How To Choose Your Jaw Surgeon

Choosing Your Surgeon

Qualifications Your Surgeon Should Have

The first step in choosing a surgeon for corrective jaw surgery is to ask for a referral from your dentist, physician, and orthodontist. Then you must interview any potential surgeons.

Your surgeon should:

Be board certified by the American Board of Oral and Maxillofacial Surgery.
Have extensive training and experience in corrective jaw surgery.
Currently perform corrective jaw surgery on a regular basis.
Inform you how many corrective jaw surgery procedures he/she has performed in the last 12 and 24 months.
Perform corrective jaw surgery in a facility where the anesthesiologists, nurses, and ancillary staff are very familiar with this specialized type of surgery.
Work closely with many of the orthodontists in his state treating patients requiring corrective jaw surgery.
Be considered an expert in corrective jaw surgery by his colleagues.
Notify you if residents or students will be involved in your care.
Notify you if he will not be the only surgeon performing your procedure.
Identify who will be performing the pre-surgical planning.
Identify who will be taking care of you in the hospital and post-operatively.
Show you before and after photos of his/her patients with similar patterns of facial imbalance.

Interview Any Potential Surgeon

Orthognathic surgery is very complex. The potential for failure and complications such as facial numbness, loss of teeth, or a bad bite requiring additional surgery are less likely to occur when this type of surgery is performed by an experienced jaw surgeon. The recovery and the post–operative period are more comfortable and faster when the surgery is performed with expertise.

Therefore, you should interview potential surgeons. Your surgeon should be asked to answer the questions contained in this chapter titled “Choosing a Surgeon for Corrective Jaw Surgery”.

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Questions to Ask Your Potential Surgeon

Are you certified by the American Board of Oral and Maxillofacial Surgery?
Do you have a medical license?
Do you have a dental license?
Where did you complete your training in Oral and Maxillofacial Surgery? (Please list all programs)
Did you complete any additional fellowship training?
Did you complete training in any other surgical specialties?
Were you trained during your residency in this type of surgery?
Was it a significant part of your residency program?

— If not, how and where did you get your training?

How many orthognathic surgery cases have you performed in private practice?

— How many cases in the last five years?

— How many in the last two years?

— How many in the last year?

Will you be the only surgeon performing the surgery?

— If not, who else will be performing or assisting in the surgery?

— What portion of the procedure will they be performing?

— Are they members of your practice?

— If not, why do you need the help of surgeons not in your practice?

— Will you be charging separately for their services?

What percentage of your practice is dedicated to orthognathic surgery?
What hospital has granted you privileges to perform orthognathic surgery?
Where will you perform my surgery?

— Do they have an ICU?

— Do they have invasive radiology capability?

— Is the nursing staff experienced with the post-op care of patients after corrective jaw surgery?

Will there be any resident or fellow involvement in my surgery?
If so, how much involvement and what portions of the surgery will they perform?
Do you have a computerized diagnostic program to analyze my face and facial bones? Can I see the results of the analysis?
Will you provide the names of your patients who have had similar surgery so that I can speak with them regarding their experience?
How many times have you performed the same surgery that is required?
How many orthodontists do you work with performing orthognathic surgery?
Are you affiliated with any craniofacial centers where you perform orthognathic surgery?
Do you have a program to deal with my insurance company if they deny or in any way try to control or regulate my care?
Do you consider yourself an expert in the diagnosis and treatment of patients requiring orthognathic surgery?
Who will be planning my surgery, performing the pre-surgical planning, and fabricating the surgical splints?
Who will be taking care of me in the hospital?
Who will be taking care of me during the post-operative period?
Who can I call if I have a problem in the middle of the night?

Insurance Considerations

Surgeons who participate in insurance plans are commonly not screened for proficiency. The insurance companies rarely have any criteria, or data that would indicate the doctor’s proficiency in corrective jaw surgery. You may be appointed a surgeon with very little or no experience in this type of surgery simply because the doctor participates with your insurance company. You cannot be forced to undergo this type of intricate surgery with an inexperienced surgeon simply because he participates with your insurance plan.

It should be noted that if your insurance company cannot provide you with an experienced and competent surgeon “in-network”, they must allow you to be treated by an “out-of-network” surgeon without it costing you more than your network obligation.