For most patients, orthodontic treatment alone can correct bite and alignment issues. But for a subset of cases involving significant jaw size or position discrepancies, teeth can only move so far before the underlying skeletal mismatch becomes the limiting factor — and that’s where corrective jaw surgery (orthognathic surgery) comes in.

When surgery typically becomes part of the conversation:

• A significant underbite, overbite, or crossbite caused by jaw position rather than tooth position alone
• Facial asymmetry related to uneven jaw growth
• Difficulty chewing, speaking, or breathing that’s linked to jaw structure rather than dental alignment
• Cases where an orthodontist determines that braces or aligners alone would need to compensate so heavily for the jaw discrepancy that the bite wouldn’t be stable or functional long-term

How the combined treatment process generally works:

1. Pre-surgical orthodontics, often 12-18 months, aligning the teeth within each jaw individually (sometimes making the bite look temporarily worse, since teeth are being decompensated in preparation for the jaws to move)
2. Surgical jaw repositioning, performed by an oral surgeon, moving the upper jaw, lower jaw, or both into proper alignment relative to each other
3. Recovery, typically several weeks for initial healing, with swelling gradually subsiding over the following weeks
4. Post-surgical orthodontics, fine-tuning the bite into its final position over several more months

Why this is a true team procedure: the orthodontist and oral surgeon plan the case together from the start, often using joint imaging and digital surgical planning software to map the exact jaw movements before surgery day. Neither phase works well in isolation from the other.

This isn’t a decision made lightly, and it’s not the right path for most orthodontic patients — but for the subset of cases where jaw position itself is the core issue, it’s often the only way to achieve a stable, functional, comfortable bite.

If your orthodontist has raised the possibility of jaw surgery, our oral surgeons at Falcon Implants & Oral Surgery are glad to consult directly with your orthodontic team and walk you through what the process would involve.