Braces and aligners are very good at moving teeth. They cannot move a jaw. For most people that distinction never comes up — the bite can be corrected by repositioning the teeth within the jaws they have. For a small number, the jaws themselves sit too far forward, too far back, or unevenly, and no amount of tooth movement will make them meet properly. That is when surgery becomes part of the plan.
If you have been told you may need it, or have been referred to us by a surgeon, we know how that sounds. This page explains what it involves and who does what. Come and talk it through at a consultation; nothing is decided on the day.
What surgical orthodontics is
The formal name is orthognathic treatment: orthodontic care and corrective jaw surgery planned together. An oral and maxillofacial surgeon repositions the jaw; your orthodontist moves the teeth so that they fit once it has been. The two parts are sequenced around each other — usually a period in braces first, so the teeth are lined up for the new jaw position, then the surgery, then a shorter finishing phase.
The American Association of Orthodontists regards it as the standard of care for a jaw discrepancy that orthodontics alone cannot resolve.
When it comes up
Rarely. Signs that a bite problem is in the jaw rather than the teeth include:
- an underbite, overbite or open bite that is too large to close with braces
- trouble biting, chewing or speaking that traces back to how the jaws meet
- a face that is visibly asymmetric, or strain in the jaw joint
- a bite that has stopped improving with conventional treatment
Jaw surgery is done once growth has finished, so it is almost always part of an adult plan. In a child whose jaw is still growing, early treatment can sometimes guide the growth instead — one of the reasons the age-seven check-up exists.
Who plans your case
Your orthodontist here — both of ours are board certified — diagnoses the case, plans the orthodontic side and stays in direct contact with your surgical team throughout. Records and iTero scans are shared between the two offices so that the plan is one plan, not two. If you do not yet have a surgeon, we will help you find one.