JAW SURGERY & SURGICAL ORTHODONTICS
Expert orthodontic planning for a healthier bite, balanced jaws, and a confident smile.
Orthodontics moves the teeth.
Jaw surgery repositions the jaws.
Together, they can create a healthier relationship between the teeth, jaws, bite, and face.
When straightening teeth is only part of the solution
Orthodontic treatment can move teeth into healthier positions, but braces and aligners may not always be the best option for correcting significant differences in the underlying jaw bones.
When the upper jaw, lower jaw, or both jaws are substantially out of position, moving the teeth alone may not create the healthiest bite or facial balance. In these situations, orthodontics can prepare and align the teeth while corrective jaw surgery repositions the jaws. The orthodontist and oral and maxillofacial surgeon work closely together throughout treatment. Orthodontics is usually completed both before and after surgery so that the teeth fit properly once the jaws are in their new positions.
When the upper jaw, lower jaw, or both jaws are substantially out of position, moving the teeth alone may not create the healthiest bite or facial balance. In these situations, orthodontics can prepare and align the teeth while corrective jaw surgery repositions the jaws. The orthodontist and oral and maxillofacial surgeon work closely together throughout treatment. Orthodontics is usually completed both before and after surgery so that the teeth fit properly once the jaws are in their new positions.
ORTHODONTIC JAW SURGERY
Who May Benefit?
A surgical orthodontic evaluation may be appropriate when the position of the jaws—not simply the teeth—is contributing to the bite misalignment. Conditions that may involve a treatment recommendation for jaw surgery include:
Severe Underbite
The lower teeth or jaw sit significantly in front of the upper teeth or upper jaw. In growing children, underbites may respond to growth-guidance treatment. Once jaw growth is complete, some underbites may benefit from a combination of orthodontics and jaw surgery.
Recessed Lower Jaw or Severe Overjet
The lower jaw and chin may be significantly set back, and the upper front teeth may project or protrude in front of the lower teeth. In growing children, overjet is often treated with growth-guidance treatment. Once jaw growth is complete, some overjets may benefit from a combination of orthodontics and jaw surgery. The appropriate treatment depends on jaw growth, jaw structure, tooth position, facial balance, among other factors.
Skeletal Open Bite
The front teeth are significantly apart and do not meet when the back teeth are together. Some open bites can be corrected with braces or aligners only, while more severe skeletal open bites may benefit from surgical treatment.
Facial or Jaw Asymmetry
The chin, lower jaw, bite, or facial features may shift toward one side if jaw growth was asymmetric over time. Careful diagnosis is important since asymmetry may involve the teeth, jaws, jaw joints, or a combination of factors.
Severe Crossbite or Jaw-Width Imbalance
The upper jaw may be significantly narrow in relation to the lower jaw. Depending on the patient’s age and anatomy, treatment could involve orthodontic expansion, skeletal expansion (ex. MSE, MARPE, MASPE), surgically assisted expansion (SARPE), or jaw surgery.
Functional Difficulties
Some patients experience difficulty biting or chewing food, excessive tooth wear, difficulty bringing the lips together comfortably, or concerns with speech or swallowing.
Breathing or Airway-Related Concerns
Jaw position can be one component of a comprehensive airway evaluation. Collaboration with medical and surgical specialists may be indicated when sleep-disordered breathing is suspected. Advancement of the upper and lower jaws is a treatment considered for obstructive sleep apnea when jaws are recessive or severely constricted. An orthodontic examination is needed to determine whether the concern is dental, skeletal, functional, or a combination.
Severe Underbite
The lower teeth or jaw sit significantly in front of the upper teeth or upper jaw. In growing children, underbites may respond to growth-guidance treatment. Once jaw growth is complete, some underbites may benefit from a combination of orthodontics and jaw surgery.
Recessed Lower Jaw or Severe Overjet
The lower jaw and chin may be significantly set back, and the upper front teeth may project or protrude in front of the lower teeth. In growing children, overjet is often treated with growth-guidance treatment. Once jaw growth is complete, some overjets may benefit from a combination of orthodontics and jaw surgery. The appropriate treatment depends on jaw growth, jaw structure, tooth position, facial balance, among other factors.
Skeletal Open Bite
The front teeth are significantly apart and do not meet when the back teeth are together. Some open bites can be corrected with braces or aligners only, while more severe skeletal open bites may benefit from surgical treatment.
Facial or Jaw Asymmetry
The chin, lower jaw, bite, or facial features may shift toward one side if jaw growth was asymmetric over time. Careful diagnosis is important since asymmetry may involve the teeth, jaws, jaw joints, or a combination of factors.
Severe Crossbite or Jaw-Width Imbalance
The upper jaw may be significantly narrow in relation to the lower jaw. Depending on the patient’s age and anatomy, treatment could involve orthodontic expansion, skeletal expansion (ex. MSE, MARPE, MASPE), surgically assisted expansion (SARPE), or jaw surgery.
Functional Difficulties
Some patients experience difficulty biting or chewing food, excessive tooth wear, difficulty bringing the lips together comfortably, or concerns with speech or swallowing.
Breathing or Airway-Related Concerns
Jaw position can be one component of a comprehensive airway evaluation. Collaboration with medical and surgical specialists may be indicated when sleep-disordered breathing is suspected. Advancement of the upper and lower jaws is a treatment considered for obstructive sleep apnea when jaws are recessive or severely constricted. An orthodontic examination is needed to determine whether the concern is dental, skeletal, functional, or a combination.
UNDERSTANDING JAW SURGERY
What is Orthognathic (Jaw) Surgery?
Orthognathic surgery is corrective jaw surgery performed by an Oral and Maxillofacial Surgeon. It may be recommended when a jaw imbalance affects the way the upper and lower teeth come together or contributes to functional concerns involving chewing, speech, toothwear, facial balance, or breathing.
Although changes in facial appearance are often benficial, the primary purpose of orthognathic surgery is often to improve jaw alignment and function.
Jaw surgery may involve:
Although changes in facial appearance are often benficial, the primary purpose of orthognathic surgery is often to improve jaw alignment and function.
Jaw surgery may involve:
- Repositioning the upper jaw
- Repositioning the lower jaw
- Repositioning both jaws
- Correcting jaw or chin asymmetry
- Surgically expanding the upper jaw
- Correcting a cant (slant) in the jaw
- Repositioning segments of the jaw
- Combining jaw correction with other individualized surgical procedures
The exact procedure is determined by the oral and maxillofacial surgeon in coordination with the orthodontist and based on the patient’s anatomy, health, bite, and treatment goals. Our jaw surgery orthodontists, Dr. Godley and Dr. Bradley, are both Board Certified and experienced in collaborative, multidisciplinary care and work closely with local maxillofacial surgeons.
YOUR ORTHODONTIST’S ROLE
Why Your Orthodontist Is Essential to Jaw Surgery Treatment
Though the oral and maxillofacial surgeon performs the operation, the orthodontist directs the positioning of the teeth and coordinates the bite.
In many cases, the teeth have naturally tried to stay together and are “compensated” for the underlying jaw imbalance. For example, teeth may lean forward or backward in an attempt to meet despite the jaws being out of position. Before surgery, the orthodontist carefully moves the teeth into the best positions in the jaws, to allow the surgeon to properly reposition the jaws.
This process requires an understanding of:
In many cases, the teeth have naturally tried to stay together and are “compensated” for the underlying jaw imbalance. For example, teeth may lean forward or backward in an attempt to meet despite the jaws being out of position. Before surgery, the orthodontist carefully moves the teeth into the best positions in the jaws, to allow the surgeon to properly reposition the jaws.
This process requires an understanding of:
Close communication and collaboration between the orthodontist and maxillofacial surgeon is important from the initial diagnosis through final bite detailing. Successful jaw surgery treatment is not an isolated procedure. It is a carefully coordinated process involving the patient, orthodontist, and jaw surgeon.
THE JAW SURGERY PROCESS
1. Orthodontic Consultation
- Your smile and bite journey begins with an evaluation by an orthodontist to review your concerns, goals, bite, facial balance, and treatment.
- Diagnostic records may include photographs, digital scans, and imaging.
2. Consultation with Oral and Maxillofacial Surgeon
- After an oral and maxillofacial surgeon provides an evaluation, the orthodontist and surgeon review the diagnosis and coordinate the proposed orthodontic and surgical plan.
- The surgeon determines the appropriate surgical procedure, discusses medical considerations, and reviews the expected operation and recovery.
3. Pre-Surgical Orthodontics
- Braces or aligners are used to position the teeth within the jaw before surgery.
- The bite may temporarily appear misaligned or feel uncomfortable, as the teeth are being moved to their ideal positions in the jaws to fit correctly after surgery.
- The orthodontist and surgeon confirm tooth positions, bite goals, and jaw movements.
4. Corrective Jaw Surgery
- The oral and maxillofacial surgeon performs the procedure in a hospital or surgical setting.
- Swelling, discomfort, and dietary restrictions are common during the early healing period.
- Your surgeon will provide instructions concerning nutrition, hygiene, activity, medication, and follow-up care.
5. Post-Surgery Orthodontics
- Once healing has progressed, orthodontic treatment continues.
- Your orthodontist refines the bite, adjusts the final tooth positions, and works toward the most stable and functional result possible.
6. Retention
- After treatment is complete, retainers protect the final tooth positions.
- Long-term retainer wear is important for maintaining the treatment results.
FREQUENTLY ASKED QUESTIONS
Do I need jaw surgery, or can braces fix my bite?
This depends on whether the concern is primarily caused by the position of the teeth or by the underlying jaws. Braces and aligners move teeth, but they cannot always correct a substantial skeletal jaw imabalance in a patient who is done growing. Your orthodontic evaluation will help distinguish between dental and skeletal causes.
At what age is jaw surgery performed?
Corrective jaw surgery is generally planned after the jaws have finished growing, often during the later teenage years or adulthood. Timing varies according to the patient, growth pattern, diagnosis, and procedure being considered.
Does orthodontic treatment happen before or after surgery?
Typically, orthodontics begins before surgery and continues afterward. The pre-surgical phase positions the teeth in the best position in the jaw for the planned surgical movement, while the post-surgical phase refines and finalizes the bite.
Who performs the jaw surgery?
Jaw surgery is performed by an oral and maxillofacial surgeon. Your orthodontist plans and manages the tooth movement and works closely with the surgeon to coordinate the bite before and after surgery.
Can I have Invisalign or clear aligners with jaw surgery?
Some surgical cases can be treated with clear aligners. Other cases may require braces for greater control. The method depends on your orthodontist and surgeon’s preference, the planned surgery, and the tooth movements needed.
Will jaw surgery change my appearance?
Repositioning the jaws may change facial proportions, the profile, lip support, chin position, or smile. The degree of change depends on the procedure. Although facial balance may improve, jaw surgery is generally recommended to address functional and skeletal concerns rather than solely for cosmetic reasons.
How long does surgical orthodontic treatment take?
The total timeline varies significantly. It depends on the complexity of the bite, the amount of pre-surgical tooth movement, surgical scheduling, healing, and the amount of post-surgical orthodontic finishing required. You will receive a personalized estimate after the orthodontic and surgical teams have completed their evaluations.
What is recovery from jaw surgery like?
Patients commonly experience swelling, discomfort, temporary numbness, fatigue, and dietary changes during early recovery. The type of surgery and individual healing response affect the recovery timeline. Your oral and maxillofacial surgeon will provide the most accurate expectations and post-operative instructions.
Is jaw surgery covered by insurance?
Coverage varies according to the insurance plan, diagnosis, documentation, and medical-necessity requirements. Jaw surgery is generally evaluated through medical insurance, while the orthodontic portion may be evaluated separately through dental or orthodontic benefits. Patients should obtain plan-specific information from their insurer and surgical office.
Do I need a referral to meet with Dr. Godley and Dr. Bradley?
No. You may schedule a complimentary orthodontic consultation directly with Godley Family Orthodontics. If a surgical opinion is appropriate, our team can help coordinate the next step.