• Brian B Farrell and Myron R Tucker.
• Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA. bfarrell@uomsnc.com
• J. Oral Maxillofac. Surg. 2009 Oct 1;67(10):2064-71.

AbstractThere has been a dramatic decline in the number of orthognathic surgery cases over the past 15 to 20 years. This decrease is a result of several compounding factors including decreasing coverage by major medical insurance companies and increasing health care costs. The difficulty associated with making orthognathic surgery financially practical has turned the interest of many oral and maxillofacial surgeons away from orthognathic procedures. The combination of these factors has resulted in decreased availability of surgeons participating in the correction of dentofacial deformities and has forced orthodontists and patients, without surgical correction as an option, to settle for less-than-ideal treatment results. To reverse this trend and make surgery more affordable and available, surgeons must work to make surgical treatment more acceptable to patients. This can be accomplished in several ways. First, the oral and maxillofacial surgery profession must reinforce the importance and value of orthognathic surgery to insurance providers, patients, and referring clinicians, as well as to surgeons within our own specialty. Alternative methods for providing high-quality surgical services at a reasonable cost must be explored including providing options for cost-effective outpatient surgical care, making better arrangements for financial assistance, and exploring options to obtain coverage from third-party providers. Outpatient surgery in facilities that can substantially reduce cost can be an effective way of providing quality treatment that is affordable to patients. Efficient, safe, and effective outpatient orthognathic surgery will help patients benefit from this valuable service.

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