Facial growth is a coordinated process that guides the development of the upper and lower jaws, the position of the teeth, and overall facial balance. When that process does not follow a typical pattern, patients can develop jaw relationships that interfere with function and appearance. These skeletal discrepancies range from mild imbalances that affect bite and symmetry to more pronounced differences that complicate chewing, speech, or airway function.
Many issues begin in childhood but aren’t fully apparent until the jaw structures and dentition have finished maturing. In other cases, trauma, congenital differences, or medical conditions can alter normal growth and create longstanding problems. Even when the teeth appear crowded or misaligned, the underlying cause may be a mismatch between the size or position of the jaws rather than tooth position alone.
Left unaddressed, problematic jaw relationships can create a cascade of functional challenges. An improper bite (malocclusion) may increase wear on teeth, place strain on the temporomandibular joint (TMJ), and reduce chewing efficiency. For some patients, jaw position can also influence facial proportions and breathing patterns, making timely evaluation important for both health and quality of life.
At our North Hollywood practice, early assessment and careful monitoring help determine whether a child or adult will benefit from more than routine orthodontics. When skeletal issues are suspected, a collaborative evaluation with imaging and clinical measurements provides the most reliable picture of what corrective steps will be needed.
Orthodontic appliances—braces, clear aligners, and related devices—excel at moving teeth within the jawbone. However, when the underlying problem is a skeletal discrepancy between the upper and lower jaws, tooth movement alone cannot fully correct the relationship. In those situations, orthognathic surgery (commonly called corrective jaw surgery) is the complement that allows both form and function to be restored.
Surgical orthodontics is not a shortcut or a replacement for standard orthodontic care; rather, it expands the range of correctable conditions. By repositioning the jawbones, surgeons create a skeletal foundation that orthodontists can then fine-tune by aligning the teeth to meet properly. The result addresses both the functional needs of the bite and the aesthetic goals of facial balance.
Decisions about whether to pursue surgery are based on thorough clinical assessment, diagnostic imaging, and a discussion of realistic outcomes. For many patients, a combined approach provides improvements in chewing, speech, breathing, and facial harmony that would not be possible with orthodontics alone.
Surgical orthodontics is a team-based discipline. An orthodontist evaluates and prepares the dental arches, aligning teeth into positions that will work with the planned surgical changes. An oral and maxillofacial surgeon then performs the corrective procedures on the upper jaw, lower jaw, or both, according to the agreed surgical plan. When necessary, other specialists—such as an ENT physician or a sleep medicine expert—may be consulted to address related airway or medical concerns.
The collaborative pathway typically begins with a comprehensive consultation where photographs, models, and advanced imaging (often including 3D scans) are reviewed. Together, the team develops a step-by-step plan that sequences orthodontic preparation, the surgical procedure, and post-surgical orthodontic finishing. Clear communication and shared goals help ensure predictable, coordinated care from start to finish.
Throughout treatment, patients receive explanations of each phase so they understand how tooth movement and jaw repositioning work together. This planning stage is also where surgical goals are aligned with cosmetic and functional expectations, allowing patients to make informed decisions about their care.
Preparation for orthognathic surgery includes medical clearance, preoperative orthodontic work, and detailed discussions about anesthesia and recovery. Before the operation, the orthodontist typically positions the teeth so they can be brought into an optimal relationship once the jaws have been corrected. Medical assessments ensure the patient is fit for surgery and that potential risks are identified and managed.
On surgery day, procedures are performed in a controlled operating-room environment under general anesthesia. Depending on the specific movements required, the surgeon will make precise bone cuts and reposition the jaws using plates and screws to stabilize the new alignment. Because most approaches are made through the mouth, visible scarring is usually minimal or nonexistent.
The duration and complexity of the procedure vary by case, but patients can expect close monitoring in the immediate postoperative period. Pain control, breathing assessments, and nutrition planning are key initial priorities. The surgical team provides instructions for wound care, dietary modifications, and activity restrictions to support healing and reduce the risk of complications.
Recovery after corrective jaw surgery is a gradual process. Initial swelling and soreness are common, and dietary adjustments—moving from liquids to purées and then soft solids—help protect healing areas. Follow-up appointments with both the surgeon and orthodontist are important to monitor bone healing, adjust orthodontic appliances if needed, and ensure the bite is moving toward the planned endpoint.
As healing progresses, patients typically notice improvements in bite function, facial symmetry, and comfort. Long-term stability depends on careful surgical technique and adherence to postoperative guidance, as well as ongoing orthodontic care to refine tooth positions. In many cases, patients find their speech, chewing, and overall oral comfort significantly improved after full recovery.
Maintaining the results of surgical orthodontics also involves regular dental care and monitoring. Retention strategies—such as removable or fixed retainers—help protect tooth alignment, and routine dental visits support both oral health and the longevity of the surgical outcome. When patients and clinicians work together through the postoperative phase, the functional and esthetic benefits of treatment are most likely to endure.
Corrective jaw surgery is a significant decision that can deliver meaningful improvements in function and appearance. If you’re exploring options for skeletal-related bite or facial concerns, the team at Caring Bear Dental can help evaluate whether surgical orthodontics is a suitable path. Please contact us for more information and to discuss the next steps in personalized care.
