Surgical Orthodontics

In cases of very severe crowding or misalignment of the teeth, orthodontics alone is inadequate to achieve a successful result. Surgical treatments such as extraction of teeth, uncovering teeth that are not erupting properly, grafting deficient areas of gums, or repositioning of the jaw may be needed to achieve the desired orthodontic result. We work in close cooperation with your orthodontist, who will specify which teeth or areas of your jawbone require corrective treatment.

Extraction of Teeth for Orthodontic Reasons

Teeth can become crowded or even impacted when there is not enough room in the jaws. One or more permanent teeth are sometimes strategically extracted to create space to properly align the others. Deciduous teeth (baby teeth) sometimes do not loosen and fall out as they should. If that happens, certain deciduous teeth may need to be extracted to allow proper eruption of the permanent teeth.

Wisdom teeth can impede your orthodontic treatment and very often contribute to crowding of the teeth after completed treatment. It is best to extract wisdom teeth either before or immediately after orthodontic treatment. Waiting too long after braces to remove the wisdom teeth may result in relapse and crowding, and even the need re-do the orthodontic treatment.

Learn more about wisdom teeth

Impacted wisdom teeth on a 16 year ole at an ideal stage for extraction.

Missing Teeth

Some people fail to develop all the permanent teeth. In such a case, it may be possible to simply slide neighboring teeth over to close the space orthodontically. Other times, orthodontic space closure is not advisable and the missing tooth space is left open. Dental implants are then placed to fill in for missing teeth.
Learn more about dental implant treatment

A missing incisor tooth is left open by the orthodontist to be replaced by a dental implant.

Extra Teeth

Some people develop more than the normal 32 permanent teeth. These extra teeth, called supernumerary teeth, are often small or deformed, and can cause other normal teeth to become impacted or crowded. A cyst can sometimes form on these supernumerary teeth, just as it can on wisdom teeth. Early extraction of extra teeth, even as young as age 6-8, is advisable to minimize these risks.

Two extra (supernumerary) teeth are present in the lower jaw.
A small extra tooth is present between the upper front teeth.

Exposure of Unerupted Teeth

If an unerupted or impacted tooth is critical to the orthodontic result, a procedure called expose and bond is done to surgically uncover the tooth and attach (bond) an orthodontic bracket with a short gold chain. With the impacted tooth now accessible, your orthodontist attaches springs or elastics to guide that tooth into position.

Multiple impacted teeth on the upper jaw in need of the expose and bond procedure.
Two week postoperative photo of the above patient after expose and bond procedure. Note the gold chains that provide a means of orthodontic attachment.

Corrective Jaw Surgery

Corrective jaw surgery is used to reposition all or part of the upper jaw, lower jaw or chin. This can bring your teeth and jaws into a new position that is more balanced, functional, and healthy.

Before your surgery, orthodontic braces are used in preparation for jaw surgery. After your jaws are repositioned surgically, the orthodontic treatment is completed. Depending on the procedure, corrective jaw surgery may be performed in our office or in a hospital. Incisions can be hidden inside the mouth.