Washington Dental
Non-Surgical Skeletal Orthodontics
Underbite & facial asymmetry —
not every case needs jaw surgery
When the cause lies in the jaw joint and the bite rather than the bone itself, correction can often be attempted with orthodontics alone. Precise diagnosis comes first.
The principle: teeth move, bones don't
Orthodontics moves teeth — it does not relocate jaw bones. That is why the first step is always to determine whether your underbite, asymmetry or protrusion is skeletal (the bone itself), functional (jaw-joint position and bite), or dental (tooth angulation). We use cephalometric (lateral skull) analysis to make this distinction, and we explain the findings with your own imaging.
| Condition | Non-surgical approach |
|---|---|
| Underbite (Class III) | Functional underbite caused by jaw-joint position or bite interference can often be improved without surgery; true mandibular overgrowth may require combined surgery — we tell you which one you have and why |
| Facial asymmetry | Many cases stem from jaw-joint displacement and bite collapse rather than bone. Correcting the bite can reduce chin deviation and smile-line asymmetry |
| Lip / mouth protrusion | Dental protrusion often improves with orthodontics alone; alveolar (bone) protrusion is evaluated for combined approaches |
| Receding chin, gummy smile, deep/open bite | Treated with orthodontic mechanics such as mini-screw anchorage, depending on the diagnosis |
Jaw joint first
If you have jaw-joint pain or restricted opening, we evaluate and stabilise the joint before starting orthodontic treatment — starting orthodontics on a painful joint is not recommended.
If you have been told you need two-jaw surgery
Two-jaw surgery repositions the jaw bones surgically; orthodontics improves the bite by moving teeth. Before committing to surgery, it is worth having an orthodontic specialist confirm whether your case is truly skeletal. We provide this assessment with imaging evidence, and we are equally clear when surgery is the right answer.