Smiling young woman with long red hair sitting outdoors in a park, representing a confident and healthy smile for orthodontic care content.
Smiling young woman with long red hair sitting outdoors in a park, representing a confident and healthy smile for orthodontic care content.

Surgical Orthodontics and Corrective Jaw Surgery

Medically Reviewed by Dr. Duane S. Shank, DDS, Board-Certified Orthodontist

Some bite problems are caused by the jaws being the wrong size or out of position relative to each other. Braces move teeth, but they cannot move a jaw. When the discrepancy is large enough, orthodontic treatment is combined with corrective jaw surgery, called orthognathic surgery, performed by an oral and maxillofacial surgeon.

This page exists mainly so you know what it involves and when it is genuinely needed. At this practice, surgery is considered only when orthodontic treatment alone cannot correct the problem, which is a small minority of cases.

When it is actually needed

The question is whether the problem is in the teeth or in the skeleton underneath them.

A jaw that grew too far forward or too far back, an upper and lower jaw that are badly mismatched in size, an open bite where the front teeth do not meet no matter what the teeth do, or a marked facial asymmetry are skeletal problems. Braces can tip and move teeth to camouflage a mild discrepancy. Past a certain point, camouflage produces a compromised result: teeth tipped into unstable positions, gum recession over time, and a bite that does not hold.

Beyond appearance, a significant jaw discrepancy can make chewing genuinely difficult, affect speech, and in some cases contribute to breathing and sleep problems.

The one age rule that matters

Corrective jaw surgery is normally performed after facial growth is complete, which is roughly age 16 in females and 18 in males. Operating on a jaw that is still growing risks the correction changing afterwards.

This is why some skeletal problems in children are addressed with growth guidance instead, years earlier, using appliances that influence how the jaws develop. That is the argument for the age-seven evaluation on the early orthodontic treatment page: a jaw problem caught at eight sometimes never becomes a surgical case at eighteen.

How the treatment runs

Three stages, and the whole sequence typically takes about two years.

Pre-surgical orthodontics. Braces go on first, usually for 12 to 18 months. The aim is not to make the teeth look straight; it is to position each arch correctly on its own jaw so the two arches fit together once the jaws are moved. Teeth often look worse before surgery, and that is expected.

Surgery. Performed in hospital by an oral and maxillofacial surgeon, under general anesthesia. The jaw is repositioned and held with titanium plates and small screws that stay in place permanently. Incisions are usually inside the mouth, so external scarring is uncommon. Most patients rest for around two weeks before returning to normal activity, with a soft diet for longer.

Post-surgical orthodontics. Braces stay on for roughly six to twelve months afterwards, refining how the teeth meet in their new relationship. Retainers follow.

Planning it properly

Digital imaging is used to plan the movement before anything happens, so the functional and aesthetic result can be shown and discussed in advance rather than described. Computerized planning also shortens the procedure and, with modern fixation materials, the recovery period.

Dr. Shank coordinates directly with the oral surgeon throughout. He practiced general dentistry for five years before specializing in orthodontics, which he has said is what made him comfortable planning cases that involve other specialists.

Risks, plainly

Corrective jaw surgery is real surgery under general anesthesia, and it carries the risks that go with that: infection, bleeding, and temporary or occasionally lasting numbness in the lip or chin from nerve irritation. Recovery involves swelling, a restricted diet, and several weeks of adjustment.

Those risks are discussed properly by the oral surgeon before you consent to anything. They are worth weighing against what an uncorrected significant jaw discrepancy does over a lifetime.

Get an assessment first

Most people who wonder whether they need jaw surgery do not. The only way to know is an examination, and it costs nothing here.

Dr. Shank will tell you whether your case is orthodontic, surgical, or somewhere in between, and if surgery is genuinely indicated, what the alternatives and their compromises would be.

Call (631) 265-3666 or request an appointment online.

Smithtown Orthodontics 200 E Main St. Smithtown, NY 11787 (631) 265-3666

Frequently Asked Questions

Patients often have questions about surgical orthodontics and what to expect. Here are some helpful answers to guide you.

It is orthodontic treatment combined with corrective jaw surgery, used when the jaws themselves are misaligned rather than just the teeth. The orthodontist positions the teeth on each jaw before and after the operation; an oral and maxillofacial surgeon repositions the jaws. The formal name for the operation is orthognathic surgery.

An oral and maxillofacial surgeon, in a hospital, under general anesthesia. Orthodontists do not perform jaw surgery. Dr. Shank plans the orthodontic side of the case and coordinates with the surgeon throughout, before and after the operation.

Normally after facial growth is complete, around age 16 in females and 18 in males, because operating on a growing jaw risks the correction shifting later. Skeletal problems identified in younger children are often managed instead with appliances that guide growth, which sometimes avoids surgery altogether.

About two years in total for most cases: roughly 12 to 18 months of braces before the operation to position the arches, the surgery itself with about two weeks of rest, then six to twelve months of braces afterwards to finish the bite. Retainers follow, as with any orthodontic treatment.

There is no surgical substitute for braces. Surgery moves jaws and braces move teeth, and a case needing surgery needs both. What does exist is the reverse trade: for milder skeletal discrepancies, braces alone can camouflage the problem without surgery, accepting a compromise in how far the correction can go. Which of those applies to you is exactly what an examination determines.