Jaw Surgery & Orthodontics in Jacksonville, FL

Some bite problems are caused by the jaw bones, not the teeth that sit in them. When the skeletal discrepancy is large enough that braces or aligners alone cannot produce a stable, functional result, orthognathic surgery combined with orthodontic treatment becomes the definitive answer. Bold Bite Orthodontics in Jacksonville handles the pre- and post-surgical orthodontic phases in-office and coordinates directly with oral and maxillofacial surgery partners for the surgical phase itself — Dr. Cao’s CAGS training at Jacksonville University covered exactly this kind of multi-specialty coordination.

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A woman wearing a beige facial compression bandage with a neutral background, likely recovering from jaw surgery at Bold Bite Orthodontics in Jacksonville, FL.
Home / Surgical Orthodontics

When is Jaw Surgery Needed?

Orthodontic treatment straightens teeth inside the jaws. Orthognathic — or jaw — surgery repositions the jaw bones themselves. When a patient’s upper and lower jaws grow at different rates, or the chin projects forward or backward relative to the mid-face, tooth movement alone cannot produce the bite or the profile the anatomy was meant to have. A 3D Vatech Green CT scan at the free consultation makes the diagnostic picture clear within minutes.

Cases that need both orthodontics and surgery follow a three-stage timeline: pre-surgical orthodontics to align the teeth within each jaw so the surgeon can reposition the bones precisely, the surgical procedure itself performed at a hospital or ambulatory surgical center by the oral and maxillofacial surgery partner, and a shorter post-surgical orthodontic finishing phase to settle the bite after the bones heal. Total treatment typically runs 18 to 24 months end to end, with some severe cases extending to 30 months.

Bold Bite Orthodontics does the pre-surgical and post-surgical orthodontics in-office. The surgery itself is performed by a Jacksonville-area oral and maxillofacial surgeon — Dr. Cao and Dr. Marty coordinate directly with the surgeon’s team on 3D virtual surgical planning, splint fabrication, and post-op orthodontic hand-off. The patient has one central orthodontic office and one central surgical office. Bold Bite owns the coordination so the patient doesn’t have to.

Conditions That May Require Jaw Surgery

Severe Underbite (Class III)

Lower jaw projects beyond the upper jaw. Adult Class III skeletal cases — past the growth window — typically require a mandibular setback or a combined upper-lower surgery to correct both the bite and the profile.

Severe Overbite / Overjet (Class II)

The lower jaw is recessed or the upper jaw is protrusive, creating excessive overlap and a retruded profile. When the discrepancy is skeletal in an adult, mandibular advancement repositions the lower jaw forward so the bite and airway both improve.

Anterior Open Bite

Front teeth cannot touch even when the back teeth are closed, often from long-standing tongue posture, vertical maxillary excess, or a skeletal pattern that tooth movement alone cannot close predictably.

Facial Asymmetry

One side of the jaw grew differently than the other, producing an uneven chin point, canted occlusal plane, or shifted midline. CBCT confirms whether the asymmetry is dental, skeletal, or both — which determines whether surgery is required.

Vertical Maxillary Excess (“Gummy Smile”)

The upper jaw grew downward, exposing a wide band of gum tissue above the front teeth at rest and during smiling. When the excess is skeletal rather than dental, a Le Fort I impaction reduces the visible gum display.

Severe Obstructive Sleep Apnea (OSA)

Recessed jaws crowd the tongue backward and narrow the airway behind it. Maxillomandibular advancement (MMA) moves both jaws forward together, permanently widening the retrolingual airway. Considered when CPAP has failed or cannot be tolerated.

Types of Jaw Surgery Bold Bite Coordinates

Each procedure repositions the jawbone using titanium plates and screws placed through incisions inside the mouth — no visible scars. Bold Bite handles the orthodontic preparation and finishing; the oral and maxillofacial surgeon performs the skeletal repositioning. Every case is planned digitally on 3D CBCT imaging before anyone enters the operating room.

Le Fort I Osteotomy (Upper Jaw)

The upper jaw (maxilla) is cut above the tooth roots and repositioned up, down, forward, or backward depending on the correction needed. Used for open bite, crossbite, vertical maxillary excess (gummy smile), and midface deficiency. The maxilla is secured in its new position with small titanium plates that remain permanently.

Bilateral Sagittal Split Osteotomy (Lower Jaw)

The most common orthognathic procedure worldwide. The mandible is split on both sides behind the last molar, and the tooth-bearing segment is slid forward or backward. Used for severe Class II overbite (mandibular advancement) or severe Class III underbite (mandibular setback). Recovery is generally faster than upper-jaw surgery because the blood supply to the lower jaw is robust.

Bimaxillary Surgery (Both Jaws)

When both jaws need repositioning, Le Fort I and bilateral sagittal split are performed in the same session. Bimaxillary surgery produces the most balanced facial and occlusal result because the surgeon can control the relationship between both jaws simultaneously. Total operating time is longer (typically 3 to 5 hours), but the recovery period is a single healing phase rather than two separate surgeries.

Genioplasty (Chin Repositioning)

The lowest portion of the chin bone is cut and repositioned forward, backward, or vertically. Often combined with BSSO for profile refinement when the mandibular body is correctly positioned but the chin point itself needs to advance or recede. Some patients need only a genioplasty without full jaw surgery.

Maxillomandibular Advancement (MMA) for Severe Airway Obstruction

Both jaws are moved forward 8 to 12 millimeters to permanently widen the airway behind the tongue. Considered the most definitive surgical option for severe obstructive sleep apnea when CPAP has failed or cannot be tolerated long-term. Bold Bite provides the pre-surgical and post-surgical orthodontic care — the oral and maxillofacial surgeon performs the advancement. Read more about airway orthodontics at Bold Bite.

The Surgical Orthodontic Timeline

Surgical orthodontic treatment is a coordinated sequence, not a single event. Understanding each phase up front is what makes surgical cases feel manageable rather than overwhelming.

1

Pre-Surgical Orthodontics

6–18 months

Braces or, in select cases, aligners align the teeth within each jaw so the surgeon can reposition the bones precisely. This phase is called decompensation — the body spent years tilting teeth to compensate for the jaw discrepancy, and those compensations have to be reversed first.

The bite may temporarily look or feel worse during this phase. That is intentional and necessary for an optimal surgical result.

2

Surgery Day

1 to 5 hours, usually outpatient or 1 night

The oral and maxillofacial surgeon performs the osteotomy in a hospital or ambulatory surgical center under general anesthesia. 3D virtual surgical planning is completed before the date, so every millimeter of movement is mapped digitally in advance.

All incisions are made inside the mouth — no visible scars. Titanium plates and screws hold the jaws in their new position permanently. Jaw wiring is rarely used with modern plate fixation; most patients use only light orthodontic elastics after surgery.

3

Post-Surgical Orthodontic Finishing

6 to 12 months

Once the jaws have healed in their new position (roughly 6 to 8 weeks after surgery), Bold Bite fine-tunes the bite with bracket adjustments and elastics, closes any remaining spaces, and confirms the final occlusion. Retainers are delivered at debonding.

Most patients return to work or school within 2 to 3 weeks of surgery. Normal chewing function returns over 2 to 3 months. Total end-to-end treatment typically runs 18 to 24 months.

Surgery-First Approach

Select cases qualify for a surgery-first approach — the osteotomy is performed in month 1 or month 2, and most of the orthodontic work follows afterward. The approach shortens the overall timeline and gives patients facial aesthetic improvements sooner. It is evaluated case-by-case with the surgeon using CBCT, iOrtho aligner simulation, and the clinical exam, and it is not appropriate for every diagnosis. Bold Bite does not offer surgery-first as a default — the standard pre-surgical-first sequence remains the most predictable path for the majority of skeletal cases.

Coordinated Surgical Team

Bold Bite does not perform surgery in-house. Jaw surgery is performed by an oral and maxillofacial surgery specialist in the Jacksonville area, and Bold Bite coordinates directly with the surgeon’s team from the consult through the post-op orthodontic hand-off. Patients work with a single orthodontic office (Bold Bite) and a single surgical office — the two teams communicate on every case, not the patient.

Oral & Maxillofacial Surgeon

Dr. John Landis & Dr. Zane Khan

Oral and maxillofacial surgery partners for orthognathic procedures — Le Fort I, bilateral sagittal split, bimaxillary surgery, genioplasty, and MMA for severe OSA. The surgical team handles pre-op medical clearance, the osteotomy itself, and the immediate post-operative recovery. Bold Bite provides the pre-surgical orthodontic work-up and the post-surgical finishing.

Oral & Maxillofacial Surgeon

Beaches Oral Surgery

Additional oral and maxillofacial surgery referral relationship used when scheduling, insurance, or geography makes a different surgical office the right fit for a particular family. Bold Bite coordinates the same way with every surgical partner — written treatment plan, CBCT, iOrtho simulation, and timeline are shared directly with the surgical team.

Periodontics

Dr. Doug Storch, Modern Perio

Periodontal partner for surgical exposure of impacted teeth, crown-lengthening, and TAD (mini-implant) placement when the orthodontic plan requires skeletal anchorage. Not an orthognathic surgeon, but part of the same multi-specialty coordination model — Bold Bite writes the prescription, Dr. Storch places the implant or exposure, and Bold Bite activates the mechanics.

Sleep Medicine & ENT

Jacksonville ENT & Sleep Physicians

For MMA cases driven by severe obstructive sleep apnea, Bold Bite coordinates a formal sleep study and ENT evaluation before the surgical consult. The surgical decision — and the dual airway outcome — is documented with sleep-medicine findings alongside the CBCT airway analysis.

Why Bold Bite Handles Surgical Coordination

Surgical orthodontic outcomes depend heavily on the quality of the pre-surgical orthodontic preparation. Teeth positioned incorrectly before surgery force the surgeon to compromise on the osteotomy plan. Bold Bite’s two-doctor model is built for exactly this category of case.

Dr. Trang Cao — CAGS in Orthodontics, Jacksonville University. Certificate of Advanced Graduate Study training above the standard orthodontic residency, with a focus on the complex cases general orthodontists refer out — surgical orthodontics, airway, and craniofacial coordination.
Dr. Trang Cao — Diplomate, American Board of Orthodontics. ABO Board Certified, the highest voluntary credential in the specialty and a distinction held by fewer than half of practicing orthodontists in the United States.
Dr. Marty Greenberg — DMD, MS in Orthodontics & Research Fellowship, Jacksonville University. ABO Board Eligible. Eight-plus years in general dentistry before specializing, bringing a broader restorative perspective to multi-specialty planning.
Vatech Green CT + iOrtho aligner simulation. Every new patient receives a free ultra-low-dose 3D CBCT scan plus a digital simulation of the proposed bite result — the two-tool combination is what makes the surgery-versus-camouflage conversation concrete rather than speculative.
Coordinated with oral surgery, not replacing it. Bold Bite owns the orthodontic timeline and the communication with the surgical team — including virtual surgical planning reviews, splint design coordination, and post-op elastic protocols. The patient works with one orthodontic office and one surgical office.
Vietnamese-language consultations available. Dr. Cao is fluent in Vietnamese, which matters when a surgical conversation includes intra-operative risk, recovery expectations, and family decision-making.

Dr. Cao’s approach to the surgery-versus-camouflage decision

Most patients arrive hoping to avoid surgery if a non-surgical path exists. Dr. Cao listens to what the patient actually wants corrected — bite function, facial profile, airway, or all three — then uses the CBCT scan, iOrtho aligner simulation, and an iTero or Allied Star digital scan to determine whether the concern can be addressed without surgery or whether orthognathic surgery is the most predictable path. The decision is made on measurements and patient priorities, not on a rigid threshold.

When surgery is the right answer, Bold Bite says so plainly at the consult rather than months into treatment. When orthodontic camouflage is reasonable, the trade-offs — aesthetic ceiling, long-term stability, airway impact — are named up front so the family chooses with full information.

Cost & Insurance

Orthodontic portion: quoted at the consult based on case complexity

The orthodontic portion — pre-surgical braces or aligners plus post-surgical finishing — is quoted in full at the free consultation after the CBCT and clinical exam. Bold Bite’s standard in-house 0% APR financing is available with no credit check and custom down-payment and term. Cherry third-party financing is also accepted (subject to credit approval; terms vary), and pay-in-full receives a discount.

The surgical fee is billed separately by the oral and maxillofacial surgeon’s office — Bold Bite does not mark up or pass through the surgical fee. For orthognathic surgery that corrects documented functional problems (difficulty chewing, breathing, or sleeping), the surgical portion is frequently covered by medical insurance rather than dental insurance. The orthodontic portion is typically processed under dental insurance orthodontic benefits where the plan includes them. Bold Bite verifies both medical and dental benefits as a courtesy before treatment begins.

Accepted PPO dental plans include Delta Dental, Blue Cross Blue Shield, Aetna, Guardian, MetLife, United Healthcare, and Cigna Healthcare. Military, teacher, first-responder, healthcare-worker, family, and college-student discounts apply where eligible and stack with financing.

Frequently Asked Questions

Does Bold Bite perform the jaw surgery in-office?

No. Jaw surgery is performed by an oral and maxillofacial surgeon at a hospital or ambulatory surgical center. Bold Bite Orthodontics handles the pre-surgical and post-surgical orthodontic phases in-office and coordinates directly with the surgeon’s team on diagnosis, 3D virtual surgical planning, splint design, and post-op elastic protocols. Surgical partners include Dr. John Landis and Dr. Zane Khan, with Beaches Oral Surgery as an additional referral relationship when scheduling or geography calls for it.

How does Dr. Cao decide whether a case needs surgery or can be treated with braces alone?

The decision is driven by measurements on the Vatech Green CT scan, an iOrtho aligner simulation of the proposed final bite, and an iTero or Allied Star digital scan — set against what the patient actually wants corrected. Most patients prefer a non-surgical path when one exists, and Dr. Cao respects that preference whenever camouflage can produce a stable, healthy long-term bite. When the skeletal discrepancy is large enough that tooth movement alone cannot deliver the result safely, surgery is named as the right answer at the consult rather than months into treatment.

How long does the full surgical-orthodontic treatment take?

Total end-to-end treatment typically runs 18 to 24 months: 6 to 18 months of pre-surgical orthodontics, a recovery period of 6 to 8 weeks after the osteotomy itself, and 6 to 12 months of post-surgical orthodontic finishing. Severe cases can extend to roughly 30 months. Select cases qualify for a surgery-first approach that shortens the timeline, but surgery-first is not appropriate for every diagnosis.

Will my jaw be wired shut after surgery?

Rarely, with modern titanium plate fixation. Most patients wear only light orthodontic elastics (rubber bands) after surgery to guide the bite into its new position — the mouth can open, speak, and be cleaned, just not chew solid food for the first few weeks. Any wiring decision is made by the oral and maxillofacial surgeon based on the specific osteotomy.

How much does jaw surgery with orthodontics cost at Bold Bite?

The orthodontic portion is quoted at the free consultation after the CBCT scan and clinical exam — surgical cases vary more than routine cases, so a single list price is not accurate to publish. Bold Bite offers in-house 0% APR financing (a down payment, then monthly payments), Cherry third-party financing, a pay-in-full discount, and stacked military, teacher, family, first-responder, healthcare-worker, and college-student discounts where eligible. The surgical fee itself is billed separately by the oral and maxillofacial surgeon — Bold Bite does not mark it up or pass it through.

Does insurance cover jaw surgery?

The surgical portion is frequently covered by medical insurance (not dental insurance) when the case documents functional problems such as difficulty chewing, breathing, or sleeping. The orthodontic portion runs through dental insurance orthodontic benefits where the plan includes them. Bold Bite verifies both medical and dental benefits as a courtesy before treatment begins and files claims as a courtesy on behalf of the family. Call (904) 595-6869 and Bold Bite can review specific coverage before the consult.

What is the minimum age for jaw surgery?

Jaw growth must be effectively complete before orthognathic surgery — typically around age 16 for females and age 18 for males. A CBCT scan confirms growth status. For younger patients still growing, Dr. Cao and Dr. Marty evaluate whether growth-modifying appliances such as MARPE palatal expansion, Herbst or MARA functional appliances, or reverse-pull headgear can reduce the severity of the skeletal discrepancy and potentially avoid surgery altogether.

Does Bold Bite coordinate MMA for sleep apnea?

Yes. For severe obstructive sleep apnea where CPAP has failed or cannot be tolerated, maxillomandibular advancement is coordinated with the oral and maxillofacial surgery partner and documented alongside a formal sleep study and ENT evaluation. The airway outcome is measured on the same CBCT AI-assisted analysis Bold Bite uses at every new-patient screening.

See airway orthodontics.

Can I have Invisalign instead of braces for a surgical case?

In most surgical cases, braces provide superior control for pre-surgical tooth positioning because the surgeon needs precise bracket locations for surgical hooks and for post-op elastics. Some mild or carefully selected cases allow an aligner-based pre-surgical phase — Bold Bite runs Invisalign and Angel Aligners routinely, including Invisalign and Angel Aligners. The clinical priority is the surgical result, so Dr. Cao recommends braces when they produce a better outcome and aligners when the case allows.

What if I am anxious about surgery?

That reaction is normal. During the consultation, Dr. Cao and Dr. Marty walk through the 3D virtual surgical planning images so patients can see exactly how the jaws will be repositioned before anything is scheduled. Modern orthognathic surgery is performed through intra-oral incisions (no visible scars), uses rigid internal fixation instead of wiring, and has well-documented high success rates when the pre-surgical orthodontic preparation has been done carefully. Dr. Cao is fluent in Vietnamese for families where the surgical conversation benefits from that option.

Conditions Surgical Orthodontics Treats

Most patients arrive on this page after being told their bite cannot be corrected by braces or aligners alone. The conditions that most commonly route to surgical coordination:

Severe overbite with a Class II skeletal jaw relationship.
Skeletal underbite (Class III) where growth has completed.
Skeletal open bite that cannot be closed with TADs alone.
Severe transverse deficiency requiring SARPE plus an in-house palatal expander.
Pre-surgical braces alignment followed by post-surgical refinement at Bold Bite Orthodontics.
Browse all orthodontic appliances used during the surgical workflow.

Ready to discuss? Book a surgical-coordination consultation. The 3D CBCT scan is included for patients under 18; adults get a CBCT only when clinically needed, and we tell you the cost first.