18–30 months
Roughly 9–15 months of orthodontics, then surgery, then 6–12 months of finishing.
Oral surgeon
Dr. Roark plans the orthodontic phases around it and coordinates timing with them.
About 2 weeks
Most patients return to normal routine within a fortnight of the operation.
Sometimes the teeth are not the problem — the jaw is
Orthodontics moves teeth. It cannot change the size or position of a jaw. So when the underlying issue is that the lower jaw sits too far forward or too far back, or the upper jaw is underdeveloped, or the bite is open — moving the teeth into alignment will not hold, because the foundation they are moving into is the thing that is wrong.
Surgical orthodontics (also called orthognathic treatment) solves this by planning the orthodontic work and corrective jaw surgery together as one course. Braces or aligners align the teeth before surgery so the jaws can be positioned accurately, the surgeon repositions the jaw, and then a finishing phase of orthodontics fine-tunes the bite.
Dr. Roark completed complex surgical cases during her three-year residency at Montefiore Medical Center in New York, and plans and coordinates these cases here in Franklin in conjunction with your oral and maxillofacial surgeon.
Signs the jaw, not just the teeth, may be the issue
These are functional signs rather than aesthetic ones.
An underbite
The lower jaw sits noticeably ahead of the upper, so the lower front teeth overlap the upper.
A significant overbite
The lower jaw is set well back, often with a receding chin and a strained profile.
An open bite
The front teeth do not meet when the back teeth are closed, making it hard to bite through food.
A chin that shifts sideways
The jaw swings to one side when closing, often with uneven wear on one side of the teeth.
Difficulty chewing or speaking
Persistent trouble biting through food, or a lisp related to the jaw relationship.
Severe jaw joint problems
Significant problems with the temporomandibular joints, such as a jaw that locks or a joint that is breaking down — not just occasional clicking or aching.
Nothing here is a diagnosis. Only an examination and imaging can confirm whether jaw surgery is indicated for you. If you recognize several of these, it is worth a consultation — and if surgery is not needed, we will say so plainly and treat you with braces or aligners alone.
The treatment sequence, phase by phase
Roughly 18 to 30 months end to end. Your own timeline depends on how much the teeth need to move before the jaws are repositioned.
1 · Consultation & records
2 · Planning together with the surgeon
3 · Pre-surgical orthodontics
4 · The surgery
5 · Post-surgical orthodontics
6 · Retainers
Insurance and Cost
The orthodontic phase is usually claimed against your dental plan and its orthodontic lifetime maximum. Insurance for the surgery itself is handled by the surgeon’s office.
- A consultation together with the oral surgeon before you commit to anything
- The orthodontic phase quoted separately, with your dental benefit verified
- 0% interest payment plans — down payment at the start
- HSA and FSA dollars welcome
Message sent
We have it, and a reply will come to your email — usually the same or next business day. For anything urgent, call (615) 814-4884.
Surgical orthodontics questions
What is surgical orthodontics?
It is treatment where braces or aligners and corrective jaw surgery are planned together as a single course. The orthodontist straightens and aligns the teeth, the oral and maxillofacial surgeon repositions the jaw itself, and then the orthodontist finishes the bite. It is used when the underlying problem is the position or size of the jaws, which moving teeth alone cannot correct.
How do I know if I need jaw surgery rather than just braces?
The signs are usually functional rather than cosmetic: a lower jaw that sits noticeably too far forward or back, an open bite where the front teeth do not meet, a chin that shifts to one side when you close, difficulty chewing or biting through food, or severe jaw joint problems. A board certified orthodontist can identify this from your records and will refer you to a surgeon for a joint assessment if it applies.
Who performs the surgery?
An oral and maxillofacial surgeon. Dr. Roark does not perform the surgery — she plans the orthodontic phases around it in conjunction with the surgeon, and coordinates the timing with them. You will typically meet the surgeon at the consultation stage, before committing to anything.
How long does the whole process take?
Typically 18 to 30 months in total. The usual sequence is a pre-surgical orthodontic phase of 9 to 15 months to align the teeth, the surgery itself, then a post-surgical phase of roughly 6 to 12 months to finish the bite. Recovery from the surgery usually means about two weeks away from normal routine.
How does insurance work for surgical orthodontics?
The orthodontic phase is usually filed with your dental plan, and we verify that benefit for you. Insurance for the surgery itself is handled by the surgeon's office.
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Treatment menu