Dr. Roland Paul Williams, DDS

In general, everything pose some type of risk or adverse effect. The risk for bone graft is relatively low or negligible. The biggest of which is rejection or loss of the graft. We expect to loose 8-10% of the graft during the healing process, so as a patient you may feel some grains of sand after the procedure. The remaining risk are the risk for any surgical procedure, (pain, swelling, infection, damage to adjacent structures, delayed wound healing, etc.) but it should be stressed that the risk are minimal.

The first day is the worst, unfortunately. Pain is the body’s way of telling the brain 1. Something happened or is happening that can damage the body or 2. There is an infection. Either way, swelling is usually present and that swelling can cause pain as the sensory pain nerve fibers are stimulated. After the initial injury or trauma to the body, swelling can increase for the first 72 hours so some clinicians will say at least 3 days till the tissues stabilize. The true answer is way more complex than that just because of multiple factors. The general consensus is after day 3 it should be decreasing. Most clinicians give pain medication for 5 days, after that, if the pain levels are increasing or acute, the infection should be considered and that requires evaluation by your clinician.

Absolutely!! Most of us recommended it if the extraction is routine. In some cases, the retainer can be used as a bandage to cover and protect the surgical site. Very rarely it is advised to not wear a retainer and your dentist, surgeon, or orthodontist will tell you.

Not necessarily, bone needs to be immobilized to heal. Back in the day, all we had to keep the jaws from moving was wires and looping them around the teeth to create that stable reproducible bite. Now we have plates and screws which can accomplish the same goal. If your surgeon feels that they can complete your case and keep your bite stable during the healing process with just plates and screws, then the answer is yes. Otherwise, the answer is "you will get wired up".

So your question is not a fair question. All surgeries are serious in the eyes of the surgeon. The better question is what component of the process are you fearful of? In general, human nature creates a fear of the unknown and that is what most of my patients tell us. The second fear I run into is the fear of being put to sleep. I can assure you as much as you fear that, all of us that hold an anesthesia license want to wake up once we are finished.

Without minimizing the risk of surgery, take a deep breath and relax. There is an inherent risk with any surgery and as a surgeon, it is our responsibility to minimize those risks and if they do occur have a solution ready to mitigate those risks. In short, as much as we love our patients, we love our license more.

Jaw surgery (orthognathic surgery) is usually performed by a Maxillofacial surgeon. However, there are 2 other surgeons (ENT, Plastics) that can perform the needed jaw surgery because we all receive and perform the same training in residency, and our license, depending on the state, allows us to perform the same surgeries regardless of location on the body. The main difference in the 3 specialities are as follows and what we do the most:
-Maxillofacial - bone, tooth, and soft tissue of the head and sometimes neck, usually above the angle of the mandible.
-Ear, Nose, Throat (ENT) - bones of nose and soft tissue of throat and neck, usually below the angle of the mandible.
-Plastics - Soft tissue anywhere on the body and occasionally bones of the face. Note: most specialize in what they are good at (i.e., facelifts, rhinoplasty, tummy tucks, breast and breast lifts, cancer)

Depends on what you are trying to chew. The textbook answer is 6 weeks. Bone that has been cut takes 4-6 weeks to heal. Depending on how the surgeon stabilizes the bones after your jaws are aligned, your diet may advance sooner. For example, if all you have at the end of surgery are wires the full 6 weeks is what is recommended. In contrast, if after surgery you have plates and screws, you may be allowed by your surgeon to start with a soft diet by week 2 and advance to full diet by week 6. Remember, there is NO RUSH if you want to keep your new jaws where your surgeon intended. Eating too hard of foods or advancing your diet too soon can cause relapse or shifting in your bite because the bones aren’t mature enough for the stress given.

Actually, you sleep the same way you did prior to getting it wired. Most patients sleep on their back slightly propped up with one or two pillows. Realistically, there is no change except when there is a cut or laceration outside of the mouth, then most patients lay on the opposite side.