Surgical Orthodontics

When Jaw Surgery Is Part of the Plan

For most patients, a straighter smile is achievable with braces or clear aligners alone. But in some cases, the underlying problem is not just about tooth position. When the jaw structure itself is significantly misaligned, surgery becomes part of the conversation. Surgical orthodontics is a specific, well-established path for those patients, and it is a process Dr. Rawlins coordinates with great care.

Surgical orthodontics, also called orthognathic surgery, is a treatment path used when the upper and lower jaws are significantly out of alignment and braces alone cannot fully correct the bite. According to the American Association of Orthodontists, an orthodontist and an oral and maxillofacial surgeon work together in these cases to reposition the jaws, with orthodontic treatment typically beginning before surgery and continuing afterward to bring the teeth into their final position. Orthognathic surgery is typically performed once jaw growth is complete, generally around age 16 for females and 18 for males.

Most Orthodontic Treatment Does Not Involve Surgery

The large majority of patients who come through our doors in Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas, are treated with braces or clear aligners alone. Surgical orthodontics represents a small subset of cases, and it is only ever recommended when the clinical picture genuinely calls for it.

That said, it is an important part of what a Board-Certified orthodontist is trained to recognize and coordinate. When Dr. Rawlins recommends it, it is because a proper, lasting bite correction is not achievable any other way.

Schedule A Free Consultation

What Surgical Orthodontics Is

Orthognathic surgery addresses problems that originate in the jaw structure itself, not just the position of the teeth. When the upper jaw, lower jaw, or both are positioned in a way that creates a significant bite problem, no amount of tooth movement will resolve it on its own. Surgery repositions the jaw or jaws, and orthodontic treatment handles everything before and after to ensure the teeth fit together correctly within that new framework.

This is a collaborative process. R. Baker Rawlins II, DMD, MS, whose specialty training was completed at New York-Presbyterian/Columbia University Medical Center, one of the most respected academic medical institutions in the world, works alongside an oral and maxillofacial surgeon to coordinate your care from start to finish. You will always know who is doing what and why.

Who May Need Orthognathic Surgery

Surgical orthodontics is considered when jaw misalignment creates functional problems that cannot be resolved through orthodontic treatment alone. Some of the most common situations include:

1. A significant overbite or underbite caused by jaw position rather than tooth position

2. An open bite where the upper and lower teeth do not make contact properly

3. A crossbite that affects jaw alignment rather than individual tooth position

4. Chronic jaw pain, chewing difficulty, or speech issues tied to structural jaw problems

5. Facial asymmetry caused by uneven jaw growth

Not every patient with these concerns will need surgery. Dr. Rawlins will evaluate your bite and jaw relationship thoroughly at your consultation and give you a clear, honest picture of what your options are.

How the Treatment Process Works

Surgical orthodontics is a phased process, and understanding the sequence helps remove the uncertainty around it.

Orthodontic Treatment Comes First

Before surgery takes place, braces are placed to begin aligning the teeth. This phase prepares the teeth to fit together correctly once the jaws are repositioned. It typically takes several months to a year, depending on the complexity of the case.

Surgery Follows

The procedure is performed by an oral and maxillofacial surgeon in a hospital setting. Surgery time varies by case, but most patients plan for a recovery period of about two weeks before returning to work or school. Dr. Rawlins will help you understand exactly what to expect during this window so you can plan ahead.

Orthodontic Treatment Continues After Surgery

Once the jaw has healed, Dr. Rawlins resumes orthodontic care to fine-tune the bite and bring the teeth into their final positions. Most patients have their braces removed within six to twelve months following surgery. A retainer is worn afterward to maintain the result.

What to Expect from Your Recovery

Recovery from orthognathic surgery is meaningful, and we want you to go into it with realistic expectations. The first two weeks require rest, and most patients take time away from their normal schedule during this period. Swelling and some discomfort are expected and manageable. Your surgeon will provide detailed post-operative guidance, and Dr. Rawlins will be in close contact throughout your recovery to monitor your orthodontic progress.

The long-term results are significant. Patients who go through surgical orthodontics often describe the outcome as life-changing, particularly when chronic jaw pain, difficulty eating, or self-consciousness about their profile has been part of daily life for years.

Your Care Is Coordinated, Not Complicated

We understand that surgical orthodontics can feel like a lot to take in. What we want you to know is that you are never managing this process on your own. At Rawlins Orthodontics, we coordinate directly with the surgical team, walk you through each phase before it begins, and stay in close contact throughout the entire treatment timeline. Our patients across Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas, have trusted us with complex care for over a decade. You are in good hands.

Frequently Asked Questions About Surgical Orthodontics

How do I know if I need jaw surgery as part of my orthodontic treatment?

The only way to know for certain is through a clinical evaluation. Dr. Rawlins will assess your bite, jaw alignment, and facial structure at your consultation and explain clearly whether surgery is a consideration for your case. Many patients with significant bite issues are candidates for treatment with braces or aligners alone. When surgery is genuinely indicated, Dr. Rawlins will explain the reasoning fully before any decisions are made.

Will I need braces even if I am having jaw surgery?

How long does the full surgical orthodontics process take?

The complete treatment timeline from the start of braces through the end of post-surgical orthodontics typically ranges from one to three years, depending on case complexity. Surgery itself takes place after months of pre-surgical orthodontic preparation, with most patients completing the post-surgical phase within six to twelve months. Dr. Rawlins will give you a realistic estimate for your specific situation at your consultation.

Is orthognathic surgery covered by insurance?

Coverage depends on your plan and whether the condition is classified as medically necessary rather than cosmetic. Many cases of significant jaw misalignment that affect bite function, chewing, or breathing qualify for medical or dental insurance coverage. We recommend reviewing your benefits carefully and bringing any questions to your consultation. Our team will help you understand your options.

What happens after braces are removed following surgery?

If you have been told you may need jaw surgery, or if you have questions about whether your bite issue requires surgical orthodontic treatment, we are happy to talk it through. We see patients from Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas. Schedule a free consultation with Dr. Rawlins at RawlinsOrthodontics.com or by calling (302) 239-3531. You are in good hands with our Rockstar Team, and we will walk you through everything.

About Rawlins Orthodontics

Rawlins Orthodontics is a family-owned, Board-Certified orthodontic practice serving Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas. R. Baker Rawlins II, DMD, MS has cared for thousands of patients since 2011 and is named annually as one of Delaware's Top Orthodontists by Delaware Today Magazine. We offer braces, Invisalign, Invisalign Teen, and early intervention orthodontics for children and adults.

LOVE • LIFE • SMILING