Surgical Orthodontics


Depending on the specifics of the individual case, Dr. Koch might recommend surgical orthodontics (also known as orthognathic surgery) as part of treatment. Surgical orthodontics corrects jaw irregularities to improve the patient’s ability to speak, bite, breathe and for improved facial appearances. Orthodontics straightens the teeth, and surgical orthodontics straightens the jaw. Correcting jaw alignment also moves the teeth, so braces are always required as part of this treatment.


To be a candidate for surgical orthodontics, the patient must have a fully grown jaw. Jaw growth typically ends by age 16 for girls and 18 for boys. Although the surgery cannot be performed until the patient’s jaw stops growing, the teeth can begin alignment with braces one to two years before that time.

Before the surgical treatment, the patient will have orthodontics for 12 months in the typical case. As the teeth move with braces before surgery, the patient may question if the alignment is correct. What is important to remember is that the teeth are being moved so after the surgery they will be in proper position. The alignment goal is based on the patient’s future jaw positioning, not current.

The surgery is performed in a hospital with an oral surgeon. The specifics of the surgery can vary depending on the particular case. In lower jaw surgery, the jaw bone behind the teeth is separated, and the tooth-bearing portion is positioned forward or backward, as desired. If the focus is the upper jaw, it can be moved forward or backward, or the jaw can be raised or lowered. 

When you have completed surgery, you should be able to return to school or work within one week. After a healing time of 4-8 weeks, Dr. Koch will make small adjustments on your teeth to fine tune your alignment. After the braces are removed, a retainer will be used to keep your teeth in their final position.