In the profession’s efforts to cure bite diseases and TMD issues, a lot of different approaches have been attempted with varying degrees of success. Commonly orthodontists will attempt to improve the bite with orthodontic means, like braces. In a number of those cases, the surgeon is called in to surgically change the jaw position to something that aligns the teeth better. The issue is that these cases are surgically fixed at the tooth interface, but the actual issue may be totally unaddressed.
If the patient is in a situation where the upper jaw is literally too far posteriorly, then surgically moving that upper jaw anteriorly is not only a potential solution, it may well be an ideal step to include. This can create a much more appropriate facial profile and soft tissue contour. If the case is one where the lower jaw is too far back, it is most likely going to be much better addressed non-surgically.
In these cases the surgical approach would move the teeth into position but leave the muscles where they previously were. It has been clearly demonstrated that about 90% of the pain the body is from muscles and failure to include attention to the musculature in the treatment plan will result in little or no post-surgical improvement in many of these cases. Additionally, it is impossible to determine which patients will get better because you have done some intervention and which will continue to suffer because the root cause of the pain was not addressed.
As we are teaching at LVI, a neuromuscular dentist will have other options to explore. A more predictable and much more conservative approach would be to look first at the muscles for guidance as to how they want to align the jaws. Find that neutral position for the musculature and support that with an orthotic and it can be determined if the patient will enjoy improvement. In the vast majority of cases the jaw position that is found by physiologically relaxed muscles is very effective in helping to create a pain free life! Jaw surgery is best reserved for those rare cases where all other means have been exhausted or where the deficiency is centered around the upper arch and cannot be addressed any other way.