Effect of Jaw Problems and Treatment on Quality of Life

New three-year grant studies perceptions relating to facial appearance, braces, and jaw surgery

This project is enrolling teenagers, 14 -20 years of age, and will include: 1) those with braces, 2) those without braces and 3) those needing both braces and surgery to make jaws and teeth fit together well. If jaw surgery is indicated, surgery can be provided at no cost at Shriners Hospital for Children - Chicago. Pravin K. Patel, MD, craniofacial surgeon, is principal investigator; Kathy Kapp-Simon, Ph.D., psychologist, serves as co-principal investigator. Other members of the team include dentists Stephen Grud, D.D.S. and Adriana Da Silveira, D.D.S.; psychology fellow Claudia Crilly Bellucci, Ph.D.; speech pathologist, Mary O’Gara, CCC-SLP; and research specialist/engineer Linping Zhao, Ph.D. The craniofacial team will study  how participating teenagers feel about their facial appearance and everyday functions such as speech, bite force and nasal breathing.

What will subjects be asked to do?
Subjects, whether or not they have braces, need braces, or need braces and surgery, will be asked to complete a questionnaire, speak, provide a nasal breathing sample, and bite a special wafer to determine the force of their bite.

What is jaw surgery? Who benefits from jaw surgery?
If the upper and lower jaws do not line up properly, then the patient’s “bite” will also fail to line up properly, causing problems with chewing and speaking certain sounds. Teeth can be repositioned with braces, but sometimes the facial bones or jaws must be repositioned surgically to create the best balance between the upper and lower jaws to function well for biting, chewing and speaking. An important consideration is how teenagers view quality of life: when they don’t need braces, when they do, and when they need both braces and surgery to improve their jaw relationship.

What are the kinds of jaw surgeries are performed at Shriners Hospital for Children, Chicago?
If the lower jaw is small, upper teeth may jut out in front of the lower teeth too much; the lower jaw can be surgically brought forward to create the facial balance and improved bite. If the lower jaw is larger than the upper jaw, the lower teeth may jut out in front of the upper teeth, giving the child’s face a sunken look. In this case, the lower jaw may be surgically pulled back and/or the upper jaw advanced. In some cases, the upper or lower jaw is asymmetric. Surgical procedures can be done to one side, or both sides, to one of the jaws, or to both jaws, to improve facial symmetry, appearance and function. Sometimes, when the molars (back teeth) bite, the front upper and lower teeth do not meet, causing an open bite. Braces alone can sometimes close the bite, but sometimes surgery is required to achieve a normal bite.

Can participants receive necessary jaw surgery even if they change their mind about participating in the study?
There is no penalty for withdrawing at any time, and surgery will still be provided as needed.

Contact Claudia Crilly-Bellucci, (773) 385-5409, for more information.

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