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Before Surgery

At the Beginning (12-18 Months Before Surgery)

  1. Orthodontist: Teeth are straightened and aligned using orthodontic braces. 
  2. Speech:  When the jaws are repositioned speech can be improved and sometimes worsen after jaw surgery. It is important that our speech pathologist is involved to help with speech. 
  3. Psychologist: Surgery can be stressful during adolescence and our psychologist can help with reducing the anxiety about surgery, ensure support from parents and help with school or work 
  4. Surgeon
    • Wisdom Teeth: If lower jaw surgery is a possibility, then the lower jaw wisdom teeth are removed at least 6 months before the jaw surgery. The upper jaw wisdom teeth do not need to be removed before the jaw surgery. They can be removed at the time of surgery. 
    • Cleft Alveolar Bone Graft: In most patients with cleft lip and palate, the cleft alveolar bone graft was already done by late childhood. If the bone graft is adequate on x-rays then nothing more needs to be done.  If it is not adequate, then it may require to be bone grafted before the jaw surgery. In some patients who have never had a cleft alveolar bone graft, then this procedure must be done before the jaw surgery. 
    • Coordinate  jaw surgery with the orthodontist and other members of the support team. 
  5. Education about Jaw Surgery: Study the details at the website www.pkpatelmd.com and other sources. A notebook to write down important information. 

3-6 Months Before Surgery

  1. Appointments with the Surgeon, the speech pathologist and the psychologist 
  2. Dental records from the orthodontist to see how close we are to surgery 
  3. Obtain insurance approval
    a. Submitting letters, pictures and x-rays 
    b. Letter from the patient discussing the physical/functional problems
  4. Scheduling surgery date
    a. Need insurance approval 
    b. Need approval from the orthodontist that the teeth are ready 
    c. Need approval from the surgeon confirming the orthodontist that the teeth are ready 

4-5 Weeks Before Surgery

  1. Education about Jaw Surgery: Review all the information on the website  www.pkpatelmd.com 
    • Immediate preparation for surgery 
    • Recovery after surgery 
    • What to have at home 
    • Oral care and Nasal Care 
  2. Pre-Operative appointment 
  • Surgeon
    • Review and answer questions about surgery 
    • Planning for the surgery 
    • Prescriptions that should be filled before surgery 
  • Nursing 
    • Review and answer questions about preparation, hospitalization and recovery 
    • Go over pain management after surgery 
    • Go over diet after surgery 
    • Review what you should have home before surgery 
  • Anesthesia
    • Preparation for surgery under general anesthesia 
  • Primary Care Doctor 
    • Check that you are heathy for surgery 
  • Orthodontist
    • Secure brackets on teeth 
    • Place surgical hooks
  • Surgical Records
    • CBCT Scan (X-Rays) 
    • Digital Dental Scan or Physical Plaster Model 
    • Photographs