Dysgnathia - Specialists and Information

Medical professionals generally distinguish between:

• prognathism and
• retrognathia

In prognathism, the lower jaw is so prominent that it protrudes beyond the upper jaw and sticks out from the face. In some cases, the lower row of teeth is so prominent that it lies in front of the upper row of teeth when the mouth is closed. The chin and lower lip are in a protruding position.

In retrognathia, the chin recedes backward because the lower jaw is set back behind the upper jaw. The upper lip and upper jaw protrude, which is why the rows of teeth do not align when the mouth is closed. The upper row of teeth protrudes significantly more than the lower row.

Dysgnathia affects both the mental and physical well-being of those affected. The most common symptoms are problems with the jaw’s chewing ability. 

It is difficult to chew solid food. Many people with this condition also experience pain while chewing. Often, the upper and lower rows of teeth do not align properly. Those affected must contort their jaws to chew effectively. 

This results in muscle strains and strain-related pain in the facial area, which often leads to headaches as well.

A problem that may be even more significant, especially during adolescence, is the impact of dysgnathia on self-esteem. Those affected often feel unattractive and inferior to those around them. 

They are ashamed of their misaligned jaw and their smile. In many cases, this leads to social isolation, which they often bring upon themselves out of shame. 

In general, those affected suffer from actual or perceived social ostracism by those around them. The psychological distress associated with dysgnathia is therefore very high.

In the long term, however, malocclusions can also lead to serious physical consequences.

Progressive fusion of the jaw bones is possible, causing the pain to worsen over time. In addition, the increased effort required for chewing and speaking places excessive pressure on the periodontium. For this reason, premature tooth loss cannot be ruled out.

First and foremost, those affected should consult an orthodontist. During an initial examination, the orthodontist will assess the situation. 

This is done by:

• jaw impressions and 
• X-rays of the head

Typically, the orthodontist treats malocclusion with braces designed to realign the jaws and teeth into a more favorable position. 

In cases of true dysgnathia, however, the issue is a deviation in bone alignment. In such cases, orthodontic treatment is often insufficient. Therefore, a referral to an oral and maxillofacial surgeon is often recommended.

Oral and maxillofacial surgery focuses on the surgical correction of malocclusions. This is preceded by further professional examinations, such as 3D CT scans (a three-dimensional imaging technique). 

Based on these findings, the oral surgeon develops a plan for the surgical correction of the malocclusion. During the procedure, the surgeon adjusts the jaw to restore both functional and aesthetic alignment.

If the malocclusion is related exclusively to the position of the teeth, orthodontic treatment is sufficient. 

Using braces and brackets (attachment elements for fixed appliances), the orthodontist moves the teeth into the correct position. 

If dysgnathia involves an anomaly in the skeletal structure, surgical intervention is often unavoidable. A combination of orthodontic and oral and maxillofacial surgical measures, which generally follows a set protocol, has proven effective in such cases.

During the preliminary treatment phase, orthodontists use braces to move the teeth into their intended positions. This allows them to achieve a normal alignment within half a year to a full year. 

During this time, the discrepancy (gap) between the two jaws usually widens initially. Once the jaws are in a normal position, the surgeons develop a surgical plan using jaw impressions, plastic bite registrations, and X-rays.

The subsequent surgery is performed under general anesthesia and leaves no visible external scars.

During the surgery, surgeons separate the upper and lower jaws from one another in order to reposition them correctly. 

To ensure the new positioning is maintained long-term, titanium plates secured with screws are used for stabilization. In addition, rubber bands placed between the jaws after surgery control the range of motion, preventing any counterproductive strain. 

Oral surgeons remove the plates in a follow-up surgery, usually after nine months. The patient can go home within a week. It takes about six weeks before they can eat soft foods again.

This is followed by another six months of orthodontic fine-tuning until the doctors remove the fixed braces. The total duration of treatment depends on the severity of the dysgnathia (approximately 2 to 3 years).

The treatment of malocclusion is a cosmetic procedure that relieves the patient of enormous psychological distress. 

The procedure is important for preventing serious physical complications. 

Orthodontic and oral surgical treatments help patients develop a better sense of self-worth. This improves their quality of life and promotes long-term oral health.