Jaw growth and jaw surgery
When the upper and lower jaws do not line up, braces alone may not be enough to correct the bite. In growing children, appliances can sometimes guide jaw growth. In adults, jaw surgery (orthognathic surgery) combined with orthodontics can correct the jaw position. These are the questions we are asked most often.
For children and teenagers
Can jaw growth be changed in children?
To a degree. Orthodontists use appliances during growth to improve the way the jaws relate to each other. The research shows what these can and cannot do:
| Problem | What early treatment can do |
|---|---|
| Upper front teeth that stick out (Class II) | Early treatment with a functional appliance lowers the chance of injury to the front teeth (about 19% compared with 30% in one large review), but by the end of treatment the jaws end up much the same as with treatment in the teenage years. |
| Lower jaw ahead of the upper (Class III) | A facemask that pulls the upper jaw forward improves the bite in the short term. The benefit fades over several years, and some children still need surgery as adults. |
What is bone-anchored protraction?
For some children with an underdeveloped upper jaw, small titanium plates are placed in the upper and lower jaws, usually in early adolescence. Elastic bands between them gently pull the upper jaw forward, without an external facemask. We place and later remove the plates; your orthodontist manages the elastics and braces.
What if the upper jaw is too narrow?
In children, an expander widens the upper jaw by opening the growth seam in the palate. Once that seam has fused in late adolescence or adulthood, expansion may need mini-implants, or a minor operation to release the bone (surgically assisted expansion) before the expander is turned.
Jaw surgery for adults
Who needs jaw surgery?
People whose jaws are too far forward or back, too long or short, or uneven, where braces alone cannot give a stable, functional bite. Common reasons include difficulty biting or chewing, an open bite, difficulty closing the lips, and facial imbalance.
When is the right time?
Usually once jaw growth has finished, typically in the late teens for women and around the late teens to early twenties for men. Your orthodontist and surgeon will judge this with you.
What does treatment involve?
- Planning: a joint consultation with your orthodontist and surgeon, records and a 3D scan.
- Braces before surgery: often 12 to 18 months, to line the teeth up for their new jaw position.
- Surgery: in hospital under general anaesthetic, usually with 1 to 2 nights’ stay. The cuts are made inside the mouth.
- Braces after surgery: often 6 to 12 months to fine-tune the bite.
For some people, surgery can be done earlier in the process (“surgery first”), which may shorten treatment. We decide this with your orthodontist.
Which operations are used?
- Upper jaw (Le Fort I osteotomy): moves the upper jaw forward, up, down or levels it
- Lower jaw (sagittal split osteotomy): moves the lower jaw forward or back
- Chin (genioplasty): repositions the chin
- Both jaws together for larger or combined problems
What is recovery like?
Expect swelling for 2 to 3 weeks, a soft diet for about 6 weeks, and 2 to 3 weeks off work or study. Most people find the first week the hardest.
What are the risks?
Numbness of the lower lip and chin is common at first after lower jaw surgery. In a review of studies, it was still present one year later in about 13 to 18% of people, usually as a partial change in feeling. Other risks include the bite shifting over time, bleeding, infection, and the need to remove a plate later. We discuss your individual risks in detail before you decide.
Hospital and funding
Jaw surgery is done in a private hospital and attracts Medicare and private health fund rebates. Check your hospital cover early, as waiting periods may apply. Orthodontic fees are separate. You will receive a written estimate with item numbers after your consultation.
Getting started
Do I need a referral?
Yes. Ask your dentist (or your GP) for a referral to Dr Tom Jaunay. If you already have a referral, call us and we will book you in.
What should I bring to my consultation?
- Your referral, and any X-rays, scans or models from your orthodontist
- Your orthodontist’s name
- What bothers you most about your bite or jaw
- A list of your medicines, especially blood thinners, bone-strengthening medicines (such as Prolia or bisphosphonates), and any history of head and neck radiotherapy
How do I contact you?
Call 02 8513 9810 (9am to 5pm, Monday to Friday) or email reception@oromaxnsw.com.au. Sydney CBD Level 2, 225 Macquarie St · Hurstville Suite 9.06, Level 9, 288 Forest Rd · Miranda Suite 2, Level 5, 86 Kiora Rd. See our locations.
References
- Batista KBSL, et al. Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents. Cochrane Database Syst Rev. 2018. doi:10.1002/14651858.CD003452.pub4
- Owens D, et al. Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children. Cochrane Database Syst Rev. 2024. doi:10.1002/14651858.CD003451.pub3
- Colella G, et al. Neurosensory disturbance of the inferior alveolar nerve after bilateral sagittal split osteotomy: a systematic review. J Oral Maxillofac Surg. 2007. PubMed
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.