Jaw Surgery
Orthognathic surgery, commonly called jaw surgery, repositions the upper jaw, lower jaw, or both so the teeth and jaws meet correctly. It is recommended when a bite problem, such as a severe underbite, overbite, or open bite, is caused by the jaw bones themselves and cannot be corrected with braces alone. Treatment combines orthodontics before and after surgery, and the operation is done in hospital under general anesthesia, usually with a one- to two-night stay.
Key takeaways
- Jaw surgery corrects skeletal bite problems that braces cannot fix alone.
- It is usually done after facial growth is complete, typically in the late teens or later.
- Braces are worn for months before and after surgery.
- Most people return to school or desk work within a few weeks; the jaw heals over about six weeks.
- Jaw surgery can also help selected patients with obstructive sleep apnea.
Who Needs Jaw Surgery?
Your orthodontist or dentist may suggest a surgical consultation if you have:
- Underbite (Class III): the lower jaw sits forward of the upper jaw
- Severe overbite or retruded lower jaw (Class II): the lower jaw sits too far back
- Open bite: the front teeth do not meet when the back teeth are together
- Facial asymmetry: the jaw is shifted to one side
- Difficulty chewing, biting, or swallowing due to the jaw relationship
- Chronic mouth breathing or obstructive sleep apnea related to jaw position
- Excessive wear of teeth caused by the bite
Braces Alone Or Surgery?
| Situation | Usual approach |
|---|---|
| Teeth are crooked but the jaws are well matched | Braces or aligners alone |
| Mild jaw mismatch in a growing child | Orthodontic growth modification may help |
| Moderate to severe jaw mismatch after growth is complete | Combined orthodontics and jaw surgery |
| Jaw position contributing to sleep apnea | Jaw advancement surgery may be considered |
The Treatment Process
- Consultation and records. Examination, photos, and imaging, often including 3D cone beam CT, to plan jaw movements precisely.
- Pre-surgical orthodontics. Braces align the teeth to fit the planned jaw positions. This commonly takes about a year or longer, and the bite may temporarily look worse as the teeth are positioned for surgery.
- Surgical planning. The surgeon and orthodontist plan movements digitally or with models.
- Surgery in hospital. Under general anesthesia, the jaw bones are repositioned and secured with small titanium plates and screws, usually working inside the mouth so there are no visible facial scars.
- Post-surgical orthodontics. Braces fine-tune the bite over several months.
Types Of Jaw Surgery
| Procedure | What it corrects |
|---|---|
| Upper jaw (maxillary) surgery | Open bite, crossbite, excessive gum display, underbite from a small upper jaw |
| Lower jaw (mandibular) surgery | Receding lower jaw or a lower jaw that is too far forward |
| Double-jaw (bimaxillary) surgery | Larger or combined discrepancies |
| Chin surgery (genioplasty) | Chin position, often combined with jaw surgery |
| Maxillomandibular advancement | Moves both jaws forward to enlarge the airway in sleep apnea |
Recovery Timeline After Jaw Surgery
| Timing | What to expect |
|---|---|
| 1 to 2 nights | Hospital stay for monitoring, pain control, and fluids |
| First week | Swelling peaks around day 2 to 3; liquid diet; lots of rest |
| Weeks 2 to 3 | Swelling improving; many return to school or desk work |
| About 6 weeks | Bone healing allows a gradual return to soft chewing foods |
| 3 months and beyond | Swelling fully resolves; numbness of the lip or chin, if present, often continues to improve |
Temporary numbness of the lips or chin is common after lower jaw surgery because the nerve runs through the bone. For most people it improves over weeks to months, but it can occasionally persist. Your surgeon reviews this and other risks in detail before surgery.
Benefits Beyond The Bite
Patients often report easier chewing and biting, improved speech, reduced jaw strain, a more balanced facial profile, and, in patients with obstructive sleep apnea, improved breathing during sleep. Read more in sleep apnea treatment options.
Cost And Coverage
Coverage for jaw surgery depends on the specific procedure, whether it is performed in hospital, and your provincial and private insurance. Ask the surgeon's office and your insurer what applies to your treatment plan before committing.
Jaw Surgery Assessment In Waterloo Region
Jaw surgery is planned together with your orthodontist. If you live in Waterloo, Kitchener, Cambridge, Guelph, or Stratford and your orthodontist has recommended a surgical opinion, call our office at 96 Union Street East in Waterloo at +1 (519)-743-7811 to ask whether a consultation with our surgeons is appropriate for your situation. Learn more about the training of oral and maxillofacial surgeons.
Sources
- Canadian Association of Oral and Maxillofacial Surgeons, patient information on the specialty.
- Zaghi S, Holty JEC, Certal V, et al. Maxillomandibular advancement for treatment of obstructive sleep apnea: a meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 2016.
FAQ
What Age Can You Have Jaw Surgery?
Jaw surgery is usually done once facial growth is complete, often in the late teens for females and somewhat later for males. Adults of any age can have jaw surgery if they are healthy enough.
Is Jaw Surgery Painful?
Surgery is done under general anesthesia. Afterward, swelling and discomfort are expected and managed with medication. Many patients describe swelling and the liquid diet as harder than the pain itself.
Will My Face Look Different After Jaw Surgery?
Often, yes, in a way that brings the face into better balance. Your surgeon can show you the expected changes during planning.
How Long Do I Need Braces With Jaw Surgery?
Most patients wear braces for about a year or more before surgery and several months afterward. Your orthodontist will estimate your timeline.
Are There Scars After Jaw Surgery?
Most jaw surgery is performed through incisions inside the mouth, so there are usually no visible facial scars.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.