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.

What is teeth straightening surgery used for?

Teeth straightening surgery is typically reserved for significant medical issues that can’t be fixed with treatments like braces or aligners.

Insurance companies like BlueCross BlueShield also require people to prove that their issue causes more than simple cosmetic issues. In other words, you must prove that your crooked teeth make it hard for you to do things like chew or talk.

Conditions doctors might treat with surgery include the following:

• A protruding lower jaw (mandibular prognathism)

• Crossbite

• Open bite

• Overbite

• Underbite

Some people need surgery because they were born with jaw deformities. Others need help after a traumatic injury.

In an overview study published in 2023, researchers examined the success rate of orthognathic surgery in 674 people. They found that complications and problems were rare, as about 4% of people had them. The most common complication was infection.

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

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:

• Overbite

• Overjet

• Cross bite

• Open bite

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:

• Cleft palate

• Cleft lip

• Syndromic craniosynostosis

• Miller syndrome

• Treacher Collins syndrome

• Hemifacial microsomia

How do you prepare for surgery?

If your dentist believes you need jaw surgery, you’ll need to take steps to prepare. Your dental team will guide you through this process very carefully to ensure you know just what to do. You won’t be alone.

In general, the steps you’ll follow include the following.

1. Scanning: Your surgeon needs clear images of your jaws to prepare for surgery. You’ll have tests like x-rays or computer tomography (CT) scans. Your doctor may also perform general health checks (such as taking some blood) to ensure you’re healthy and ready for surgery.

2. Conversation: Based on your test results, your dental team can create a treatment plan. You’ll hear what it involves, what you must do, and how much it might cost. Nothing will happen until you approve of the plan.

3. Orthodontic treatment: Some people need treatment with braces or aligners for months before they have surgery. These techniques could reduce the amount of tissue your surgeon has to change during the procedure. Some people need orthodontic care after surgery too.

How does jaw surgery work?

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.

How does recovery work?

After surgery, you’ll need to take special care with your teeth, mouth, and gums. Your surgery team will provide you with detailed instructions, and you’ll also have several check-up appointments. Your team will ensure that everything is healing properly.

While every person is different, most people who have surgery heal at a similar rate. It might look like the following.

What can you eat after teeth straightening surgery?

While your teeth and bones recover from surgery, you can’t eat all of your favorite foods. Your mouth needs time to heal, and chewing can cause additional harm.

The NHS Foundation Trust explains that most people follow a schedule when recovering from surgery. These are the stages involved, along with typical foods you can eat at each point. Your doctor can help you explain which stage applies to you at each part of your recovery.

Liquid diet

In the first days after surgery, it isn’t safe to chew on anything at all. You should still eat three meals per day, but they must be in fluid form. Try the following foods:

• Milkshakes

• Soup

• Fruit juice

• Yogurt (diluted with milk if it’s too thick to drink)

• Pureed foods (such as rice or pasta)

Soft diet

When your mouth is slightly healed and you can open and close your jaws, it might be time to add a few soft foods to your diet. If your doctor says it’s safe to do so, your diet might include the following:

• Cereal soaked in milk

• Oatmeal with milk

• Mashed fruit

• Mashed eggs

• Soup

• Pasta mashed with a fork in sauce

• Risotto

Costs of Teeth Straightening Surgery

The cost of teeth straightening surgery varies based on factors like these:

• Surgeon fees

• Location

• Hospital costs

• Anesthesia fees

• Diagnostic fees

• Medical prescriptions

• Case complexity

Most health plans cover the cost of jaw surgery when it is considered medically necessary to restore functions like speech or chewing.

Risks

Jaw surgery can be a safe and effective way to deal with a severe tooth problem. However, surgeries do come with risks. Understanding what they are can help you determine if this approach is right for you and your health.

In 2017, researchers studied common problems that happened to people who had jaw surgery. They found these issues happened most often:

• Infections: 4.08%

• Broken devices after surgery, such as plates or screws: 2.49%

• Nerve problems: 1.89%

• Temporomandibular disorder: 1.02%

Benefits

Teeth straightening surgery can significantly improve your quality of life and overall health.These are some of its benefits:

• A more confident smile 

• Enhanced self-esteem

• Expanded diet options

• Speech improvement

• Enhanced facial appearance

Alternative Options 

There are several other ways to correct a bad bite besides orthognathic surgery. These include:

• Distraction osteogenesis

• Camouflage therapy

• Braces with orthodontic anchors

Teeth Straightening Surgery Frequently Asked Questions