When most people think of the orthodontist they think braces. It does not normally cross their mind that surgery can be an option as a part of their orthodontic treatment. There are times that the only way to correct a person’s concern or bite is having surgery to align the jaws along with the braces that align the teeth. An orthodontist is able to determine from measuring certain x-rays if your jaw discrepancy is large enough to require a surgical jaw movement. This recommendation is an option when braces alone cannot produce an acceptable outcome.
Jaw surgery is able to correct multiple anomalies. They include a small lower jaw, a protrusive lower jaw, an open bite (where the front teeth do not touch), a cant (where your jaw is slanted), a narrow smile and a gummy smile. For example, if a patient does not like their small chin, braces may correct the alignment of the teeth but not the actual shape or size of the chin. That is where the surgical procedure comes into play.
Most of the time, the process starts with placing braces first to align the teeth within the patient’s jaws. Think of the jaws as the foundation of a house. If the jaws are the foundation, the teeth are the house. If the jaws are off, the teeth will be off. So how can one correct the foundation? A patient would need to see an oral surgeon to perform the surgical procedures necessary to align the jaws and therefore get the teeth to fit. Typically, treatment time for a surgical case is 24 months. The braces are placed and about 1 year into the treatment, the patient’s teeth have aligned within the jaw and the jaws are ready to be worked on by an oral surgeon. The braces stay on and then the oral surgeon completes the surgical procedure. After tissues heal from the surgery, the patient returns to the orthodontist with jaws that are well aligned and the orthodontist spends approximately the next 12 months detailing the the teeth into their final positions. The braces are then removed and retainers are delivered to maintain all the hard work they have been through.
Ultimately, if the patient has crooked teeth but a good jaw relationship, braces are usually enough to correct the problem. However, if the jaws are not in good alignment an oral surgeon’s expertise helps correct the underlying jaw issue. For those with jaw alignment issues that do not want surgery but straight teeth, that is an option too, it just comes with some compromises.