More complex methods of outpatient anesthesia, including I.V. sedation and general anesthesia, have become commonplace. Patient selection and preoperative evaluation are discussed, as well as the choice of who will deliver anesthesia. Appropriate outpatient facilities and monitoring are reviewed. The authors’ favorite methods of anesthesia, caveats, and suggestions are presented, as well as prevention and treatment of anesthesia problems and emergencies.

Corrective jaw, or orthognathic surgery is performed by an oral and maxillofacial surgeon (OMS) to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient’s appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.

Your dentist, orthodontist and OMS will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. The OMS determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your OMS and orthodontist understand that this is a long-term commitment for you and your family, and will try to realistically estimate the time required for your treatment.

Open-joint arthroplasty is surgery to repair, reposition, replace, or remove parts in a joint. When used to treat temporomandibular disorder (TMD), this usually involves the articular disc that cushions the jaw joint

During open-joint arthroplasty of the jaw, an incision is made in the skin to expose the jaw joint. The surgeon may repair, reposition, or replace the disc with your own tissue or an artificial disc. Scar tissue or bony growths in the jaw joint can also be removed.

Open-joint arthroplasty is done under general anesthesia. You can normally expect to go home the same day.

When jaw joint movement cannot be regained becausethe disc has changed too much or the joint has broken down, the surgeon may need to remove the disc (discectomy) and replace it with an artificial disc.

Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP). A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disorders.

Cleft lip and palate are the result of tissues of the face not joining properly during development. As such, they are a type of birth defect. The cause is unknown in most cases. Risk factors include smoking during pregnancy, diabetes, obesity, an older mother, and certain medications (such as some used to treat seizures). Cleft lip and cleft palate can often be diagnosed during pregnancy with an ultrasound exam.

A cleft lip or palate can be successfully treated with surgery. This is often done in the first few months of life for cleft lip and before eighteen months for cleft palate. Speech therapy and dental care may also be needed. With appropriate treatment outcomes are good.

Cleft lip and palate occurs in about 1 to 2 per 1000 births in the developed world. CL is about twice as
common in males as females, while CP without CL is more common in females. In 2013 it resulted in about 3,300 deaths globally down from 7,600 deaths in 1990. The condition was formerly known as a hare-lip because of its resemblance to a hare or rabbit, but that term is now generally considered to be offensive.