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Braces are highly effective for straightening teeth and improving bite alignment, but in some cases, orthodontic treatment requires more than just moving the teeth. When jaw growth or bone structure is significantly out of balance, additional treatment may be needed to achieve a functional, healthy, and harmonious smile.
That’s where growth modification and jaw surgery come in. These approaches address skeletal issues — not just tooth alignment — ensuring that the teeth and jaws work together properly. Understanding when these treatments are necessary can help patients and parents make informed decisions about orthodontic care.
Understanding the Limits of Braces
Braces work by applying gentle, continuous pressure to shift teeth within the jawbone. This method corrects crowding, gaps, and bite problems caused by tooth position. However, braces can’t change the size, shape, or position of the jaw itself.
When the upper and lower jaws don’t grow in balance, the bite can’t be fully corrected with braces alone. These cases may involve:
- Significant overbites or underbites caused by jaw growth differences
- Open bites where the front teeth don’t touch
- Crossbites due to narrow or misaligned jaws
- Facial asymmetry affecting the appearance and function of the jaw
In these situations, orthodontists look beyond braces to treatments that guide or correct jaw growth — either during childhood or adulthood.
Growth Modification in Children and Teens
One of the biggest advantages of early orthodontic evaluation is the opportunity for growth modification. Because children’s bones are still developing, orthodontists can use special appliances to gently influence jaw growth and alignment before it’s complete.
Growth modification is most effective during the pre-teen and early teen years, typically between ages 7 and 14. Treatment may include:
- Palatal expanders — Widen the upper jaw to correct crossbites or create space for crowded teeth.
- Herbst appliances or twin blocks — Encourage the lower jaw to grow forward in children with underdeveloped mandibles.
- Headgear — Helps guide upper jaw growth when the upper teeth or jaw are too prominent.
These devices work with the body’s natural growth patterns to improve the jaw relationship and reduce the need for future surgery. When completed at the right time, growth modification can create a balanced bite and better facial symmetry without invasive treatment.
What Happens If Jaw Imbalance Persists
Even with early treatment, not every skeletal discrepancy can be corrected during growth. Once growth is complete — usually in the late teens or early twenties — jawbone structure can only be changed surgically. In these cases, orthodontists may recommend orthognathic (jaw) surgery in combination with braces or clear aligners.
Surgery may be necessary if:
- The upper and lower jaws are significantly misaligned
- Breathing issues, such as sleep apnea, are related to jaw position
- Chronic jaw pain, speech problems, or chewing difficulties are present
- Facial imbalance affects function or appearance
Jaw surgery creates a stable foundation so the teeth can meet correctly, improving both aesthetics and overall oral health.
Orthognathic (Jaw) Surgery Explained
Jaw surgery is performed by an oral and maxillofacial surgeon in collaboration with your orthodontist. The process typically involves three phases:
- Pre-surgical orthodontics — Braces or aligners are used to align the teeth in preparation for surgery.
- Surgery — The surgeon repositions the jawbones to achieve proper alignment and balance.
- Post-surgical orthodontics — Braces remain in place for several months to fine-tune the bite and ensure a stable, lasting result.
Most patients are surprised to learn that recovery is faster and more comfortable than they expect, with noticeable improvements in function and facial harmony once healing is complete.
Benefits of Correcting Jaw Discrepancies
While the idea of jaw surgery or orthopedic appliances may seem intimidating, these treatments can have life-changing benefits. Beyond creating a more attractive smile, they can improve breathing, chewing, speech, and self-confidence.
Key benefits include:
- Enhanced facial balance and symmetry
- Reduced strain on the jaw joints and muscles
- Improved bite efficiency and comfort
- Easier oral hygiene maintenance
- Long-term stability of orthodontic results
By addressing the root cause — the bone structure — these treatments provide functional and aesthetic improvements that last a lifetime.
Life After Growth Modification or Surgery
After treatment, patients often notice significant changes not just in appearance but in comfort and daily life. Eating and speaking become easier, and facial proportions appear more natural. Regular follow-ups with your orthodontist ensure that teeth remain aligned and that your bite stays balanced.
Maintaining good oral hygiene, attending post-treatment checkups, and wearing retainers as prescribed are key to preserving results.
Is Surgery Always Necessary?
Not always. Many patients can achieve an excellent outcome through growth modification if caught early, or through orthodontic treatment alone if their jaw discrepancy is mild. Each case is unique, which is why a thorough orthodontic evaluation — often including 3D imaging and growth analysis — is so important.
Your orthodontist will consider your age, facial growth, and overall oral health before recommending any approach. The goal is always to find the least invasive method that achieves a stable, functional, and beautiful result.
Creating Balance for a Lifetime
When braces alone aren’t enough, growth modification or jaw surgery can make a dramatic difference in both function and appearance. These treatments don’t just straighten teeth — they help ensure that the jaws align properly, creating a smile that feels as good as it looks.
By working with an experienced orthodontist and, when necessary, a surgical specialist, patients can achieve harmony between the teeth, jaws, and facial structure for long-term health and confidence.
Explore Comprehensive Orthodontic Options in Denver
If you’ve been told that your orthodontic needs go beyond traditional braces, the team at Speaks Orthodontics in Denver, CO can help. Dr. Clif Speaks offers expert diagnosis and treatment planning for patients who may benefit from growth modification or surgical orthodontics.
We proudly serve families throughout Denver, including Capitol Hill, Washington Park, LoDo, and Cherry Creek.
Schedule your complimentary exam today and learn how our personalized approach can help you achieve balanced, lasting results.