Orthognathic Surgery

Orthognathic surgery, also called corrective jaw surgery, repositions the upper jaw, lower jaw, or both to correct a skeletal bite issue that orthodontic treatment alone cannot fully address. For patients with significant jaw misalignment, surgery combined with orthodontic treatment can improve bite function, facial balance, and in some cases breathing, in a way that braces or clear aligners cannot achieve on their own.

We coordinate closely with experienced oral and maxillofacial surgeons to plan and sequence this treatment, providing the orthodontic portion of care before and after surgery. This page explains what orthognathic surgery involves, who may benefit from it, and what to expect if it becomes part of your treatment plan.

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What Is Corrective Jaw Surgery?

Orthognathic surgery addresses situations where the upper and lower jaws do not align correctly at the level of the bones, rather than only at the level of individual teeth. While braces and clear aligners move teeth within the jaw, they cannot reposition the jawbones themselves in an adult patient. When a bite issue is primarily skeletal, meaning the jaws are misaligned rather than only the teeth, surgery becomes the tool that allows us to correct what orthodontic movement alone cannot.

Surgery is performed by an oral and maxillofacial surgeon, not by our team directly. Our role is to evaluate whether surgery is likely needed, refer you to the surgeon, coordinate with your surgeon on treatment planning, and manage the orthodontic treatment that takes place before and after the surgical procedure.

Do You Need Jaw Surgery?

Many people live with a jaw misalignment for years without realizing that surgery, combined with orthodontic treatment, could meaningfully improve their bite, comfort, and quality of life. You may benefit from an evaluation if you experience:

Not sure whether your case requires surgery or can be treated with braces or aligners alone? Book a free consultation and we will evaluate your bite and jaw alignment to help you understand your options.

Conditions Treated with Orthognathic Surgery

Overbites and Underbites

Surgery corrects cases where the upper or lower jaw protrudes to a degree that orthodontic treatment alone cannot resolve.

Open Bites

Surgery closes a persistent gap between the upper and lower teeth that remains when the mouth is closed, when this gap is caused by jaw position rather than tooth position alone.

Crossbites

Significant skeletal crossbites, where the jaws themselves are misaligned rather than only the teeth, may require surgical correction alongside orthodontic treatment.

Jaw Misalignment From Growth or Injury

Surgery can address jaw discrepancies that developed during growth or resulted from an earlier injury to the face or jaw.

Sleep Apnea and Breathing Difficulty

In select cases, repositioning the jaw can improve the airway and reduce symptoms connected to obstructive sleep apnea.

TMJ Disorders

For some patients, correcting the underlying jaw alignment can reduce pain and dysfunction connected to the jaw joint.

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Benefits of Orthognathic Surgery

  • Improved ability to chew, speak, and breathe comfortably
  • A more balanced facial appearance
  • Relief from chronic jaw pain connected to skeletal misalignment
  • Reduced long-term risk of uneven tooth wear and related dental issues
  • Improved confidence in both bite function and appearance
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The Treatment Process

1. Initial Consultation and Evaluation

Your evaluation begins with a comprehensive exam at our office, including digital x-rays and a 3D scan to assess your bite and jaw alignment. If we determine that your case is likely skeletal in nature, we will refer you to an oral and maxillofacial surgeon and begin coordinating a treatment plan together.

2. Pre-Surgical Orthodontic Treatment

Before surgery, most patients require a period of orthodontic treatment using braces or clear aligners to align the teeth within each jaw. This step may feel counterintuitive, since your bite may look or feel less aligned during this phase, but it ensures your teeth will fit together correctly once your jaws are repositioned during surgery.

3. The Day of Surgery

Surgery is performed by your oral and maxillofacial surgeon under general anesthesia. The surgeon repositions the jawbone or bones to their corrected position. Depending on the complexity of your case, you may stay in hospital overnight or return home the same day. Your surgeon will review these specifics with you directly as part of your surgical planning.

4. Post-Surgical Orthodontic Care and Recovery

Following surgery, you will need time to heal, along with some dietary adjustments and careful oral hygiene while swelling subsides. Once initial healing is underway, we resume orthodontic treatment to fine-tune your bite into its final position. Most patients return to normal daily activities within a few weeks, while full healing typically continues over several months.

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Is Surgery Right For You?

Orthognathic surgery is not for everyone with a skeletal jaw size difference. There may be patients who have a skeletal issue who may benefit from surgery but who opt to not have it for many reasons. We give non-surgical options to all patients who would benefit from treatment. Deciding whether to move forward with orthognathic surgery is a personal decision, and one we will help you think through carefully rather than rush. At your consultation, we will discuss:

  • The severity of your jaw misalignment and whether it is primarily skeletal or dental
  • How the misalignment affects your daily comfort, chewing, breathing, or speech
  • Whether non-surgical orthodontic treatment could achieve an acceptable result on its own
  • The general treatment and recovery timeline specific to your case

We want you to leave your consultation with a clear understanding of your options, not pressure toward a single path.

Cost and Treatment Time

Surgical and highly complex orthodontic cases, including those involving orthognathic surgery, typically range from $8,000 to $11,000 for the orthodontic portion of treatment, with the full course of treatment, including pre-surgical and post-surgical orthodontics, generally taking over 24 months. Surgical fees from your oral and maxillofacial surgeon, along with any hospital costs, are separate from this estimate and will be discussed with you directly by your surgical team. We offer low monthly payments and interest-free financing to make it more affordable.

The hospital procedures required for jaw surgery in New Brunswick are generally covered by Medicare. There are additional fees for the orthognathic surgery consultation with the surgeon as well as for all the planning and preparation that the surgeon has to do. We encourage you to confirm your specific coverage directly, and we are happy to help you understand how the orthodontic portion of your treatment fits into your overall cost.

Why Choose MacKenzie Orthodontics

  • Dr. MacKenzie has treated over 10,000 patients, and has more than 15 years of clinical experience
  • Close coordination with experienced oral and maxillofacial surgeons throughout your surgical treatment plan
  • Advanced digital x-rays and 3D scanning used to evaluate and plan your case
  • Pain-free orthodontics using the Dental Pain Eraser throughout your pre- and post-surgical treatment
  • Dr. MacKenzie is the orthodontist on the Cleft Lip and Palate Team at the Saint John Regional Hospital and works together with plastic surgeons and Oral and Maxillofacial surgeons on complex cases
  • Three convenient New Brunswick locations in Saint John, Quispamsis and Rothesay, and St. Stephen, with the St. Stephen location also serving families from St. George, St. Andrews, and Northern Maine
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Frequently Asked Questions

How long is the recovery time for jaw surgery?

Most patients return to normal daily activities within a few weeks, while full healing typically continues over several months. Your surgeon will provide a recovery timeline specific to your procedure.

Will I need braces before or after jaw surgery?

Yes. Most patients require orthodontic treatment with braces or clear aligners both before and after surgery, so that the teeth fit together correctly once the jaws are repositioned.

Does jaw surgery hurt?

You will be under general anesthesia during the procedure itself. Your surgical team will provide pain management for the recovery period, and we will support you with any orthodontic-related comfort measures during this time.

Is jaw surgery covered by insurance?

Coverage varies depending on your provincial health plan and the medical necessity of your case. We recommend confirming your specific coverage directly, and we are glad to help clarify how the orthodontic portion of treatment fits into your overall cost.

How do I know if I need jaw surgery or just braces?

If your bite issue is primarily skeletal, meaning the jaws themselves are misaligned rather than only the teeth, surgery may be part of the recommended treatment. If the issue is primarily dental, braces or clear aligners alone may be sufficient. We will evaluate your specific case at your consultation and recommend the appropriate path.

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Ready to Start Your Journey?

If you are living with chronic jaw pain, a significant bite misalignment, or facial asymmetry, book a free consultation at any of our three New Brunswick locations. We will evaluate your bite and jaw alignment and help you understand whether orthodontic treatment alone or a combined surgical approach is right for you.

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