Assessment, Treatment & Follow Up

New Patient Clinic

Your first appointment at Bristol Dental Hospital will be for an initial assessment at a New Patient Clinic led by an orthodontic Consultant.  The Consultant or a member of their team will look at your face, teeth and bite.  If indicated they will take X-rays, photos and putty moulds of your teeth before deciding whether you need orthognathic treatment. The moulds will then be used to make a model of your teeth.

This is a good place to find out the basics about jaw surgery.  If treatment is advised you will be referred to the Orthognathic Clinic.  If you have more growing to do, you will be invited to come back for a review at a later date, which may be up 2 years later.

At the new patient clinic it is important to tell the clinician if you have:

• A complex medical history - for example if you or a member of your family have problems with a general anaesthetic (operations when you are put to to sleep)
• Had a previous injury to your teeth or face
• Pain in your jaw(s)
• Worn braces in the past
• Important things going on in your life for example starting university, going travelling, starting a new job, 

 

Orthognathic Clinic

At this clinic you will meet both a consultant Oral and Maxillofacial Surgeon and a consultant Orthodontist who work together to provide orthognathic treatment.  They will assess you again, and start planning your treatment.

The consultants want you to be well informed and reassured about your treatment. Orthognathic treatment can be a daunting and long process. They will happily answer any questions you have to help guide you through the treatment.  If you need more time to decide if treatment is for you, the consultants will happily book another review appointment at a later date. 

 

 

 

Treatment

Treatment includes fixed metal braces for 18 months to 2 years before surgery then the braces stay on for typically another 4-9 months after.  This allows for the bone to settle in its new position and for the orthodontist to make the finishing adjustments. 

For more information about the surgery click on Surgery and Hospital Stay.

Surgical Planning is done by the surgeon using measurents of your face and moulds of your teeth:  Models from moulds of the teeth are carefully set up on a frame called an articulator by the lab technician in the after surgery position (see photo right).  The articulator mimics the jaw joints allowing the surgical planning.  They then use the moulds to make a plastic wafer which will help position your jaws during the surgery. 

Your wisdom teeth may need to be taken out before having a lower jaw operation as this is where the surgical incisions (cuts) will be made.  

Once treatment has started orthodontic appointments typically last about 20 minutes for the braces to be adjusted.  Appointments with the surgeon can be longer.  Overall treatment time is lengthened by missed appointments and any breakages to the brace (see Brace Breakages and Emergencies under Braces, Retainers and Dental Health). 

Understandably the surgeon and orthodontist cannot be held responsible if you miss your appointment, and your brace is left unsupervised and damage has occured to your teeth.  If you can't attend an appointment please contact the department and rearrange your appointment so not to delay your treatment. 

 

Follow up after your treatment is complete

After your treatment you will have an improved bite.  You will be fitted with retainers to keep your teeth aligned and help keep a stable result.   Wearing them long term is essential.  Remember to bring your retainers with you to get them checked by the orthodontist.  (see Braces, Retainers and Dental Health for more information).  The consultant orthodontist and surgeon will still continue to care for you, seeing you on the Orthognathic Clinic at:

• 3 - 6 months post operation
• 1 year
• 2 years - following which you will be discharged

Although it is a big commitment having orthognathic treatment, most patients have more confidence with their appearance and improved function with eating.

 

Missed Appointment Policy

It is important to always update us with any changes to your contact details at reception.

As with any New Patient Appointments to the Hospital, if you do not attend your first appointment, you will be discharged.  

Once treatment has started, missing more than 2 consecutive appointments will result in no further appointments being made until you contact the department.  If you miss 2 consecutive review appointments you will be discharged.