Orthodontic treatment can correct many problems involving crooked teeth, spacing, crowding, and bite alignment. However, some alignment problems are caused not only by the position of the teeth but also by the size or position of the jawbones. When these skeletal issues are significant, braces or clear aligners alone may not be enough to achieve the desired result.
In these situations, surgical orthodontics may be recommended. This treatment combines orthodontic care with corrective jaw surgery to improve the relationship between the teeth and jaws while supporting better function and facial balance.
What Is Surgical Orthodontics?
Corrective jaw surgery, also known as orthognathic surgery, is performed to reposition one or both jaws when their development or alignment creates functional or structural problems.
Treatment typically involves cooperation between an orthodontist and an oral and maxillofacial surgeon. The orthodontist focuses on positioning the teeth appropriately, while the surgeon addresses the underlying jaw structure.
Because the jaws generally need to finish growing before corrective surgery is performed, this approach is most commonly used for adults and older teenagers.
When Might Jaw Surgery Be Recommended?
Minor bite problems can frequently be corrected with conventional orthodontic treatment. Surgery may be considered when the discrepancy between the upper and lower jaws is too significant for orthodontic appliances alone to correct effectively.
Examples may include:
- A pronounced underbite or overbite
- An open bite
- Significant facial asymmetry
- A lower jaw that extends too far forward or sits too far back
- Difficulty bringing the lips together comfortably
- Problems with chewing or biting food
- Certain speech difficulties related to jaw position
Every patient’s situation is different, so a complete orthodontic and surgical evaluation is necessary to determine whether surgery is appropriate.
The Treatment Usually Begins With Orthodontics
In many cases, patients wear braces before undergoing jaw surgery. This stage aligns the teeth within each individual jaw so they will fit together correctly once the bones have been repositioned.
Interestingly, the bite may temporarily appear worse during this stage. This can happen because the orthodontist is positioning the teeth based on where the jaws will eventually be located rather than compensating for their current positions.
Regular appointments allow the orthodontist to monitor progress and determine when the teeth and jaws are ready for the surgical phase.
What Happens During Corrective Jaw Surgery?
The exact procedure depends on the patient’s anatomy and treatment needs. A surgeon may reposition the upper jaw, lower jaw, or both.
The bones are carefully moved into their planned positions and typically stabilized using small plates and screws. Many procedures are performed through incisions inside the mouth, helping minimize visible external scarring.
Modern treatment planning may incorporate digital scans, three-dimensional imaging, and computerized simulations to help the orthodontist and surgeon plan jaw movements precisely.
Recovery After Surgery
Recovery varies according to the complexity of the procedure and the individual patient. Swelling and temporary discomfort are common during the early stages.
Patients may initially need to follow a liquid or soft-food diet while healing progresses. They will also receive instructions regarding oral hygiene, physical activity, medication, and follow-up appointments.
Returning to everyday activities usually happens gradually. Complete bone healing takes longer than the initial recovery period, so following the surgical team’s instructions remains important even after the patient begins feeling better.
Orthodontic Treatment Continues After Surgery
Corrective jaw surgery is not normally the final step.
Once sufficient healing has occurred, orthodontic treatment continues so the teeth can be refined into their ideal positions. Small adjustments help create the final bite and improve overall alignment.
When active treatment is complete, patients generally receive retainers to help maintain their results.
Functional Benefits
One of the primary goals of treatment is improving function. Correct jaw alignment can make biting and chewing easier for patients whose skeletal structure previously interfered with these activities.
Some patients may also experience improvements in speech or other functions affected by jaw positioning, depending on the nature of their original condition.
Improved alignment can also distribute biting forces more evenly across the teeth.
Changes in Facial Appearance
Because the jaws influence facial proportions, repositioning them can change a person’s appearance.
For example, correcting an excessively prominent or recessed jaw may create greater balance between the chin, lips, nose, and other facial features. These changes are carefully considered during treatment planning.
Although appearance can be an important benefit, treatment decisions should take functional health, skeletal relationships, and individual goals into account.
Who Is a Good Candidate?
Candidates generally have significant skeletal jaw discrepancies that cannot be adequately addressed through orthodontic tooth movement alone. They should also be healthy enough to undergo surgery and understand that treatment requires a considerable commitment.
A detailed evaluation may include photographs, X-rays, digital scans, bite records, and three-dimensional imaging.
The orthodontist and surgeon then develop a coordinated treatment plan based on the patient’s facial structure, dental alignment, functional concerns, and treatment objectives.
Final Thoughts
Complex bite problems sometimes involve more than crooked or improperly positioned teeth. When jaw structure contributes to the problem, combining orthodontic treatment with corrective surgery can provide a comprehensive solution.
Although the process is longer and more involved than conventional orthodontic care, it can produce substantial improvements in jaw function, dental alignment, facial balance, and long-term oral health. Anyone considering this type of treatment should consult qualified orthodontic and surgical professionals who can explain the procedure, expected results, recovery process, and available alternatives.