Will my child definitely need jaw surgery?

Almost certainly not. Even underbite surgery treatment, the most common surgical case, is usually considered only after growth is complete. Surgical orthodontics applies to a small minority of orthodontic patients, and the great majority of bite problems are corrected with braces or aligners alone. If a jaw discrepancy is identified while your child is still growing, growth-guiding appliances can frequently reduce or eliminate the need for surgery later. That is a large part of why the age-7 evaluation exists — it is the point at which the non-surgical options are still fully available.

Why do my teeth look worse before surgery?

This surprises nearly every patient, so it is worth understanding in advance. During pre-surgical orthodontics, teeth are aligned within each jaw individually, rather than compensated to disguise the jaw mismatch. Because those natural compensations are removed, the bite discrepancy becomes more visible in the months before surgery. It is a planned and temporary stage — the jaws are being set up to fit together correctly once repositioned.

How long is recovery?

Most patients return to school or desk work within two to four weeks, with swelling resolving substantially over the first month. Full bone healing takes several months, and diet is restricted during the early portion. Your oral surgeon sets the specific recovery protocol, since it depends on which jaw was moved and how. Orthodontic appointments resume once your surgeon clears you, usually within the first month or two.

Is surgery covered by insurance?

Orthognathic surgery is sometimes covered under medical rather than dental insurance when it is documented as functionally necessary — for chewing, breathing, or speech — rather than cosmetic. Coverage decisions vary considerably by plan and usually require pre-authorization with supporting records. We and your surgeon's office will help assemble that documentation, but we cannot promise an outcome.

Who is a candidate for surgical orthodontics?

Teens and adults whose jaw growth is complete, usually around age 16 to 18 or older, with a severe underbite, overbite, open bite or jaw asymmetry may be candidates.

Surgical Orthodontics & Jaw Surgery in Lexington, SC

Reviewed by Dr. Christine Esposito, Board-Certified Orthodontist at Sunset Children’s Dentistry · Updated October 12, 2026

Surgical orthodontics — also called orthognathic treatment — combines braces with a jaw procedure performed by an oral and maxillofacial surgeon. It is reserved for the small number of patients whose upper and lower jaws are mismatched in size or position by more than tooth movement can compensate for.

If you have landed on this page because someone mentioned jaw surgery, start here: most people who worry about it never need it, and the patients who do are typically finished growing. Nothing is decided at a consultation.

For families researching jaw surgery in Lexington, SC or orthognathic surgery in Lexington, SC, Dr. Esposito handles the orthodontic side of treatment — the braces before and after surgery — and coordinates with an oral and maxillofacial surgeon who performs the procedure. You can start with a free orthodontic consultation at our Lexington orthodontics office.

Book Free Consultation Call (803) 262-2455

Patient consultation about surgical orthodontics with Dr. Christine Esposito at Sunset Children's Dentistry in Lexington, SC

When is surgical orthodontics needed?

Surgical orthodontics is needed when the upper and lower jaws are mismatched in size or position and braces alone cannot correct the bite. At Sunset Children’s Dentistry in Lexington, board-certified orthodontist Dr. Christine Esposito evaluates whether surgery is truly necessary. Learn more about orthodontic care at Sunset Children’s Dentistry.

Braces move teeth through bone. They do not move the bone itself. When the problem is the size or position of the jaws rather than the teeth, there is a limit to what brackets can disguise — and pushing past that limit causes its own damage, including gum recession and unstable results.

Growing children are a different case. A jaw discrepancy caught early can often be redirected with growth-guiding appliances, which is one of the strongest arguments for an evaluation by age seven.

Significant underbite or overbite that does not resolve with growth and needs severe bite correction beyond what braces can do
Open bite where front teeth never meet, even when the back teeth touch
Facial asymmetry from one jaw growing differently than the other
Difficulty chewing, biting, or speaking that alignment alone will not fix
Obstructive sleep apnea in selected cases, where jaw position restricts the airway
Chronic jaw strain traced to a skeletal mismatch rather than tooth position

See Early Treatment Options

Learn More About Surgical Orthodontics at Sunset Children’s Dentistry

Surgical orthodontics at Sunset Children’s Dentistry combines braces with jaw surgery by an oral surgeon for bites that braces alone cannot correct.

Surgical cases involve two providers working from one shared plan. Here is how the pieces fit together, and what each stage involves.

The Orthodontist’s Role

Dr. Esposito aligns the teeth within each jaw before surgery and refines the bite afterward. She also determines whether surgery is genuinely necessary, or whether a non-surgical compromise would serve you better.

The Oral Surgeon’s Role

A board-certified oral and maxillofacial surgeon performs the procedure itself. The American Association of Oral and Maxillofacial Surgeons describes corrective jaw surgery as a process rather than a single event, with orthodontics both before and after.

Teens Still Growing

Surgery is generally postponed until jaw growth is complete — often the late teens. Before then, growth modification may reduce the severity of the discrepancy or remove the need for surgery altogether.
Dentofacial Orthopedics →

Adults Considering Correction

Adults make up most surgical cases, since growth is finished and the discrepancy is fixed. Many have lived with it for decades and are weighing function and comfort as much as appearance.
Comprehensive Orthodontic Treatment →

How do jaw surgery and braces work together?

Braces first line up the teeth, usually for 12 to 18 months, then an oral surgeon repositions the jaw, and braces finish the bite over several more months. Dr. Esposito coordinates each step with your surgeon.

Surgical cases take longer than standard treatment, and knowing the sequence up front makes the timeline far less daunting.

STEP 1

Evaluation and Second Opinion

We take records and tell you honestly whether the discrepancy is skeletal or dental. If it is borderline, we lay out both the surgical and non-surgical paths with their tradeoffs. Many patients leave this visit relieved.

STEP 2

Pre-Surgical Orthodontics

Braces align the teeth within each jaw, which often makes the bite look temporarily worse before it gets better. This stage commonly runs 12 to 18 months, and it is what allows the jaws to fit together properly once repositioned.

STEP 3

The Surgical Procedure

Your oral surgeon repositions one or both jaws in a hospital or surgical center under general anesthesia. Dr. Esposito coordinates the plan with the surgical team, so both offices are working from the same records.

STEP 4

Finishing and Retention

After healing, braces stay on for several months to settle the bite precisely. Retainers follow, and are non-negotiable after a surgical case. Retainers →

Schedule a Consultation

We love our dentist Dr. Kathy she great with the kids and does a great job. All the ladies are wonderful and sweet we have been going for several years now and have never had any problems with anything. The Atmosphere is great always so inviting and warm. Best children’s dentist!!! Thank y’all.

Verified Patient|Sunset Children’s Dentistry Family

My children and I are new patients this year, and our experience here was great. They explain everything that is wrong with their teeth, and everything that will be done to their teeth. They make them feel very comfortable, and are very caring. Thank you to the phenomenal women who work hard to help our babies everyday!!!!

Verified Patient|Sunset Children’s Dentistry Family

We had the BEST! Experience today. As a mom of 3 ( one having their first appointment) I was THOROUGHLY impressed with the efficiency of the team and the seamless experience for new patients. I also was thankful that they were able to work my kids in for an appointment without a 3 month wait time!

Verified Patient|Sunset Children’s Dentistry Family

What are the benefits of surgical orthodontics?

Correcting the jaw position can improve chewing, speech, breathing and facial balance, and it eases strain on the jaw joints. Sunset Children’s Dentistry plans treatment so results stay stable.

Correcting a skeletal mismatch changes daily function, not just appearance.

Chewing That Works

Patients with open bites or severe underbites often cannot bite through food with their front teeth at all. Restoring the jaw relationship restores normal function, which is usually the change patients notice first.

Clearer Speech

Certain sounds depend on where the tongue meets the teeth. When the jaws are significantly mismatched, speech adapts around the problem — and often improves once the structure is corrected.

Stable, Lasting Results

Attempting to camouflage a large skeletal discrepancy with tooth movement alone tends to relapse and can strain the gums. Correcting the underlying structure produces a result that holds.

Relief From Jaw Strain

Some patients with long-standing skeletal discrepancies report meaningful improvement in jaw comfort after correction, though outcomes vary and this is never the sole reason to proceed.

Why Choose Sunset Children’s Dentistry to Coordinate Your Care?

Patients choose Sunset Children’s Dentistry for surgical orthodontics because board-certified orthodontist Dr. Christine Esposito coordinates the braces and surgery steps with the oral surgeon.

The orthodontist’s most valuable contribution in a surgical case is often deciding that you do not need surgery. Dr. Christine Esposito is a Diplomate of the American Board of Orthodontics with residency training at UNC Chapel Hill and research focused on guiding jaw growth — the discipline that determines whether a young patient can avoid the operating room entirely.

When surgery is genuinely indicated, she serves as your jaw alignment surgery orthodontist and coordinates directly with your oral surgeon so you are not carrying records between two offices.

Board-certified orthodontist: Diplomate, American Board of Orthodontics
Conservative approach: surgery recommended only when the evidence supports it
Coordinated care: shared planning with your oral and maxillofacial surgeon
Early intervention focus: growth guidance that can prevent surgical cases in children
Clear timelines: the full multi-year sequence explained before you commit
One dental home: routine care continues here throughout treatment

Meet Your Orthodontic Team

Your orthodontic care is directed by a board-certified specialist who coordinates with your surgical team.

Dr. Christine Esposito

Board-certified Orthodontist in Lexington, SC

Dr. Christine Esposito is a board-certified orthodontist bringing specialized orthodontic care to Sunset Children’s Dentistry’s exclusively pediatric practice. She chose orthodontics for the way it combines science, artistry, and clinical…

Read bio

Want a Straight Answer About Jaw Surgery?

For a clear answer on whether jaw surgery is needed, book a free orthodontic consultation at Sunset Children’s Dentistry by calling (803) 996-0753.

A free consultation will tell you whether your case is truly skeletal — and what your options are either way.

Book Free Consultation Call (803) 262-2455

Frequently Asked Questions

Straight answers to the questions patients are most anxious about.

Does insurance cover surgical orthodontics?

Medical insurance often covers jaw surgery when it is medically necessary, and dental plans may cover the braces. Sunset Children’s Dentistry helps you review both before treatment starts.

Surgical cases involve two separate fees: orthodontic treatment through our office, and the surgical procedure billed by your oral surgeon. We will make sure you understand both before starting.