Orthodontic treatment is often associated with braces, clear aligners, and retainers. While these tools can effectively straighten teeth and correct many bite issues, there are cases where orthodontic treatment alone cannot achieve the desired results. For individuals with severe jaw misalignment or skeletal discrepancies, orthognathic surgery—also known as corrective jaw surgery—plays a vital role in improving both function and aesthetics.
This article explores what orthognathic surgery is, when it is necessary, and how it integrates with orthodontic treatment to transform a patient’s smile, bite, and overall oral health.
What Is Orthognathic Surgery?
Orthognathic surgery is a corrective procedure designed to realign the jaws when they do not meet properly. Unlike standard orthodontic treatments such as dental braces or clear aligners, which move teeth, orthognathic surgery addresses the underlying skeletal structure.
This surgery is typically performed by an oral and maxillofacial surgeon in collaboration with an orthodontist. The surgeon repositions the jawbones to achieve better alignment, while orthodontic treatment before and after surgery ensures that the teeth fit together correctly in the new jaw position.
Why Orthognathic Surgery May Be Needed
Not every orthodontic issue requires surgery, but there are cases where tooth movement alone cannot resolve the problem. Orthognathic surgery may be recommended when:
- The upper and lower jaws are significantly misaligned.
- Severe underbites, overbites, or open bites are present.
- The patient has difficulty chewing, biting, or speaking due to jaw structure.
- Sleep apnea is linked to jaw positioning.
- The facial appearance is affected by jaw imbalance.
While orthodontic treatment can align the teeth, skeletal discrepancies require surgical intervention for lasting results.
The Orthodontic and Surgical Team Approach
Orthognathic surgery is never a standalone procedure. It requires coordination between an orthodontist and an oral surgeon. Here’s how the process usually works:
- Initial Evaluation
The orthodontist conducts a thorough examination, which may include X-rays, 3D imaging, and bite analysis. If the misalignment appears skeletal, the orthodontist refers the patient for a surgical consultation. - Pre-Surgical Orthodontics
Before surgery, patients usually wear braces or aligners to straighten their teeth and prepare them for the new jaw position. This stage can last 12 to 18 months, depending on the complexity of the case. - Surgical Procedure
During the surgery, the oral surgeon repositions the upper jaw, lower jaw, or both, depending on the case. Plates, screws, or wires may be used to secure the bones in their new position. - Post-Surgical Orthodontics
After healing, the orthodontist continues treatment to fine-tune the bite and ensure proper alignment. - Retention Phase
Once the orthodontic treatment is complete, retainers are used to maintain the new position of the teeth and jaws.
By combining the expertise of both orthodontics and surgery, patients achieve results that are both functional and aesthetic.
Common Jaw Issues Treated with Orthognathic Surgery
Orthognathic surgery can address a wide variety of skeletal and bite problems. Some of the most common include:
- Underbite – When the lower jaw extends too far forward compared to the upper jaw.
- Overbite – When the upper jaw protrudes significantly over the lower jaw.
- Open Bite – When the upper and lower teeth do not meet when the mouth is closed.
- Crossbite – When the jaws are misaligned so that some upper teeth sit inside the lower teeth.
- Jaw Asymmetry – When one side of the jaw grows differently, creating imbalance in facial symmetry.
These conditions often impact chewing, speech, breathing, and facial appearance. Corrective surgery helps restore harmony to both function and aesthetics.
Benefits of Orthognathic Surgery
Choosing orthognathic surgery as part of orthodontic treatment can deliver transformative results. Some of the most important benefits include:
- Improved Oral Function
Chewing, biting, and speaking become easier when the jaws are properly aligned. - Better Facial Symmetry
Surgery enhances facial balance by correcting jaw discrepancies, often boosting self-confidence. - Long-Term Oral Health
Proper jaw alignment reduces uneven wear on teeth, lowering the risk of damage, gum disease, and jaw pain. - Improved Breathing
In some cases, jaw surgery can help open the airway, reducing snoring or sleep apnea. - Lasting Results
Unlike temporary solutions, orthognathic surgery corrects the root skeletal problem, providing stability for a lifetime.
Orthognathic Surgery and Braces: A Step-by-Step Journey
For many patients, the thought of combining braces with surgery can feel overwhelming. Understanding the timeline helps clarify expectations.
- Step 1: Braces Before Surgery
Patients usually begin with braces to align the teeth in preparation for the new bite. - Step 2: The Surgical Phase
The surgery itself is performed under general anesthesia. Depending on the complexity, recovery may require several weeks. - Step 3: Post-Surgical Braces
After healing, the orthodontist makes adjustments to finalize the bite. - Step 4: Retention and Aftercare
Retainers, along with regular orthodontic checkups, ensure that results are maintained.
For more detailed information on what life is like with braces before and after surgery, you can explore resources like life with braces on our website.
Recovery and Healing After Surgery
Recovery is an essential part of the process. Most patients can expect:
- Initial swelling and discomfort for 1 to 2 weeks.
- A soft-food diet during the healing phase.
- Follow-up visits with the oral surgeon and orthodontist.
- Gradual return to normal activities within 4 to 6 weeks.
The orthodontist will continue to monitor progress and make final adjustments once the jaw has healed properly.
Is Orthognathic Surgery Right for You?
Orthognathic surgery is not for everyone, but it is highly effective for patients with significant skeletal misalignments. If your bite or jaw alignment is causing functional or aesthetic concerns, a consultation with an orthodontist is the first step.
During this consultation, you will receive a personalized evaluation. The orthodontist will determine whether braces or aligners alone can correct your bite or if surgery is necessary. At East Tennessee Orthodontics, we help guide patients through every stage of this journey, ensuring that treatment is safe, effective, and tailored to individual needs.
The Emotional Impact of Jaw Surgery and Orthodontics
Beyond the physical improvements, corrective jaw surgery can have a powerful emotional effect. Many patients report increased self-esteem and confidence once their bite and facial symmetry are corrected. Improved appearance combined with functional benefits makes the process life-changing for many adults and teens.
If you are considering this treatment, it is important to know that support and guidance are available every step of the way. From the first braces adjustment to post-surgical care, your orthodontic team ensures you are comfortable and informed.
Final Thoughts: Transforming Smiles with Orthognathic Surgery
Orthognathic surgery plays a critical role in orthodontic treatment when braces or aligners alone cannot resolve complex bite and jaw issues. By addressing both the teeth and the skeletal structure, this combined approach improves oral health, enhances facial aesthetics, and creates long-lasting results.
If you are dealing with severe bite problems, jaw pain, or facial imbalance, consider scheduling a consultation with an orthodontist. Exploring whether orthognathic surgery is right for you could be the first step toward a healthier bite and a more confident smile.
FAQs About Orthognathic Surgery and Orthodontic Treatment
1. What is orthognathic surgery?
Orthognathic surgery, also called corrective jaw surgery, is a procedure that repositions the upper jaw, lower jaw, or both to improve bite alignment, function, and facial balance. It is usually done in combination with orthodontic treatment like braces or clear aligners.
2. How do I know if I need jaw surgery instead of just braces?
Your orthodontist will determine this during your evaluation. If your bite issues are caused by jaw misalignment rather than just tooth position, surgery may be recommended. Braces or aligners alone cannot correct skeletal problems.
3. At what age is orthognathic surgery usually performed?
Most patients undergo jaw surgery in late teens or adulthood, once the jaws have fully finished growing. This ensures the corrections are stable and long-lasting.
4. How long will I need braces if I have orthognathic surgery?
Most patients wear braces before and after surgery. Pre-surgical orthodontics usually lasts 12 to 18 months, while post-surgical treatment fine-tunes the bite. The total time depends on your specific case.
5. What is the recovery like after jaw surgery?
Recovery includes swelling, mild discomfort, and a soft-food diet for a few weeks. Most patients return to normal activities within 4 to 6 weeks. Your orthodontist and surgeon will provide detailed aftercare instructions.
6. Can orthognathic surgery improve my facial appearance?
Yes. In addition to correcting bite problems, surgery often enhances facial balance and symmetry. Many patients report feeling more confident in their appearance after treatment.
7. Does jaw surgery help with breathing problems like sleep apnea?
In some cases, yes. If your sleep apnea is caused by restricted airway space due to jaw position, corrective surgery can help open the airway and improve breathing.
8. Will orthognathic surgery be painful?
Most patients experience discomfort rather than severe pain, which is managed with medication. Swelling and soreness are common but improve within the first two weeks of recovery.
9. Is orthognathic surgery permanent?
Yes. Once the jaw is repositioned and stabilized with plates or screws, the changes are permanent. Combined with orthodontic treatment and retainers, the results are designed to last a lifetime.
10. How do I get started if I think I need jaw surgery?
The first step is a consultation with an orthodontist. They will evaluate your bite, teeth, and jaw alignment, and if needed, coordinate care with an oral surgeon. You can learn more about treatment options on our orthodontic services page.