Impact of Orthognathic Surgery on Oral Health QOL

Objective: To assess self-reported changes in oral health related quality of life(OHQOL) and to evaluate the effect of type of surgery, gender, and age on these changes in patients having orthognathic surgery for a dentofacial deformity.

Method: Between July 2003 and July 2010, 189 patients completed the 14-item Short Form Oral Health Impact Profile (OHIP-14)  before orthognathic surgery, 6 weeks after surgery and at the completion of orthodontics as part of an IRB approved prospective study.  Subjects with a congenital syndrome, acute trauma, or ASA III or IV were excluded.  Repeated measures analysis of variance was used to analyze the changes for the overall OHIP score (range 0 to 56). Higher scores indicate a worse oral health quality of life.

Result: 65% of the subjects were female; average age was 19.  40% had both a maxillary and mandibular ostetotomy;  36% maxillary only;  and 24% mandibular only.  Before surgery, the most frequently reported items as occurring very often because of problems related to teeth or mouth were “being self-conscious”, uncomfortable eating any foods”, and “embarrassed” (28,13, and 14% respectively).  A substantial improvement in the overall score, on average, occurred by 1 year(P<0.0001).  Older subjects reported worse OHQOL before surgery and at 1 year after surgery than younger subjects(P<0.0001).  Average OHQOL scores were significantly different among the surgery types (P<0.0001).  Patients who had a 2 jaw procedure reported the worst OHQOL before surgery and patients with a mandibular procedure (single or two jaw) had slightly worse scores, on average, at 1 year than those who had a maxillary procedure only.

Conclusion: Significant improvement in overall oral health QOL occurred by 1 year after surgery.  The type of surgery and the age of the patient at surgery had a significant effect on the change from pre–surgery to post-treatment.