You may need jaw surgery to fix your bite if the problem comes from the position or size of the jaw bones, not just the teeth, and your jaws have finished growing. Many bite problems can be corrected with braces or Invisalign alone.
Hearing the words jaw surgery can be unsettling, so it helps to understand when it is truly needed and when it is not. At Cater Galante Orthodontics in Grass Valley and Salinas, we evaluate adults and teens with significant bite problems and coordinate with oral and maxillofacial surgeons when surgery is the right path. Here is how that decision gets made.
What Is the Difference Between a Dental and a Skeletal Bite Problem?
Every bite problem comes down to how the upper and lower teeth meet, but the cause can be very different. In a dental bite problem, the jaws are a reasonable size and in a reasonable position, and the teeth are what is out of place. Moving the teeth with braces or aligners can fix that kind of problem on its own.
In a skeletal bite problem, the jaw bones themselves are too far forward, too far back, too narrow or uneven. Teeth can only move so far within the bone that holds them, so braces or Invisalign alone may not create a stable, healthy bite. When the mismatch between the upper and lower jaws is significant, surgical orthodontics corrects the underlying cause by repositioning the bones and then fitting the teeth together around that new position.
Some signs can hint that the jaws are involved. The chin may look noticeably forward or set back, the front teeth may not touch at all when you bite, or one side of the face may look different from the other. Teeth that wear down quickly because they meet unevenly can be another clue. None of these signs prove that surgery is needed, but they are worth mentioning at an evaluation.
Most people have some mix of both, which is why an orthodontic evaluation with detailed imaging matters. We use 3D imaging, including CBCT, to see the teeth, jaws and surrounding structures, and you can learn more about it on our orthodontic technology page.
Which Bite Problems May Need Jaw Surgery?
Surgery is usually considered for severe skeletal versions of familiar bite problems. A pronounced overbite, called Class II, means the upper jaw sits well ahead of the lower jaw. A Class III underbite is the reverse, with the lower jaw projecting forward. Severe crossbites, open bites where the front teeth do not meet, and noticeable facial asymmetry can also be skeletal. If you want background on the milder versions, our posts on overbites and orthodontic solutions and fixing an underbite in kids explain how those are treated during growth.
Function matters as much as appearance. People with significant skeletal problems may have trouble chewing or biting into food, find that speaking takes more effort than it should, or deal with ongoing jaw soreness. When jaw position contributes to TMJ symptoms or airway problems, correcting it can help. Our article on understanding TMJ covers jaw joint symptoms in more detail.
Can Braces or Invisalign Fix a Bite Without Surgery?
Often, yes. Many bite problems are mostly dental, or the skeletal part is mild enough that moving the teeth can produce a healthy, stable bite. In those cases, braces or Invisalign alone are the plan, and surgery never comes up. Part of a thorough evaluation is explaining honestly which side of that line your case falls on.
Age changes the options. In children, the jaws are still growing, so orthodontists can sometimes guide that growth with appliances such as expanders. Addressing skeletal issues during growth can sometimes rule out surgery in adulthood, which is one reason early evaluation matters. In adults, the bones have finished growing. That is also why an adult with a narrow upper jaw usually needs a surgically assisted approach rather than a standard expander.
When the skeletal problem is significant in an adult, trying to compensate by moving the teeth alone can leave the bite unstable or the teeth in unhealthy positions. In that situation, surgical orthodontics treats the cause instead of working around it.
How Do You Know If You Are a Candidate for Jaw Surgery?
A few conditions need to line up. Your jaw growth must be complete, which usually means the late teens or older, and you need to be in good overall health for a procedure under general anesthesia. Your bite problem should be skeletal rather than only dental, and it should be significant enough to affect function, comfort or facial balance.
| Braces or Invisalign alone | Surgical orthodontics | |
|---|---|---|
| What is corrected | Position of the teeth | Position of the jaw bones plus the teeth |
| Typical bite problems | Crowding, spacing, and mild to moderate overbites, underbites and crossbites | Severe skeletal Class II or Class III bites, open bites, crossbites and facial asymmetry |
| Who it suits | Children, teens and adults | Patients whose jaw growth is complete and who are healthy enough for general anesthesia |
| Who is involved | Your orthodontist | Your orthodontist and an oral and maxillofacial surgeon |
| Overall timeline | Depends on the case | About two to three years from start to finish |
The only way to know where you stand is an evaluation. We review your bite, jaw relationship and facial proportions, explain what we see and talk through every option, including whether surgery is necessary at all.
What Does Surgical Orthodontic Treatment Involve?
Treatment follows a planned sequence, and the surgery itself is only one part of it. First, you wear braces or Invisalign to line up the teeth so they will fit together once the jaws are repositioned. This pre-surgical phase often lasts a year or more, and your bite may look worse during it. That is expected, because the teeth are being placed for the new jaw position rather than the old one.
Next, an oral and maxillofacial surgeon performs the procedure in a hospital under general anesthesia. Depending on your needs, it may involve the upper jaw, the lower jaw or both, and the bones are secured with small plates and screws. Most patients stay one to two nights. Initial healing usually takes four to eight weeks with a modified diet. After that, orthodontic treatment continues for another six to twelve months to fine tune the bite, followed by retainers to protect the result. You can see each phase on our surgical orthodontics in Salinas page.
Throughout the process, the work is shared. Your orthodontist handles tooth alignment before and after surgery, while the surgeon repositions the jaw bones themselves, and the two plan your case together so each step sets up the next. You will know who to call with questions at every stage.
Frequently Asked Questions
Is jaw surgery covered by insurance?
Coverage depends on your plan and your diagnosis. Our team can help you understand your orthodontic benefits, and your surgeon's office can explain coverage for the surgical portion.
How old do you have to be for jaw surgery?
Your jaws need to be fully grown first. For most patients that means the late teens or older, and adults can be candidates once jaw growth is complete if they are in good overall health.
Will jaw surgery change how my face looks?
It can. Because the bones are repositioned, many patients see changes in their profile and facial balance, but surgery is planned around your bite and your goals together.
Do I still need braces if I have jaw surgery?
Yes. Braces or Invisalign are worn before and after surgery so the teeth fit together correctly in the new jaw position, and retainers protect the result afterward.
Schedule a Free Bite Evaluation
If you have been told you might need jaw surgery, or you are wondering whether your bite can be fixed without it, an evaluation will give you clear answers. Call or text our Grass Valley office at (530) 444-4215 or our Salinas office at (831) 202-3070, or request a free consultation online.