Surgical Orthodontics

Surgical orthodontics, also known as orthognathic surgery, is a type of orthodontic treatment used to correct severe cases that include bad bites, jaw bone abnormalities, and malocclusion. Oral and maxillofacial surgery is one of the nine recognized dental specialties, and it focuses on treating complex craniofacial cases that involve the mouth, jaw, face, and skull. If you need surgical orthodontics, your orthodontist will work with an oral and maxillofacial surgeon to ensure that you receive the best care possible.

When might surgical orthodontics be needed?

Surgical orthodontics may be used to treat adults with improper bites or other aesthetic concerns. Typically, jaw growth stops by age 16 in females and 18 in males. In order to receive orthognathic surgery, the jaw must be done growing. The need for surgical orthodontics occurs when the jaws do not line up correctly, and a proper bite cannot be achieved with orthodontic treatment alone. Orthognathic surgery will help properly align the jaw, and orthodontic braces will then be used to move the teeth into their proper position.

How do I know if I need orthognathic surgery?

Your orthodontist can tell you if orthognathic surgery is needed as part of your treatment. Depending on the severity of your case and the alignment of your jaw, you may or may not need surgery.

How does orthognathic surgery work?

An oral and maxillofacial surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about a two-week rest period. Since orthognathic surgery is a major treatment, we recommend that you schedule some time away from work and school during the healing process. After your jaw has healed, your orthodontist will once again “fine-tune” your bite. After surgery, you will have to wear braces, and most braces are removed within six to 12 months following surgery. After your braces are removed, you will wear a retainer to help maintain your new smile.

What are the risks associated with orthognathic surgery?

As with any major medical surgery, there may be certain risks of having orthognathic surgery. However, the process of orthognathic surgery is not new, and it has been performed for many years in practices and hospitals. If you're concerned about an upcoming treatment with orthognathic surgery, please contact our practice and let us know. We are happy to answer any questions that you may have, and provide you with any additional information. Your comfort is important to us.

What are the rewards of having orthognathic surgery?

For many patients, the most important reward of having orthognathic surgery is achieving a beautiful, healthy smile that lasts a lifetime. Whether you need orthodontic treatment to correct a bad bite, malocclusion, or jaw abnormality, orthognathic surgery can help restore your confidence and leave you smiling with confidence for many years to come.

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Conditions and Treatments:

Corrective Jaw Surgery

Corrective jaw or orthognathic surgery is performed in which the upper jaw, lower jaw, and chin may be repositioned to correct minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth which can improve chewing, speaking, and breathing. Difficulty chewing or biting food, excessive wear of teeth, a receding chin, a protruding jaw, or sleep apnea may indicate the need for corrective jaw surgery.

Wisdom Teeth

Wisdom teeth are the last set of teeth to develop. Sometimes they emerge from the gum line, and the jaw is large enough to allow room for them, but more often than not, they fail to emerge and become impacted. When a wisdom tooth is impacted, it may need to be removed. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease. The American Association of Oral and Maxillofacial Surgeons strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.

Cleft Palate

Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip or a split in the opening in the roof of the mouth. Until it is treated with surgery, a cleft palate can cause problems with feeding, speech, and hearing. Oral and maxillofacial surgeons work as part of a team of health care specialists to correct these problems through a series of treatments and surgical procedures over many years.

Temporomandibular Joint Surgery

The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet and allows the lower jaw to move and function. If you experience jaw pain, earaches, headaches, a limited ability to open or close your mouth, clicking, or grating sounds, you may have Temporomandibular Disorder (TMD). TMJ treatment may range from conservative dental and medical care to complex surgery. If non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated which can involve either arthroscopy or repair of damaged tissue by a direct surgical approach.

Impacted Canines

An impacted tooth is a tooth that is blocked or “stuck” underneath the gum line, and does not erupt into its correct position on its own. Most often, an impacted tooth will be a third molar, or wisdom tooth, though it is a common occurrence in canine teeth as well. Canine teeth are located at the corners of the arch, next to the incisors. They have one pointed edge (cusp) which is used for holding, grasping, and tearing food. Because of the canine’s long root, they are very strong, stable teeth. Canines are usually the last teeth to erupt, and usually do so when your child is around the age of 12 or 13.

The American Association of Orthodontists recommends that children have an orthodontic examination by the age of seven, which allows us the opportunity to monitor your child’s teeth eruption and detect impactions early.

If your child does develop an impacted canine, a simple surgical procedure is recommended to assist the eruption of the tooth. We will surgically expose the tooth by cutting a small flap in the surrounding gum. After the tooth is exposed, we will either leave the tooth to erupt on its own, or attach an orthodontic bracket to the tooth to help guide its descent.

With early detection and combined surgical and orthodontic treatment, impacted canines can be allowed to erupt and/or be guided to the most ideal position in your child’s mouth.