of your gums, this then hardens around your teeth to create an impression and is essentially prised from your mouth because it gets stuck. It doesn’t hurt, but it does beg the question as to why children go through a play dough-eating phase.), then a series of oral X-rays, and another appointment in the New Year for a consultation with a surgeon about what to expect and risks.


An X-ray of my jaw in profile, outlining my anterior overbite.

The surgeon I spoke to – a lovely English man with magnetic glasses who could easily enter a William Shatner look-alike competition and take home the gold – explained everything to me, what to expect and the risks involved. Fortunately for me, the UK provides this treatment completely free of charge, and because I have to have the braces along with the procedure, they’re included in this.

I don’t claim to be any kind of expert on orthognathic surgery, but what it involves depends on which part of the jaw is being operated on. Essentially a part of the jaw bone is cut out and the jaw is moved until the upper and lower teeth align.

In surgery of the lower jaw, there is a risk of the nerve that provides feeling to the lower lip being severed. This is irreparable, and the feeling can be lost for life. However, I was told that there’s a 1 in 200 chance of it happening, and even then the feeling may not be completely lost – it all depends on the individual.

The reason that I’m writing about this particular subject is that I know there may be people out there who are going through or contemplating through the same thing. Obviously the experience is different for each person, and my experiences may not be applicable, per say, but I know it would have helped to have something like this to read in the run-up to the surgical consultation, which was only this afternoon. This is also a very personal experience, and something that I’d like to keep an accurate record of for myself.

Surgery is a scary thing, and having been through it once before, I’d be lying if I said I was jumping for joy at the idea of the pain and recovery process. But I’ve had a long time to weigh up the pros and cons, and honestly I couldn’t see myself backing out now. I’ll be sure to update as things progress, and I’m happy to answer any queries anyone may have regarding this subject.


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