Teeth Straightening Surgery: How It Works, Costs, Benefits & More
Teeth straightening surgery is an aggressive treatment option for people who have imbalances between their upper and lower jaws. Called orthognathic surgery, the procedure moves one or both jawbones to align the teeth and correct speaking, chewing and bite issues.
People often must wear braces for 18 months or longer prior to the surgery.
What Is Teeth Straightening Surgery?
Teeth straightening surgery is a type of orthognathic surgery that repairs severe malocclusion by moving your jawbones into a more favorable position. Your orthodontist may recommend this procedure if your bad bite is caused by severely misaligned jaws. This surgery can help fix speech and chewing issues that impact your overall health and quality of life.
Having orthognathic surgery doesn’t mean that you will not need traditional braces or aligner therapy to straighten your teeth. One of these treatments is generally necessary to complete the teeth straightening process and restore your smile.
Types of Jaw Surgery
Aligning the teeth and jaw with surgery is a process that can take two to three years. After preparation and consultation with a specialist, a treatment plan is created to include one of the three types of teeth straightening jaw surgeries.
Types of teeth straightening surgeries include the following:
Upper jaw orthognathic surgery
Lower jaw orthognathic surgery
Lower jaw chin surgery or genioplasty
Upper Jaw Orthognathic Surgery
Upper jaw surgery, or maxillary osteotomy, is appropriate for patients with bite issues that are caused by the placement of the upper jaw. These problems may include the following:
In most cases, all of the surgery will be performed from inside the mouth, through an incision from the gum to the jawbone, so there will be no scarring on the face. The upper jawbone is then broken after being cut with a small saw. Once broken, the jawbone can be moved.
In cases of open bite, which may be caused by too much bone above the molars, the shaving and removal of bone may be needed.
Once the jaw is in its new corrected position, the surgeon secures it with screws and plates. Dissolving stitches are used on the gums.
Lower Jaw Orthognathic Surgery
Also called mandibular osteotomy, this surgery involves making incisions in the lower jaw to move it into the correct position.
Lower jaw surgery is generally an easier process than upper jaw surgery, but it is still an involved procedure. It can be used to treat cases of receding or protruding lower jaw, so it may be used to correct underbite and overbite. Lower jaw surgery sometimes includes the following:
Plates and screws to hold jaw in place
Wiring the jaw shut during recovery
Lip and chin numbness
Rubber bands used to keep jaw in place after surgery
Generally, there are three types of lower jaw surgeries:
Bilateral sagittal split osteotomy (BSSO): This is mainly used to bring the lower jaw forward, although the jaw can also be brought back with this procedure. Because plates and screws are used to secure placement, the jaw may not have to be wired shut after the surgery, but chin and lip numbness may occur.
Intraoral vertical ramus osteotomy (IVRO): This surgery is usually used to set the jaw back. Chin and lip numbness may be less likely, but the jaw may have to be wired shut for four to six weeks.
Chin genioplasty: This is used to reduce a protruding chin or push forward a receding (or small) chin. It may be performed alone or alongside another lower jaw surgery. The surgeons access the needed area through the oral cavity. Plates and screws are used to keep the new chin position.
Who Is a Candidate?
The best time to have orthognathic surgery is after your jaw stops growing. Growth usually stops sometime between the ages of 14 and 16 for females and between 17 and 21 for males.
You may choose to have orthognathic surgery to straighten your teeth if you meet any of these criteria:
You have Class III open bite (severe malocclusion) due to misaligned jaws
You want to enhance the shape of your face and jawline.
You are aware of and prepared to cope with the risks of invasive treatment, such as postoperative pain.
You have respiratory or airway obstruction, including obstructive sleep apnea.
You have been told that orthodontics will not be enough to straighten your teeth.
About 15% of people who wear braces for jaw-related corrections undergo orthognathic surgery. In addition, surgeons often use the procedure to treat various craniofacial conditions that cause upper and lower jaw imbalances, such as these:
Treacher Collins syndrome
About the Surgery
Most orthognathic surgery candidates are referred to their oral and maxillofacial surgeon by their orthodontist. Your surgeon will then take over treatment and may coordinate with your orthodontist for braces or aligners treatment, which is usually also needed.
The three general types of jaw surgery all have similar treatment steps, which include the following:
Braces or clear aligners
First, your surgeon will scan your teeth and jaws using imaging techniques like x-rays or computer tomography (CT) scans. The presurgical workup will depend on your surgeon and the type of technology they use.
Based on your consultations and the images they gather, a comprehensive treatment plan will be created. Your surgeon will discuss options, cost, and treatment timelines before proceeding.
Jaw alignment surgery alone cannot fix misaligned teeth in most cases. You may need orthodontic treatment for up to 18 months before the procedure.
Orthodontic treatment options include the following:
Braces: Small brackets are attached to the teeth, and a wire is run through the brackets. The wire is tightened during regular orthodontist visits to apply pressure and move the teeth.
Aligners: A series of clear plastic trays are customized to fit over the teeth and apply gentle continuous pressure. Aligners are removable and changed about every two weeks for a progressive movement to optimal position.
Once the surgical wound is healed and your jaws are aligned, you may undergo another round of orthodontic treatment. This will shift your teeth into their final desired positions.
During your surgery, your surgeon will do the following:
Place you under general anesthesia, so you are fully unconscious for the procedure.
Make incisions in your jawbone or chin from inside your mouth to minimize facial scars.
Reposition the jawbone or chin by moving it forward or backward to align it with the opposite jaw.
Secure the moved jawbone or chin in place, often using safe biocompatible plates and screws.
If your jawbone is not dense enough to support the surgery, your surgeon may also graft bone from other parts of your body to your jaws during this process.
Recovery time and experiences will vary greatly depending on the procedure and its complexity. Some surgeries may require the jaw to be wired shut for weeks after the procedure to keep the jaw in place, while others may use elastic bands to secure the new placement. In some cases, no wiring or rubber bands are needed, and patients are able to resume normal activities quickly.
For most patients, much of the early discomfort should be gone about six weeks after your surgery. Some patients may require up to three months to recover fully.
To minimize discomfort and accelerate recovery, you should do the following:
Avoid tobacco products
Maintain good oral hygiene
Use pain control medication as needed
Relax at home for the first one to three weeks
Avoid strenuous work or exercise
Many will need a special diet to cope with the swelling and restricted jaw movement after surgery. Your surgeon or nutritionist may recommend pureed or liquid food and nutritional supplements instead of solid food, especially during the first few weeks.
Costs of Teeth Straightening Surgery
The cost of teeth straightening surgery varies based on factors like these:
Most health plans cover the cost of jaw surgery when it is considered medically necessary to restore functions like speech or chewing.
Jaw surgery is a medically approved and generally safe option for teeth straightening. However, there are multiple postoperative risks involved, including these:
Jaw swelling, pain, and infection
Difficulty eating and chewing before recovery
Dislocation of the jaw
Tooth trauma, requiring root canal therapy
Relapse (when the jaw returns to its original position)
Some patients will also need a second round of jaw surgery to achieve the intended results.
Teeth straightening surgery can significantly improve your quality of life and overall health. These are some of its benefits:
A more confident smile
Expanded diet options
Enhanced facial appearance
There are several other ways to correct a bad bite besides orthognathic surgery. These include:
Braces with orthodontic anchors
Distraction osteogenesis takes advantage of the jawbone’s natural healing processes to correct its position. Your surgeon may recommend this procedure instead of or in addition to teeth alignment surgery.
Camouflage therapy can help disguise misaligned jaw issues by removing specific teeth from both the upper and the lower jaw. Some patients choose this nonsurgical option despite their doctor recommending jaw surgery for bite correction. Camouflage therapy does not address many of the destructive mechanisms that make a bad bite harmful, but it does eliminate many of the postoperative complications of teeth alignment surgery.
Your orthodontist may recommend orthodontic anchors to help shift your teeth in a way that’s difficult or impossible with braces alone. Sometimes, these anchors are effective enough to achieve your desired results without jaw surgery.
Teeth Straightening Surgery Frequently Asked Questions
Teeth straightening surgery is more expensive than traditional braces or clear aligners. The cost of this procedure depends on factors like surgeon’s fees, anesthesia fees, surgery facility fees and how complex your case is. Many health plans cover a significant portion of the cost of medically necessary jaw surgery.
Yes. Jaw surgery is sometimes used to correct severely misaligned bites. During the procedure, your surgeon cuts your jawbone and moves it into a more favorable position. Screws and plates are used to keep the bone in place while you heal.
Aligners and braces are the fastest way to straighten teeth. Surgical straightening can take years and usually requires several months of teeth straightening with braces before surgery. You will also need braces for a few months after your surgery to complete your treatment.