Jaw Surgery & Orthodontics in Kent and Sammamish
Coordinated orthodontic-surgical care for skeletal jaw discrepancies
Reviewed and approved by Dr. Cameron Freelove, DDS, MS · Last updated
When Is Jaw Surgery Needed?
Most bite problems are corrected with braces or aligners alone. But when the jaws themselves are significantly mismatched, a skeletal discrepancy, tooth movement can only camouflage so much. Jaw surgery (orthognathic surgery) repositions the jaws; orthodontics positions the teeth so the new bite fits.
Dr. Freelove applies no single rigid threshold. The decision weighs the severity of the skeletal discrepancy, facial esthetics, airway considerations, and the patient’s goals. Surgery is presented as the superior option when the skeletal imbalance is significant enough that orthodontics alone would produce a compromised result, and in most cases a non-surgical camouflage option is presented alongside it so the patient can make an informed choice.
Surgical evaluations include an iCat CBCT scan when clinically indicated, complimentary at the consultation. Dr. Freelove reviews the skeletal proportions in 3D and analyzes the airway with Invivo software before any recommendation is made.
Conditions That May Require Jaw Surgery
Skeletal Underbite (Class III)
The lower jaw sits ahead of the upper jaw. Once growth is complete, a significant skeletal underbite often cannot be fully corrected with tooth movement alone.
Severe Overbite (Class II)
A small or set-back lower jaw creates a large overbite. Growing patients may be treated with growth modification; adults with a significant skeletal discrepancy may be surgical candidates.
Skeletal Open Bite
The front teeth cannot touch. When the cause is posterior maxillary excess, Dr. Freelove treats with TAD-supported intrusion or coordinates orthognathic surgery, depending on the case. See open bite.
Facial Asymmetry
When one side of the jaw grows more than the other, the chin and bite shift off center. Significant asymmetry may require surgical repositioning to center the jaws and level the bite.
Severe Narrow Upper Jaw
Many narrow-jaw teens and adults can be treated with in-office MARPE expansion without surgery. For patients that have more resistance to expansion even from MARPE, a surgical assist with piezocision may be recommended.
Airway and Sleep Concerns
Jaw position influences airway dimensions, so airway findings from the CBCT weigh into every surgical decision. In selected cases, jaw repositioning surgery may enlarge the airway as part of correcting the bite.
Types of Jaw Surgery Dr. Freelove Coordinates
The surgery itself is performed by an oral and maxillofacial surgeon in a hospital or surgical center. Dr. Freelove plans and carries out the orthodontic phases before and after surgery, and the two doctors coordinate the case from shared 3D records.
Upper Jaw Surgery (Le Fort I Osteotomy)
Repositions the upper jaw up, down, or forward. Used for skeletal open bites caused by posterior maxillary excess, midface deficiency, and gummy smiles with a vertical excess component.
Lower Jaw Surgery (BSSO)
A bilateral sagittal split osteotomy advances or sets back the lower jaw. The workhorse procedure for significant Class II and Class III skeletal discrepancies.
Double Jaw Surgery (Bimaxillary)
Both jaws are repositioned in one operation. Used for larger discrepancies, facial asymmetry, and cases where airway improvement is part of the surgical goal.
Chin Surgery (Genioplasty)
Repositions the chin, often alongside another jaw procedure, to balance the profile. Dr. Freelove evaluates the full face, not just the teeth, when planning these cases.
The Surgical Orthodontic Timeline
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Pre-Surgical Orthodontics
Typically 6–18 months
Braces or aligners move the teeth into positions that fit the planned jaw relationship. Because the case is planned digitally from the CBCT on day one, every movement serves the surgical plan. The bite can look temporarily worse during this phase as dental compensations are removed; that is expected.
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Surgery and Recovery
Surgery day + several weeks
The oral surgeon repositions the jaws. Orthodontic appliances stay on through surgery, and Dr. Freelove sees the patient soon afterward to monitor the new bite as initial healing progresses.
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Post-Surgical Finishing
Typically 6–12 months
The bite is detailed and settled into the new jaw position. Appliances come off, and retainers are made in-house on 3D-printed models to protect the result.
Surgery-First Approach
In select cases the usual sequence is reversed: the surgeon repositions the jaws first and orthodontic alignment follows. A surgery-first approach can shorten total time in appliances and delivers the facial change up front, but it fits only certain bite patterns. Dr. Freelove and the oral surgeon decide candidacy case by case from the CBCT records and the patient’s goals.
Coordinated Surgical Team
Surgical cases succeed on coordination. Dr. Freelove shares 3D records and planning directly with the surgeon so the orthodontic setup and the surgical plan describe the same finish.
PNWOMS
The majority of Freelove Orthodontics surgical patients are treated by PNWOMS, the practice’s primary oral surgery partner for orthognathic cases and surgical exposures.
Community Oral Surgeons
The practice also works with many oral surgeons in the community, so each patient can be matched with the right surgeon for their case.
ENT Physicians
When the CBCT airway analysis or sleep history raises concerns, Dr. Freelove coordinates with local ENTs for airway evaluations and sleep-disordered breathing workups.
Why Dr. Freelove Handles Surgical Coordination
Surgical orthodontics punishes imprecision. The teeth must arrive at surgery in exactly the positions the surgical plan calls for, and the finishing phase determines whether the new jaw position becomes a stable, comfortable bite. Dr. Freelove builds every surgical case on complete 3D records and a digitally planned finish.
Board certification
ABO board-certified orthodontist, a voluntary credential that requires written and clinical exams
Specialist education
MS in Craniofacial Biology from USC, training centered on jaw growth and skeletal relationships
Advanced training
Advanced training that includes surgical orthodontics alongside MARPE and TADs
3D imaging
iCat CBCT with Invivo airway analysis when clinically indicated
Informed choices
Both paths presented: surgical correction and non-surgical camouflage, so the choice is informed
One doctor at both offices
One doctor for the orthodontic phases before and after surgery, at both the Kent and Sammamish offices
Cost & Insurance
Orthodontic phase: priced by case complexity; the case fee is the same for braces or clear aligners
Surgical-orthodontic coordination: $1,000
The surgeon’s fee and facility costs are billed separately by the surgical practice and are often submitted to medical insurance when the procedure is medically necessary; the surgical office confirms that coverage. For the orthodontic portion, Freelove Orthodontics accepts all PPO orthodontic plans, verifies benefits at no charge, and files claims on the patient’s behalf. in-house plans start at $300 down and $199/month, CareCredit offers 0% APR promotional financing, a 5% pay-in-full discount applies, and HSA and FSA funds are accepted.
Frequently Asked Questions
How does Dr. Freelove decide between jaw surgery and orthodontics alone?
There is no single rigid threshold. The decision weighs the severity of the skeletal discrepancy, facial esthetics, airway considerations, and the patient’s goals. Surgery is presented as the superior option when the skeletal imbalance is significant enough that orthodontics alone would produce a compromised result, and in most cases a non-surgical camouflage option is presented alongside it so the patient can make an informed choice.
Who actually performs the jaw surgery?
An oral and maxillofacial surgeon performs the operation in a hospital or surgical center. The majority of the practice’s surgical patients are treated by PNWOMS, and Dr. Freelove also works with many other oral surgeons in the community. Dr. Freelove personally handles the orthodontic phases before and after surgery at the Kent and Sammamish offices.
How long does surgical orthodontic treatment take?
It varies by case. Pre-surgical orthodontics typically runs 6 to 18 months, followed by surgery and several weeks of initial recovery, then a post-surgical finishing phase of roughly 6 to 12 months. Because every case is planned digitally from digital records and clinically indicated imaging at the start, the workflow is designed to avoid wasted months.
Will insurance cover jaw surgery?
The surgical portion is billed by the surgeon and is often submitted to medical insurance when the procedure is medically necessary; the surgical practice confirms that coverage before scheduling. For the orthodontic portion, Freelove Orthodontics accepts all PPO orthodontic plans, verifies benefits at no charge, and files claims on the patient’s behalf.
Is there a non-surgical alternative?
Often, yes. Camouflage treatment moves the teeth to mask a moderate skeletal discrepancy without surgery, and Dr. Freelove presents that option in the majority of cases. For a narrow upper jaw, in-office MARPE can achieve skeletal expansion without surgery for many teens and adults, and some skeletal open bites can be closed with TAD-supported intrusion instead of an operation.
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:
Free Surgical Consultation
Free consultation includes bite analysis and a clear explanation of whether surgery is needed.