If your overbite is severe or is taking forever to straighten with conservative treatment, the field of oral and maxillofacial surgery (jaw surgery) may have an answer for you. Treatment is usually very effective but can be quite expensive, and you should consider dental insurance.
Overbite surgery, a type of maxillofacial procedure, aims to bring your lower jaw forwards, in line with your upper jaw.
Patients whose malocclusions originate from the jawbones are often advised to have surgery.
Maxillofacial surgery is reliable and, in many cases, faster than conservative treatment.
The average cost of jaw surgery and its risks can make this treatment route undesirable for many.
Braces, aligners, and splints can be effective alternatives in treating milder cases of overbite.
Orthognathic surgery, or jaw surgery, aims to correct issues with jaw alignment. It is a specialty of oral and maxillofacial surgery and includes upper and lower jaw surgery, as well as procedures to straighten the chin.
The aim of jaw surgery in cases of malocclusion is to bring the upper and lower teeth together. Temporomandibular joint disorders can be treated with jaw surgery too, and there are procedures specifically for the joint itself.
In both upper jaw and lower jaw surgery, the surgeon cuts into the gums just behind your teeth under general anesthesia. Your jaw can then be moved forward or backward and kept in its new position using titanium screws or plates.
Corrective jaw surgery is typically necessary in cases of severe jaw misalignment. Facial injury, birth defects, and other issues that affect the development of your upper and lower jaws can call for surgical treatment, as braces only straighten teeth.
In these situations, there can be chronic jaw pain, and significant difficulties with eating, speaking, or even breathing. Gum disease and tooth decay are also potential long-term consequences of an untreated, seriously misaligned jaw [1].
Jaw surgeries are generally reserved for patients who have issues with jaw alignment that are too severe for camouflaging treatment, such as braces or splints. If you are reading this for your child, jaw surgery is also left for patients too old for growth modification therapy [2].
Jaw surgery aims to correct misalignments by bringing the jaw bone forward or backward, in situations too severe for traditional orthodontic treatment.
The type of jaw surgery for overbite correction is known as a mandibular osteotomy. This procedure involves your maxillofacial surgeon cutting behind the teeth of your lower jaw, essentially causing a jaw fracture.
Your lower jawbone is then pulled forward and kept in place by titanium screws or plates. This is an overall safe operation, but there is a risk of nerve injury or jaw joint pain, particularly if you have TMJ dysfunction [2].
Jaw surgeries are a reliable way to bring your lower jaw forward in cases of overbite. They can help to reduce facial asymmetry and even correct certain breathing problems caused by incorrect bone development.
Lower jaw surgery is a faster way to correct your overbite than more conservative treatment. Whereas you can expect to wear splints, braces, and aligners for over a year, and sometimes more than two years.
A study comparing splints to lower jaw surgeries found that patients having surgery needed braces for a shorter amount of time after the procedure. Those using splints wore braces for 14 months on average, while surgical patients needed them for 10 months [3].
Jaw surgery can be a faster, more reliable method of treating overbite, particularly in severe cases.
Orthognathic surgery overall is estimated to cost $20,000 to $40,000 without medical insurance, according to CostHelper. However, you can expect the price to be at the lower end of this scale if you only need upper jaw surgery. The cost of jaw surgery includes the consultations, surgeon’s fee, hospital fee, materials, and follow-up care.
Why you are seeking upper jaw surgery can determine whether you get insurance coverage. Obstructive sleep apnea, another breathing issue, or certain speech impairments may be the only covered indications. Other reasons are often classified as plastic surgery.
If your insurance company will cover your jaw surgery costs, you may pay as little as $100, or as much as over $5,000. This does not include braces, which are often needed alongside orthognathic surgery.
The cost of overbite surgery varies by the procedure you need and whether your insurance will cover it.
In many cases, you will start preparing for jaw surgery by wearing braces or aligners to begin the process of bite correction. Whether you need upper, lower, or even double jaw surgery is decided, and further examination such as X-rays, molds, and measurements are taken to plan and predict your postoperative facial appearance.
Preparation for any surgical procedure is just as psychological as it is physical. Several weeks of limited activity, a swollen face, medication side effects, and an eventual new facial appearance can be emotionally difficult. You should also feel that you have a good rapport with your maxillofacial surgeon long before the actual surgery [2].
As for the length of time off that you need, it is best to plan for a three-week absence from work or study. Issues such as paid leave, medical bills, and the cost of any hired domestic support must be addressed well in advance.
Preparing for jaw surgery includes pre-operative treatment, determining precisely what procedure you need, and planning for recovery.
The recovery process of jaw surgery takes an average of six to eight weeks, but different after-effects may require more or less time.
You can expect nausea to resolve within five days, while the average person will also see their bruising and any bad breath dissipate in a week. Swelling may take up to three weeks to resolve, but half of the patients no longer have it by day 10.
Pain and discomfort take a little longer. Three-quarters of patients report only slight discomfort, if any, after 18 days, but intermittent pain may still flare-up. However, a small percentage of people continue to take non-narcotic painkillers after two to three months.
As for returning to normal activities, everyday routine and social life generally take four weeks. Patients report that recreational activities take a little longer, but any issues are mostly resolved within eight weeks [4].
Most people recover from overbite surgery in two months, with the most unpleasant symptoms of nausea, pain, and facial swelling usually resolving in less than one month.
Alternative treatments to jaw surgery include:
Fixing an overbite may only call for traditional orthodontic treatment. If you have both skeletal and dental irregularities, treating the dental aspect alone could be enough. Research shows that alternatives to jaw surgery can be about as effective in moving teeth to the correct position, up to a certain degree of severity [5].
Learn more about how to fix an overbite here.
Whether you cannot afford the cost of orthognathic surgery, don’t want the risks of general anesthesia, or find everything about these invasive medical procedures off-putting, these alternatives may be for you.
Clear aligners, such as Invisalign, are a less painful and often faster alternative to metal braces. Studies show they can be equal to metal braces in some aspects such as overall orthodontic scores but are best suited to treat mild cases of crooked teeth or overbite [6]. However, Invisalign can be more expensive than metal braces.
Byte aligners are a cheaper braces alternative than Invisalign, a key advantage as many Americans do not have dental insurance that covers non-emergency treatment. Just like Invisalign, a set of clear plastic aligners are designed to fit your teeth and gradually reposition them, but without the pain and discomfort of regular braces.
Using an at-home impression kit, simply send off molds of your teeth to the Byte team, where a personalized set of aligners and treatment plans are made for you. You can contact your Byte care team any time you have any questions, and you are supplied with aftercare retainers once treatment is done.
AlignerCo is perhaps the cheapest of all aligner brands, at only $1,145 and with discounts often available. Unlike Byte, you can buy aligners for teenagers, but there is less personalized support from dentists.
It is important to remember that the American Dental Association does not currently recommend at-home aligners. However, many customers report them to be effective.
Wearing braces is most effective when your overbite is predominately dental, meaning your teeth are out of alignment. Different types of braces can correct less severe skeletal overbite, too.
Tooth extraction is usually used to mask upper jaw misalignment. The first premolars are the most commonly extracted teeth, which creates more space for the incisors (front teeth) so they don’t protrude forward [5].
Splint therapy, commonly with the metal Herbst appliance, can reactivate bone growth in adults. Research suggests that it recruits stem cells into the lower jaw bone, correcting mild cases of growth deficiency. A potential disadvantage is that it can cause proclination of the lower teeth, which means they can be pushed forward.
Human studies show that the Herbst splint is equally effective as jaw surgery in treating borderline skeletal overbite. Both demonstrated a reduction in overjet of over 8mm and improved molar relation by over 6mm [3].
Braces, aligners, and tooth extraction can camouflage overbite, while splints may correct the underlying jaw issues by stimulating bone growth.
What are the most important things we need to know about jaw surgery?
Overbite surgery is an effective, reliable treatment where the lower jaw is brought forward, in line with the upper jaw. This can provide great relief to chewing or speaking difficulties, and improve your facial appearance.
However, the potential for complications and surgery costs make alternatives more appealing. Aligners, braces, and splint therapy are effective substitutes for milder cases of overbite, which are safer and generally cheaper, too.
