What Is Surgical Orthodontics (Orthognathic Surgery)?
Surgical orthodontics, also called orthognathic surgery, combines orthodontic care with jaw surgery to correct severe skeletal misalignment. It repositions the upper jaw, lower jaw, or both to improve bite function, facial balance, and long-term oral health.
Sometimes a beautiful, functional smile requires more than braces or aligners can offer. When the upper and lower jaws don't fit together properly due to skeletal differences, surgical orthodontics delivers lasting correction. This combined approach addresses the root cause of severe bite concerns rather than simply masking them. For patients across the Lehigh Valley and beyond, this type of advanced care can be life-changing.
This approach brings together the expertise of an orthodontist and an oral surgeon. The orthodontist prepares the teeth for optimal positioning, while the oral surgeon repositions the jaw bones themselves. Together, they create results that neither specialty could achieve alone.
Dr. Ely at Orthodontics of the Lehigh Valley works closely with skilled oral surgeons to coordinate care for patients who need this advanced approach. His training at Harvard School of Dental Medicine included extensive preparation for managing complex cases that require surgical intervention. As a board-certified doctor, he brings a level of precision to surgical planning that families trust.
How Surgical Orthodontics Works: The Step-by-Step Process
Here's what to expect from start to finish. Surgical orthodontics follows a carefully planned sequence that typically spans two to three years. Board-certified orthodontist Dr. Ely coordinates each phase, working alongside your oral surgeon to keep everything on track.
What Happens During Pre-Surgical Orthodontics?
The process begins with braces or aligners, usually lasting 12 to 18 months. During this phase, the orthodontist moves teeth into positions that will fit together properly once the jaws are surgically aligned. Teeth might actually look worse before surgery because they're being arranged for the new jaw position, not the current one. It's a strange feeling, but it's part of the plan.
Regular appointments every four to eight weeks allow the orthodontist to track progress and coordinate timing with the oral surgeon. Digital imaging and 3D planning tools help both specialists visualize the final outcome and work backward to achieve it.
What Does the Surgical Procedure Involve?
Orthognathic surgery takes place in a hospital setting under general anesthesia. The oral surgeon makes incisions inside the mouth, leaving no visible scars. Depending on the case, surgery may reposition the upper jaw, lower jaw, or both. Modern techniques use small titanium plates and screws to hold the bones in their new positions. Most people spend one to two nights in the hospital before heading home to recover.
What Happens After Surgery?
The orthodontist fine-tunes the bite over six to twelve months following surgery. This final phase makes sure teeth fit together precisely and the bite feels natural. Once the process wraps up, retainers maintain the results for years to come.
How Long Does the Full Process Take?
| Phase | Duration | Focus |
|---|---|---|
| Pre-surgical orthodontics | 12 to 18 months | Align teeth for surgical positioning |
| Surgery and initial healing | 4 to 6 weeks | Jaw repositioning and recovery |
| Post-surgical orthodontics | 6 to 12 months | Fine-tune bite alignment |
| Full timeline | 2 to 3 years | Complete correction |
Benefits of Surgical Orthodontics for Long-Term Jaw Health
Surgical orthodontics provides lasting results that go well beyond appearance. The key benefits include:
- Permanent bite correction
- Improved chewing function
- Jaw discomfort relief
- Better breathing
- Facial harmony and balance
People often notice improvements they didn't expect when they first considered this approach.
How Does Surgical Orthodontics Improve Daily Function?
Permanent bite correction. Severe underbites, overbites, and open bites that braces alone cannot address become fully correctable. The skeletal foundation of your bite changes permanently.
When jaws align properly, teeth meet the way they're designed to. Eating becomes easier, and foods that were difficult to bite or chew become manageable again. This functional improvement is one of the first things people notice after recovery.
What about jaw discomfort? Relief is another major benefit. People with significant skeletal discrepancies often deal with TMJ-related concerns like chronic soreness, clicking, and tension headaches. Correcting the underlying jaw position often reduces or eliminates these symptoms entirely.
Can Jaw Surgery Improve Breathing and Facial Balance?
Jaw position directly affects airway size. Surgical correction can open restricted airways, helping you breathe more easily during sleep. Significant improvement in obstructive sleep apnea symptoms after this type of care is common.
Facial harmony. Repositioning the jaws creates better balance between facial features. Profiles become more proportionate. People regularly tell us they feel more confident in photos and social situations afterward. Dr. Ely and the team at Orthodontics of the Lehigh Valley help patients understand these long-term benefits during their initial evaluation.
Because surgery addresses the skeletal cause of bite concerns, results tend to remain stable over time. That long-term stability is a big part of why surgical orthodontics is worth the commitment.
Surgical Orthodontics vs. Braces Alone: Which Approach Is Right?
Braces alone correct misaligned teeth, while surgical orthodontics corrects misaligned jaws and teeth together. Choosing between the two depends on what's causing the bite concern, and understanding this distinction helps you make an informed decision.
What Can Braces and Aligners Correct on Their Own?
Traditional braces and clear aligners work beautifully for dental misalignment. They move teeth through bone, correcting crowding, spacing, and mild to moderate bite concerns. When teeth are misaligned but the jaws themselves are properly positioned, braces or Invisalign often provide full correction.
When Does a Case Require Surgical Intervention?
When the jaws themselves are misaligned, tooth movement has limits. You can't move teeth beyond the boundaries of the bone that holds them. Severe cases include:
- Lower jaw that sits significantly forward or back
- Upper jaw that's too narrow or positioned incorrectly
- Noticeable facial asymmetry affecting one side
- Open bites where front teeth don't touch when back teeth are together
- Overbites or underbites measuring more than a few millimeters
Is Camouflage an Alternative?
Some orthodontists offer "camouflage" approaches for moderate skeletal concerns. This uses braces to tip teeth in ways that hide the jaw discrepancy. While it can improve appearance, it doesn't address the underlying skeletal concern.
Camouflage may work well for people with mild skeletal discrepancies or those who prefer to avoid surgery. But it has limitations. Results may be less stable, and functional concerns often persist. Dr. Ely evaluates each case to determine whether braces alone or surgical orthodontics is the right path.
| Factor | Braces Alone | Surgical Orthodontics |
|---|---|---|
| Treats | Dental misalignment | Skeletal + dental concerns |
| Timeline | 12 to 24 months | 2 to 3 years |
| Stability | Good for dental cases | Excellent for skeletal cases |
| Best for | Misaligned teeth, mild bite concerns | Severe jaw discrepancies |
| Recovery | Minimal | 4 to 6 weeks post-surgery |
What Affects the Price of Surgical Orthodontics?
Surgical orthodontics involves two distinct components: the orthodontic phase and the surgical procedure itself. The orthodontic portion covers braces or aligners, while the surgical portion covers the hospital, anesthesia, and the oral surgeon's fee. Medical insurance often covers the surgical component when it's deemed medically necessary. Orthodontics of the Lehigh Valley helps you understand how these components break down so you can plan ahead.
What Does the Orthodontic Portion Cover?
The braces or aligner phase is similar to standard orthodontic cases, though it may run slightly longer. This fee covers all appointments, appliances, and the orthodontist's expertise in coordinating with the surgical team.
What Are the Surgical and Hospital Fees?
The oral surgeon's fee covers surgical planning, the procedure itself, and post-operative care. Hospital or surgical center fees include the operating room, anesthesia, and any overnight stay. These are typically billed separately from the orthodontic fees.
Does Insurance Cover Jaw Surgery?
Good news for many people: medical insurance often covers orthognathic surgery when it's deemed medically necessary. This typically applies when the jaw discrepancy affects function, not just appearance.
According to the American Association of Orthodontists, documentation of functional concerns like difficulty chewing, breathing difficulties, or chronic jaw discomfort strengthens insurance authorization. Your orthodontist and oral surgeon can provide the records insurance companies need. Dental insurance may cover a portion of the orthodontic phase separately. Coordinating both types of coverage can significantly reduce what you pay.
How Can You Make This More Affordable?
Low monthly payment options help spread orthodontic fees over time. We also offer a payment calculator to help families plan ahead. Many people find that breaking fees into manageable amounts makes the process more achievable than expected.
Who Is a Candidate for Surgical Orthodontics?
Not everyone with a bite concern needs surgery. Candidacy depends on several factors that your orthodontist evaluates during a thorough examination.
When Is the Right Age for Surgical Orthodontics?
Jaw growth must be complete before surgical orthodontics can begin. For most people, this means:
- Females: typically age 16 and older
- Males: typically age 18 and older
Growth plates in the jaw close at different times for different people. X-rays help confirm when growth has stopped. Adults of any age can pursue surgical orthodontics as long as they're in good general health. Our team regularly works with adults in their 30s, 40s, and beyond.
What Conditions May Require Surgery?
- Severe underbite: Lower jaw extends noticeably beyond upper jaw
- Significant overbite: Upper jaw sits far forward of lower jaw
- Open bite: Front teeth don't meet when back teeth are together
- Crossbite with skeletal component: Jaws are mismatched in width
- Facial asymmetry: One side of the face differs noticeably from the other
- Chronic TMJ dysfunction: Related to jaw position rather than other causes
- Sleep apnea: Caused or worsened by jaw position
How Does the Evaluation Process Work?
Determining candidacy involves a clinical examination, dental X-rays, photographs, and 3D imaging. These records allow the orthodontist and oral surgeon to assess the skeletal relationship precisely and plan accordingly.
During your complimentary consult, Dr. Ely can evaluate whether your case might benefit from surgical orthodontics or whether other options would serve you well. He'll walk you through what the process would look like for your specific situation and answer every question you have along the way.
Frequently Asked Questions About Surgical Orthodontics
Is jaw surgery painful?
You won't feel anything during the procedure because it's performed under general anesthesia. Afterward, expect swelling and discomfort more significant than wisdom tooth removal. The first week is typically the toughest, with steady improvement after that. Oral surgeons prescribe appropriate medication and anti-inflammatory drugs to manage recovery. Most people return to work or school by week two or three.
How long is recovery from orthognathic surgery?
Initial recovery takes four to six weeks. During the first one to two weeks, you'll follow a liquid diet as swelling subsides, then transition to soft foods with a gradual return to normal eating.
Most people feel ready to resume normal activities within four to six weeks, though complete bone healing continues for several months. Your surgeon provides specific guidance based on your procedure.
Can Invisalign be used instead of surgery?
Clear aligners move teeth through bone but cannot reposition the jaw bones themselves. If your bite concern stems from jaw position rather than tooth position, Invisalign and other aligners alone won't provide full correction. That said, some surgical orthodontic cases do use Invisalign for the pre-surgical and post-surgical phases instead of traditional braces.
What age is best for surgical orthodontics?
After jaw growth stops, usually late teens to early twenties. That's the ideal window because recovery tends to be quicker for younger adults. But adults in their 30s, 40s, 50s, and beyond successfully complete surgical orthodontics regularly. Age matters less than overall health and commitment to the full process.
Will insurance cover my jaw surgery?
Medical insurance often covers orthognathic surgery when it's medically necessary rather than purely cosmetic. Functional concerns like difficulty chewing, chronic jaw discomfort, or breathing difficulties support medical necessity. Dr. Ely and your oral surgeon collaborate to document your case and submit pre-authorization requests through Orthodontics of the Lehigh Valley. Dental insurance may separately cover portions of the orthodontic phase, so checking both types of coverage gives you the clearest picture of your financial responsibility.