Which hospitals in Singapore does jaw surgeries? How much does the jaw surgery cost? Can I claim insurance? How do I prepare for the surgery? Find answers here.
Disclaimer: This article serves as an informational tool to advise Singaporeans (and foreigners) on what to expect and how to prepare for a jaw surgery in Singapore. In no way do I seek to encourage or dissuade (you) readers from proceeding with the surgery.
Orthognathic surgery, otherwise known as corrective jaw surgery is an operation performed by an ‘oral and maxillofacial surgeon to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth.’ (MyOMS, n.d.)
Contrary to what you think, jaw surgeries is not a ‘Western’ or ‘Korean’ thing. Jaw surgeries are not uncommon at all in Singapore. I have known two friends who went through a jaw surgery in Singapore and another who’s going for the surgery in due time. Hence it’s suffice to say that Singapore has the talents and the equipment to execute such surgeries and you don’t have to go to Korea to get your surgery done (of course we can, we are like elites in the medical field aren’t we?).
You may want to consider going for a jaw surgery if you have the following problems:
- Speech and enunciation problems
- Difficulty chewing, or biting food
- Difficulty swallowing
- Chronic jaw or jaw joint (TMJ) pain and headache
- Excessive wear of the teeth
- Open bite (space between the upper and lower teeth when the mouth is closed)
- Unbalanced facial appearance from the front, or side
- Facial injury
- Birth defects
- Receding lower jaw and chin
- Protruding jaw
- Inability to make the lips meet without straining
- Chronic mouth breathing
- Sleep apnea (breathing problems when sleeping, including snoring)
Which Hospitals in Singapore does Jaw Surgeries?
I did mine at the National University Hospital (NUH). The other public healthcare institute that I know of that execute such surgeries is the National Dental Centre of Singapore (NDC). On an overall, both institutions does corrective jaw surgeries at rates which I believe to be significantly lower than private dental centres. Thomson Dental Centre and Gleneagles Medical Centre also conducts jaw surgeries. But bear in mind that private institutions and (plastic) surgery clinics may cost more and offer very much the same services and quality of care you will find at public healthcare institutes.
If you would like to check out private dental centres which executes jaw surgeries, simply google ‘orthognathic surgery in Singapore‘. In addition, this website has a list of 14 Orthognathic Surgery Clinics which you can reference from.
If you would like either NUH and NDC to execute your jaw surgery, do take note that you may/will have to be on the waiting list which shouldn’t extend beyond 6 months of waiting time.
You may contact and make an appointment with NUH via phone at +65 6772 4921.
You may contact and make an appointment with NDC via email at email@example.com or via phone at +65 6324 8802.
Can I Claim Insurance For The Surgery?
Yes and no. It really depends on your surgery classification. If your surgery is deemed as a corrective/functional surgery, your surgeon will be able to write a favourable report to help you get your insurance claims. If it is considered a cosmetic surgery, then you may not make any claims at all. So make sure you discuss with your surgeon during financial planning to get his advice. Most surgeons will be more than willing to help patients save money on their surgery.
Because my surgeon deemed this as a functional surgery, my AIA Pink of Health insurance policy can kick in and pay for the surgery bill. Do note that braces treatment will most likely be rejected for insurance claims.
When in doubt, ask your insurance agent. You paid them a hefty amount to serve you anyway.
What Are The Treatment Stages Like?
Phase 1: Treatment Planning
Treatment planning is carried out jointly by an orthodontist and an oral and maxillofacial surgeon. The orthodontist determines how braces will align your teeth in preparation for surgery. The oral and maxillofacial surgeon studies your jaw deformity and decides on the type of surgery most appropriate for your case. This initial phase of treatment will include consultation, records-taking and discussion of the treatment plan with you. (Singhealth, n.d.)
Phase 2: Presurgical Orthodontic Phase
Many patients undergo an initial period of presurgical orthodontic treatment (braces) may take 9 to 18 months. The actual time taken depends on the condition, the patient’s age, cooperation and other factors. During this time, patients are seen at intervals of 4 to 6 weekly intervals. At the end of this phase, the teeth are aligned so that they will fit into a good bite after surgery. (Singhealth et al, n.d.)
I chose NUH to do my braces and surgery. Prior to putting on the braces, you will need to extract up to 4 premolar tooth (depending on situation) and possibly all your wisdom tooth. I removed 7 tooth in total via surgery. In order to knock-down the cost, I chose the post-graduate option for my braces during which I have to wait for a post-graduate orthodontist to be assigned to me. This meant that my braces were done by a NUS dentistry graduate who is bonded to the Faculty of Dentistry’s Post-graduate clinic (like doctors who are bonded to hospitals as houseman). I will breakdown the cost for you in a while.
Is it ‘safe’? My orthodontist who’s not really a post-graduate since he has already graduated 5 years ago was very professional and personal. He even texts me a day before my monthly follow-up visits even though he didn’t have to. And the visits are very smooth. Meaning to say, you’re in safe hands.
You can also choose to go for an autologous transfusion to donate blood to yourself one week before the surgery although this is optional. While you can always take blood from the blood bank, your own blood is always the safest option. I did it.
Phase 3: Surgical Phase
Surgery is scheduled when the presurgical orthodontic phase is completed. Braces used to align teeth prior to surgery are left in place during the surgical procedure. They help in stabilising the teeth and jaw bones after surgery. (Singhealth et al, n.d.)
When it comes to surgeries, there are no post-graduate option available. Who would want to risk a not-so-experienced oral and maxillofacial surgeon to save a few hundred dollars anyway? In NUH, you will be operated by an oral and maxillofacial surgeon who’s had decades of dental surgery experience.
This is a major surgery which could take as long as 9 hours. Mine took 7 hours. As such, a urinal catheter will be inserted to help you discharge your urine during and after the surgery due to inability resulting from the anesthetic. The entire operation will be done in your mouth, hence you will not have any facial scars. Screws and plates will also be placed within your jaw. I have 4 in my jaw. The alarm will not go off even if you step through the airport scanners fyi.
Phase 4: Post-surgical Orthodontic Phase
After surgery, post-surgical orthodontics is continued to achieve final alignment of the teeth and to retain them in their new position. (Singhealth et al, n.d.)
It’s the final stretch. You will need to put on braces again for months before switching out to retainers.
Cost Breakdown (NUH)
Phase 1: Treatment Planning
Cost at this phase is almost negligible. You will pay less than $100 in total consulting fees. The general dentist will review your case, advise you and refer you to an orthodontist who will further advise you.
Phase 2: Presurgical Orthodontic Phase
Your new life with braces starts here. But before that, you have to remove some teeth. My surgery to remove 7 tooth (including all of my wisdom tooth) costed around $5,000 as it was performed by my oral and maxillofacial surgeon. Around half was covered by Medisave. Because I went through NUH’s post-graduate programme, the total cost for braces was $2,140 inclusive of GST. You can also choose to pay in full or pay by installments which also happen to be interest-free by the way. I chose to pay by installments. Medisave and insurance may not be used here as braces treatment are not claimable (in my knowledge).
There are also some hidden costs such as payment for X-rays, mold model of your jaw and all. Expect to pay about $200-$300 here.
Phase 3: Surgical Phase
I’m not so familiar with this but here goes. Before the surgery can proceed, the surgeon will need to plan and ‘practise’ on a model. Traditionally, they will need to recreate two models of the entire jaw. This costs about $2,800. With the advent of technology, 3D imaging via CT scan is now available. This option costs approximately $5,400. I initially chose the latter option but missed my appointment (Laughs). Because of the lack of time, I had to go with the first option, but it turned out okay. The surgeon assured me that it was the ‘Gold standard’ for orthognathic surgeries before the 3D imaging came along.
My total surgery cost inclusive of 4 days hospital stay (B ward) was approximately $21,291. The lowest you can go is B ward. B ward includes an air-conditioned 4-bed room (but mine only had 2 yay), bathroom, telephone and even your own television. If you are feeling rich, take the A ward (you stay alone). Government contributions remove up to 20% from total bill. Medisave takes out 40% from total bill. Because my surgery is considered a functional surgery instead of cosmetic, I can claim the maximum $10,000 for the surgery via AIA’s Pink of Health insurance policy. Right now, it appears I might be able to claim more to cover even the Medisave portion but that is still unconfirmed.
Phase 4: Post-surgical Orthodontic Phase
Follow-up visits with the surgeon costs roughly $70 per visit. Prepare $350 here. Your diet will consist of Ensure milk via syringes. Set aside $90 here although I did think you’re actually saving money here since you’re not feasting outside.
If I’m not wrong, I shouldn’t need to pay anymore for braces here. In NUH, you will go back to the orthodontist who was with you right from the beginning for your braces follow-up. I would expect to do some final X-ray scans and mold models here so $200 should be enough.
So, assuming you are following my path and you are paying the entire treatment procedure without any form of subsidy, medisave and insurance payout, expect to pay approximately $35,000.
Surgery Risks and Complications
As with every major surgery, orthognathic surgeries comes with certain risks should things go south (though it’s highly unlikely as affirmed by the surgeon). Before you sign your consent for the surgery, the oral and maxillofacial surgeon will personally inform you on this. You will be briefed again on the risks the day before the surgery (as if you need to be frightened before the surgery).
Some of the risks are as follows:
- Decreased sensation or numbness from nerve injury
- Permanent numbness from nerve injury
- Bleeding that could be potentially serious
- Jaw joint problems
- Damage to normal structures such as the teeth, gums, and bone
- Blabber problems due to damage done by catheter insertion
- Breathing problems due to blood clot and/or damage done to throat by breathing tube
Adapted from LACOMS (n.d.).
What to Expect and How to Prepare For Post-Surgery
It’s a 3-month-long recovery period from this point on. Soldier on for the next few months and you will get aligned teeth and a great smile. There are plenty of resources on the internet to teach you on what to expect and how to prepare for post-surgery. For your convenience, I have listed the things you need to know about post-surgery below to help you get by this trying recovery period.
You can also read up from the websites and blogs from past patients by googling ‘orthognatic surgery‘ on the internet.
Diet after surgery
Liquid Diet (Week 0-3)
You will be on strictly liquid diet for at least 2 weeks. You will lose weight during this period, the idea is to not lose too much. The day right after your surgery, your surgeon will push you to start drinking water and Ensure milk using the syringe. It may sound cruel, but only when you showed that you are capable enough to feed yourself will the dentist allow you to be off IV and subsequently be discharged. Drink water every hour to keep yourself hydrated.
Fun fact, every website I visited recommends Ensure. Must be one heck of a milk huh?
How much calories you need everyday depends on your BMI. But most would recommend taking 5-6 meals a day. Ideally you should be downing 5-6 glasses of Ensure milk a day at the minimum – even then, it’s not enough. One glass of Ensure milk packs 266 calories. Ensure milks comes in 3 flavours (Vanilla, Strawberry and Chocolate) and in 2 versions; 250ml pre-made can (approximately S$2.15 per can) or the 850g formula powder can (S$30). You can get approximately 16 glasses from one can of Ensure formula powder. But if you’re lazy, get the pre-made canned ones.
Make soup and pureed juices for extra taste. Make sure there’s no pulp and bits in the beverage which can end up stuck between your teeth. Focus on recovering back some pounds after the 1st week.
Soft Diet (Week 2-6)
Follow your dentist’s instructions, don’t jump the queue. Proceed to soft diet only when doc says so. When he does so, don’t get too excited yet. I tried to down scrambled eggs and failed terribly. Food that don’t require much chewing and is easy to swallow is great during this period. Porridge and mashed anything are a splendid choice.
Soft boiled eggs are my comfort food
Normal Diet (Week 6 onwards)
This is the moment you have been waiting for, to sink your teeth into something solid. Start slow. Attempt stuff that aren’t too hard. You don’t want to risk injuring your jaw.
You will be given all the necessary medications to aid in your recovery. Consume them diligently and faithfully.
To be grinded and fed through the syringe in the first week since you can’t open your mouth. It will taste horrible, mix with juices or Ribena to nullify the bitterness. Consume 3 times a day.
To be grinded and fed through the syringe in the first week since you can’t open your mouth. It will taste horrible, mix with juices or Ribena to nullify the bitterness. Consume 1 per day.
- Anti-nausea Medication
Consume when needed
- Nasal Spray
To prevent dryness in your nose and help you breathe. Spray trice a day.
- Medicated Lip Balm
Prevents peeling lips. Apply generously trice a day.
- Vitamin B Supplement
- Cough Medicine (Optional)
- Sleeping pills (Optional)
You will find it hard to sleep in the first 5 days after the surgery due to the swelling. Consume sleeping pills to aid in doing so.
You will be given a baby brush and Orasol mouthwash (containing Chlorhexidine antiseptic). Brush and rinse 3 times a day. Alternatively, you can use salt water to replace the mouthwash. Once the rubber bands are removed after the first week, you can actually brush the inside of your teeth as well, thus you don’t need the mouthwash. But if you’re lazy, brush the outside and continue to use the mouthwash.
Swelling and Bruising
Your face will swell after the surgery. But that’s not the worst. Expect the swelling to increase 48 hours after the surgery. Your face will look like a balloon but it’s only temporary. The swell will go down completely by the end of the first week.
Apply ice on the swelled area in 20 minute intervals. This will offer (temporary and much needed) relief and helps in bringing down swelling. Be careful of burns. Do this 3 times and after the 3rd time, apply heat pad – I don’t have this so I skipped it. Do this for the first 3-4 days. Apply heat after the 4th day to help bring down swelling and to help you sleep better.
You might also notice that the area around your jawline and your neck to be yellowish or even greenish in colour. Don’t worry about it. It’s temporary as well.
Sleep and Rest
As mentioned earlier, you will find much difficulty sleeping. Even after consuming the sleeping pills, I slept less than 3 hours during the 3rd day and less than 5 hours during the 4th day. Follow the above instructions to bring the swelling down. If you have a recliner at home, celebrate. If not, invest in another pillow and attempt to sleep in an elevated position (double pillows). This will also help bring the swelling down as well.
Your teeth will be bond together by rubber band for the first week or two depending on where you got your surgery done. My surgeon at NUH remove my rubber band after one week. While bond together, you won’t be able to speak at all.
Once untied, you can speak albeit with significant difficulty. Celebrate your new found freedom and keep your spirits up.
Because the surgery is done in the mouth, the surgeon had to put the breathing tube through your nose and into your throat to help you breathe during the surgery. You may experience difficulties breathing through the nose because there might be some blood clot stuck in the nose. Do not attempt to extract or blow it out as it may cause complications. Use the nasal spray.
You can also breathe through your mouth.
You will be drooling a lot – and I mean A LOT – during the first month due to the numbness of the nerves around your lips. Keep your handkerchief and tissues close by at all times.
Recovering from a corrective jaw surgery can be a daunting experience. The dentist will issue you one month’s MC which can be a boon or bane depending on your personality. Many patients tend to be depressed during this period. It’s important to surround yourself with family and friends during this trying time. Take this time to catch up on your favourite dramas, take a walk around the neighbourhood, enjoy the company of your friends when they visit, and keep your spirits up. Remember that pain is only temporary, the result is final.
I wish you well in your preparing for the surgery. Feel free to share this article with any of your friends who are going through or are about to go through an orthognathic surgery. If you have any enquiries regarding corrective jaw surgery, feel free to email me at firstname.lastname@example.org and I will try my best to assist you. All the best! RW
Online Resources You Can Refer To:
Los Angeles Center for Oral and Maxillofacial Surgery
Steffies Orthognathic Surgery Blogspot
Dr William R. McDonald Post Operative Instructions
Double Jaw Surgery Recovery Tips
My Jaw Surgery and I Blogspot