Last Updated on August 10, 2026 by Dr. Adam Veit
Surgical Orthodontics
Surgical orthodontics, also called orthognathic surgery, combines braces with corrective jaw surgery to treat bite problems that come from the position of the jaws rather than the position of the teeth. The orthodontist moves the teeth. An oral and maxillofacial surgeon repositions the jaw. Together they correct discrepancies that neither could fix alone.
It is not a common treatment, and most people who wonder about it turn out not to need it. But when a jaw genuinely sits in the wrong place, braces on their own can only camouflage the problem. Surgery is what actually solves it.
Dr. Adam Veit plans and manages the orthodontic side of these cases at Bright Orthodontics, working with an oral and maxillofacial surgeon who performs the surgery itself.
When Jaw Surgery Becomes Part of the Plan
Teeth sit in bone. If the bone the teeth sit in is too far forward, too far back, too narrow or off to one side, then moving the teeth is only ever going to compensate for the mismatch.
Cases where surgery is often the honest answer include:
- A lower jaw noticeably behind or ahead of the upper jaw, when growth has finished
- An open bite, where the front teeth do not meet even when the back teeth are closed
- Facial asymmetry, where one side of the jaw has developed differently from the other
- Difficulty chewing, biting or closing the lips comfortably
- Teeth wearing unevenly because the jaws do not meet correctly
- A bite problem that is causing ongoing jaw joint discomfort
None of this can be diagnosed from a website, and it should not be. An exam with records tells us whether a case is skeletal or dental, and that single distinction is what decides the whole plan.
How the Treatment Works
Surgical cases run longer than ordinary orthodontic treatment and follow a clear sequence.
- Diagnosis and records. Photos, X-rays and a three dimensional scan. This is where we establish whether the problem is in the teeth, the jaws, or both.
- Joint planning. Dr. Veit and the oral surgeon plan the case together, before anything begins, so both halves aim at the same finish.
- Pre-surgical orthodontics. Braces go on first, often for around a year, to move the teeth into the positions they will need to be in once the jaw is moved. This stage sometimes makes the bite look worse before it looks better, and we explain why in advance so it is not a surprise.
- Surgery. Performed by the oral and maxillofacial surgeon, usually in a hospital or surgical center under general anesthetic.
- Healing. A recovery period of a few weeks before orthodontic adjustments resume.
- Finishing orthodontics. Several more months of braces to settle the bite precisely into its new position, followed by retainers.
Who Does What
This is the part patients most often find confusing, so we set it out plainly.
Your orthodontist diagnoses the bite, decides whether the case is skeletal, positions the teeth before surgery, and finishes the bite afterwards. That is Dr. Veit, and he stays with the case from beginning to end.
Your oral and maxillofacial surgeon performs the operation that repositions the jaw, and manages the surgical recovery.
Your general dentist keeps looking after your everyday dental health throughout, and we keep them informed.
You do not have to assemble that team yourself. That is our job, and it is a large part of what makes a specialist practice useful on a case like this.
Timing and Growth
Corrective jaw surgery is generally done once facial growth is complete, which happens earlier for girls than for boys. Operating before that risks the jaw continuing to grow afterwards.
That does not mean waiting and doing nothing. In a growing child, some jaw discrepancies can be improved or intercepted without surgery at all, which is one of the strongest arguments for an early orthodontic check by age seven. Many cases that would have needed surgery in an adult can be guided in a child.
Being Honest About What It Involves
We would rather you heard this from us than found it out later.
Jaw surgery is real surgery. It carries the risks any surgical procedure carries, and your surgeon will go through them with you properly. Recovery involves swelling, a modified diet for several weeks, and time away from work or school. Total treatment time, counting the braces before and after, is usually measured in years rather than months.
What patients report on the other side is a bite that finally works, a face that fits together, and in some cases easier breathing and eating. Those are real outcomes, but they are not guarantees, and we will not describe your result before we have examined you.
Request an appointment at our Oshkosh, Fond du Lac, Ripon or Berlin office and we will tell you honestly whether surgery belongs in the conversation at all. See orthodontic financing for how fees and insurance work.
Find Out Whether It Applies to You
Most people asking about jaw surgery do not need it. The only way to know is an exam with proper records.
Request an appointment at Bright Orthodontics in Oshkosh, Fond du Lac, Ripon or Berlin. To understand how conventional treatment works first, read about braces and common orthodontic problems.
Reviewed by Dr. Adam J. Veit, DDS, MS, a board-certified orthodontist and the treating doctor at all four Bright Orthodontics offices.
Frequently Asked Questions
Orthognathic treatment can raise important questions about timing, recovery, and expectations. Here are answers to help you better understand the process.
Is corrective jaw surgery covered by medical insurance rather than dental insurance?
Often it is handled at least partly on the medical side, because it corrects a functional problem rather than an appearance one, while the orthodontic half is usually a dental benefit. Coverage varies a great deal between plans. We will help you document the case properly, and our financing page explains how we handle the paperwork.
Will I need braces both before and after surgery?
Yes, in almost every case. The teeth have to be prepared for where the jaw is going, and then finished once it gets there. Skipping either half compromises the result.
Can braces alone fix a severe underbite in an adult?
They can sometimes improve how it looks by tipping teeth to compensate, but they do not change where the jaw sits. Whether compensating is a reasonable choice depends on the size of the discrepancy and what you want from treatment, and it is a decision worth making with full information.
How long will I be away from work or school?
Most patients plan for a couple of weeks away, then a gradual return with a modified diet for several weeks after that. Your surgeon gives you a specific timeline for your procedure.