Orthognathic Surgery: When Braces Alone Can't Correct the Bite

Orthognathic surgery is a surgical procedure that repositions the upper jaw, lower jaw, or both, to correct significant skeletal discrepancies affecting bite function, facial symmetry, or both, performed by an oral and maxillofacial surgeon.

This is considered when the underlying issue involves the actual size or position of the jawbones themselves, a skeletal discrepancy, rather than simply tooth position, since braces can move teeth within the jaw but can't fundamentally change the jaw's own size or position, meaning some discrepancies are simply beyond what orthodontic treatment alone can correct.

Significant overbite or underbite related to jaw size or position, facial asymmetry from uneven jaw growth, an open bite where the jaws don't allow the front teeth to properly meet even with orthodontic effort, and certain breathing-related concerns connected to jaw structure are among the situations where this surgery might be considered.

This is virtually always combined with orthodontic treatment, both before and after surgery, with braces first aligning the teeth within each jaw to prepare for the surgical repositioning, then continuing after surgery to fine-tune the final bite relationship once the jaws are in their new, corrected position.

This is a genuinely extended process, often spanning one to two years total, including presurgical orthodontic preparation, the surgery itself, recovery, and postsurgical orthodontic refinement, making this a significant, multi-stage treatment commitment.

Depending on which jaw or jaws are being repositioned, the surgeon makes precise cuts in the jawbone, moves it into the planned new position, and secures it using plates and screws, performed under general anesthesia, typically requiring a hospital stay.

Initial recovery, including significant swelling and dietary restriction to soft or liquid foods, typically spans several weeks, with more complete healing and return to normal activities generally taking a few months, though full bone healing continues over a longer period.

Yes, since this involves repositioning the actual jaw structure, it commonly does affect facial profile and symmetry, often in ways patients specifically hope for given the underlying condition being addressed, and your surgical team discusses expected changes as part of your treatment planning.

No, while facial appearance changes are certainly part of many patients' experience and sometimes a meaningful motivating factor, this surgery is generally considered medically necessary when addressing genuine functional bite and jaw discrepancies, distinguishing it from purely elective cosmetic facial surgery.

Given its medically necessary nature for correcting significant functional discrepancies, this is often covered at least partially by medical or dental insurance, though specific coverage varies by plan, making it worth thoroughly confirming your particular coverage before proceeding.

A comprehensive evaluation by an orthodontist and oral and maxillofacial surgeon working together, including detailed imaging and analysis of your specific jaw relationships, determines whether your particular case genuinely requires surgical correction versus being appropriately addressed through orthodontic treatment alone.