Orthognathic Surgery

When Orthodontic Care Involves Jaw Surgery

There is a limit to the distance teeth can be moved with in the jaw structure. In some cases, correcting the malocclusion might include a surgical procedure to change the relationship of the jaw structure. This may be more than expected. First, we will gather information in order to give you a complete evaluation and plan of action. We will discuss all of the treatment options available. These are the steps to arrive at a surgical treatment plan.

A decision to include surgery in a plan of treatment will require careful and complete consideration of many factors. Our analysis will include:


We will make models of the teeth and a registration of the Jaw positions, X-rays (we won’t duplicate any X-rays we can borrow from the dentist), and photographs, and have consultations with the dentist and an oral surgeon. The doctors will then evaluate this information.


The evaluation process involves identifying the exact nature and details of the bite problem and then deciding how to solve each aspect of the problem. These solutions must be balanced against the degree of change that can be achieved and the patient’s desires and goals. When the evaluation is complete we will arrange for a consultation. The final plans for the surgery will be tentative until the oral surgeon can examine the patient in person.


We will discuss proposed treatment plan, and follow with a written report. The next step is to have an appointment with the oral surgeon for an examination and to discuss the proposed surgery. The oral surgeon will consult again with our doctors to finalize the treatment recommendations. Once the oral surgeon has completed the examination given all the pretreatment information, the patient should be able to decide whether to proceed. An additional written report from our doctors at this point is sometimes warranted.


Correction of bite and jaw relationship problems using a combination of orthodontic treatment and jaw structure surgery is called ortho-gnathic treatment. Typically the surgical procedure occurs in the middle of the orthodontic treatment period. The braces are not removed during the surgical phase of the treatment. Sometimes the upper and lower teeth need to be wired together during healing, and sometimes it is not necessary to do so. We will discuss the specifics during the consultation.

When the active treatment is finished and we remove the braces, the teeth are not very stable in their positions. We will make plastic retainers to wear. After a short time of full time use, the patient can use them just at night. They may need to be worn for many years.

Orthodontic treatment is a challenging journey with a satisfying reward at the end. We urge you to learn about the diagnosis and treatment plans. Ask questions, even if they seem trivial we’ll do our best to help the process be successful.