SURGICAL ORTHODONTICS
Some Things Only Surgery Can Fix. That Doesn't Make Them Unfixable.
For patients with significant skeletal discrepancies affecting the bite, the jaw, or the airway, combined surgical and orthodontic treatment can achieve what neither could accomplish alone.
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Board-Certified Orthodontist
Serving Charleston Since 1984
Best of Charleston · 6 Consecutive Years
WHO THIS IS FOR
Most Patients Arrive Here After a Long Road.
Patients who find their way to this page usually have something in common. They've been on a long road.
Some were told years ago that they needed surgery and are finally in a place, emotionally and practically, where they're ready to address it. Some have spent years managing symptoms, a bite that doesn't function correctly, a jaw that causes chronic discomfort, sleep that never feels restorative, and are ready to address the structural cause rather than the symptoms. Some are being referred by an oral surgeon who needs orthodontic preparation before surgery can proceed. Some have only recently learned that what they've been living with has a solution.
All of them arrive with questions. Many arrive with fear. Both are completely understandable, and both deserve honest answers.
WHAT ORTHOGNATHIC SURGERY ACTUALLY IS
A Precise, Carefully Planned Surgical Procedure.
Let's address the fear directly.
Patients sometimes describe surgical orthodontics as someone breaking their jaw. That framing does a disservice to what is actually a precise, carefully planned surgical procedure performed by highly skilled specialists.
Orthognathic surgery repositions the bones of the face to correct skeletal discrepancies that affect how the teeth fit together, how the jaw functions, and in many cases how a patient breathes and sleeps. It addresses structural problems at their source in a way that orthodontics alone, no matter how skilled the provider, simply cannot.
The impact on both function and appearance can be profound. Patients who have spent years accommodating a bite that doesn't work correctly, or breathing through a compromised airway, often describe the outcome in a single word.
THE PROCESS
Understanding the Sequence Makes the Process Less Overwhelming.
Combined surgical-orthodontic treatment follows a clear sequence, and understanding that sequence removes much of the uncertainty that makes it feel overwhelming.
Phase One: Presurgical Orthodontics
Before surgery, we move your teeth to their most ideal position within your existing bone structure. This phase uses either braces or Spark clear aligners depending on your clinical situation and preference. The goal is to prepare the teeth so that when the surgeon repositions the bone, everything fits together precisely. Presurgical orthodontics typically takes six to twelve months.
The Surgical Phase
Your oral surgeon repositions the bone to its most ideal position within your face. This is where the skeletal discrepancy is corrected at its source. The surgery is performed by specialists we work with closely and trust completely.
Before anyone goes near an operating room, your surgery is performed virtually. Our surgical partners use advanced virtual planning technology to map the precise movements of the procedure digitally, review the outcome, and refine the plan before a single incision is made. You and your surgical team know exactly what is going to happen before it happens.
Recovery takes time. We won't minimize that. But it is manageable, and our patients consistently tell us it was more doable than they feared going in.
Phase Two: Postsurgical Orthodontics
After the bone has healed in its new position, we return to the orthodontic work to finalize the fit of your teeth following the skeletal changes. This phase typically takes four to six months. Again, braces or aligners depending on your situation.
Total treatment time from start to finish varies by case, but a realistic expectation for most patients is twelve to eighteen months of orthodontic treatment surrounding the surgical phase.
HOW WE WORK WITH YOUR SURGICAL TEAM
This Is a Collaboration, Not a Handoff.
Surgical orthodontics is not a handoff. It is a collaboration from the first appointment to the last.
We work closely with trusted oral surgeons in Charleston and beyond, both in the presurgical setup and in the virtual planning stage. Our involvement doesn't stop at the orthodontic phases. We are active participants in planning the surgical movements, reviewing the virtual outcome, and making sure the orthodontic preparation sets your surgeon up to achieve the best possible result.
You shouldn't have to coordinate your own care across multiple providers. We do that for you, and we stay in close communication with your surgical team throughout the entire process.
Trusted Surgical Partners
We collaborate with highly skilled oral surgeons we know and trust.
Continuous Communication
We stay actively involved throughout both the orthodontic and surgical phases.
Integrated Care
Every part of treatment is coordinated around the same final outcome.
Virtual Surgical Planning
Surgical movements are mapped digitally before surgery takes place.
What Patients Tell Us After
The Word That Comes Up Most Is Relief.
We've asked surgical orthodontic patients what they want other patients considering this treatment to know.
The answers are remarkably consistent.
Recovery Was Manageable
Patients consistently tell us recovery was harder than expected but shorter than feared.
Improved Breathing & Sleep
Many patients describe dramatic improvements in breathing, sleep quality, and daily energy.
Functional Relief
Patients often realize how much effort they were spending accommodating something that wasn't functioning correctly.
A Natural Result
Patients often say their face finally looks the way it was always supposed to look.
The recovery was harder than I expected but shorter than I feared. I wish I had done it ten years ago. I didn't realize how much energy I was spending every day just accommodating something that wasn't right. I can breathe. I can sleep. My face looks like it was always supposed to look.
Relief. That's the word that comes up most.
IS THIS THE RIGHT PATH FOR YOU
The Only Way to Know Is a Thorough Evaluation and an Honest Conversation.
The only way to know is a thorough evaluation and an honest conversation. At your complimentary consultation, Dr. Bullwinkel will review your records, evaluate your clinical situation, and give you a complete picture of your options including whether a combined surgical approach is indicated and what that would involve specifically for you.
If surgery is the right path, we'll explain exactly why and what the process would look like from start to finish. If it isn't, we'll tell you that too and discuss what alternatives exist.
No pressure. No predetermined outcome. Just the information you need to make a decision you feel confident in.