Some bite problems are caused by the size or position of the jaw bones rather than the position of the teeth. When the discrepancy is large and growth is finished, correcting it takes orthodontic treatment combined with corrective jaw surgery, called orthognathic surgery. The Orthodontic Gallery in Riverview provides the orthodontic half of that work, planned jointly with an oral and maxillofacial surgeon.
An orthodontist does not perform jaw surgery. A surgeon does. The orthodontist positions the teeth so the jaws can be moved into a correct relationship, then finishes the bite afterward.
When Surgery Is Part of the Answer
Teeth can compensate for a modest jaw discrepancy. They can be tipped and moved to make a bite fit reasonably well even when the underlying bones do not match. Past a certain point that compensation stops working, and pushing it further damages the gums and roots without producing a stable result.
Cases that commonly need surgical planning include a lower jaw significantly set back or forward, an open bite where the front teeth never meet, marked facial asymmetry, difficulty chewing or biting that persists despite orthodontic treatment, and severe skeletal crossbites in adults. A narrow upper jaw on its own is a different problem and is now often correctable without an operation; see adult palatal expansion.
Growth has to be complete first, generally by around sixteen in girls and eighteen in boys, because moving a jaw that is still growing is not a durable correction. Patients born with a cleft or a craniofacial condition are a common route into these cases, because the jaws often grow into a discrepancy after the early repairs.
What the Process Looks Like
- Assessment and joint planning. Records, 3D imaging, and a consultation. Your orthodontist and your surgeon review the case together and agree on what the surgery will do and what the orthodontics has to do first.
- Pre-surgical orthodontics. Usually twelve to eighteen months. Braces align each arch on its own terms and remove the compensations the teeth have made over the years. Worth knowing in advance: your bite often looks worse during this phase, not better. That is expected, and it is the point.
- Surgery. Performed by the oral and maxillofacial surgeon, in hospital or a surgical facility, under general anesthesia. The jaws are repositioned and fixed with small plates and screws. Most patients are in hospital briefly and take around two weeks away from work or school.
- Post-surgical orthodontics. Six to twelve months of finishing. The bite is refined into its final position now that the bones are where they should be.
- Retention. Retainers, as with any case. See retainers.
Choosing to Do It, or Not
Orthognathic surgery is major surgery and it is a genuine decision, not a formality. Some patients decide the functional gain is not worth it and choose orthodontic camouflage instead, accepting a compromised result in exchange for avoiding an operation. That is a legitimate choice, and we will lay out honestly what each route can and cannot achieve.
For patients who do proceed, the functional change is usually substantial: chewing, biting, jaw comfort, and the way the face is balanced.
Frequently Asked Questions About Surgical Orthodontics
What is the surgical alternative to braces?
There is not one. Surgery moves bone; it does not straighten teeth, and every orthognathic case involves braces or aligners before and after. What people usually mean by the question is whether surgery can replace years of orthodontics, and the answer is no. It is added to orthodontics for cases the teeth alone cannot fix.
Who actually performs the surgery?
An oral and maxillofacial surgeon, in a hospital or surgical facility. We provide the orthodontic treatment before and after and plan the case jointly with them. If you do not already have a surgeon, we will refer you to one and coordinate from there.
How long does the whole process take?
Commonly two to three years end to end: roughly twelve to eighteen months of pre-surgical orthodontics, the surgery and its recovery, then six to twelve months of finishing. Cases vary, and you get a case-specific timeline in writing at the consultation.
What are the risks of orthognathic surgery?
There are some, and your surgeon will review them with you from the beginning. Broadly, they include the general risks of general anesthesia; temporary or occasional numbness of the lip and chin from nerve involvement; swelling and a restricted diet during recovery; and a small chance of needing further surgery. The surgeon owns that conversation, not us, and you should have it before committing.
Ask Whether Your Case Needs Surgery
Plenty of patients who assume they need jaw surgery do not, and some who have never been told they might do. A free consultation with imaging gives you a real answer. Call 813-867-0414 or request an appointment. We are at 10061 Beach Verbena Drive in Riverview.