In some cases, orthodontic surgery may be needed to reconstruct jaws or remove bone to address severe underbites. Such surgery is typically performed in tandem with orthodontic treatment such as braces.

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Jaw surgery, usually performed by maxillofacial or oral surgeons, involves cutting and repositioning segments of the bone in order to restore proper balance and bite relationship. In many cases, restored jaws need to be secured with plates, wires or screws while they are healing.

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In children, early intervention can help guide the growth of the jaw to hopefully prevent the need for surgery. An orthodontic exam can anticipate if there is jaw issues or identify the need for regular growth monitoring.