At Birbe Clinic, we understand that not everyone is ready or willing to consider surgical treatment for skeletal malocclusions. While surgery remains the gold standard for correcting moderate to severe jaw discrepancies, there are non-surgical options that can help improve both function and esthetics, especially for mild to moderate cases. This guide will help you understand what can realistically be achieved with non-surgical treatments and when they may be right for you.

What are skeletal M’s?

Skeletal malocclusions are misalignments of the jaw caused by discrepancies in the size or position of the upper jaw (maxilla) and lower jaw (mandible). Common types include:

• Class II (overbite): the upper jaw is too far forward or the lower jaw is too far back.
• Class III (underbite): the lower jaw is too far forward or the upper jaw is too far back.
• Open bite: the upper and lower teeth do not meet at the front when biting.
• Asymmetry: A visible imbalance between the left and right sides of the face.
  Non-surgical treatment options

1. Orthodontics alone

Orthodontic treatment focuses on aligning teeth and camouflaging mild skeletal discrepancies. What it can do:

• Correct crowding or spacing problems.
• Camouflage slight skeletal discrepancies by shifting teeth (e.g., retract upper teeth in slight overbites).
• Improve smile esthetics and bite functionality.
• Assist with minor changes in the midline.

Limitations:

• It cannot correct moderate to severe misalignments of the mandible.
• Results are less effective in cases involving facial symmetry or airway problems.

2. Clear aligners (e.g. Invisalign®)

Clear aligners are a discreet option for correcting certain skeletal and dental problems.
What you can do:

• Address mild Class II or Class III discrepancies with elastics.
• Align teeth without visible braces.
• To provide greater comfort and esthetics during treatment.

Limitations:

• Not ideal for severe skeletal problems.
• May require braces or surgery in complex cases.

3. Functional orthodontic appliances

Appliances such as Herbst, Twin Block or MARA are used to guide jaw growth and improve alignment.
What you can do:

• Mainly effective for growing patients (children and adolescents).
• Encourage forward growth of the lower jaw or restrict growth of the upper jaw.

Limitations:

• Limited efficacy in adults, as jaw growth is complete.
• The results are less predictable compared to surgical options.

4. Botulinum toxin (Botox) for jaw muscle hypertrophy.

In cases where skeletal malocclusion causes muscle imbalances or tension, Botox injections can relax overactive muscles, particularly in the jaw.
What you can do:

• Reduce symptoms such as jaw pain or tension headaches.
• Temporarily improve facial proportions in some cases.

Limitations:

• The results are temporary (3 to 6 months).
• It does not address underlying skeletal problems.

5. Facial aesthetic improvements

For patients seeking non-surgical ways to improve their appearance, aesthetic treatments such as dermal fillers can be used.
What you can do:

• Improve jawline definition.
• Camouflage asymmetries or minor deficiencies.

Limitations:

• Purely esthetic; does not affect dental or functional problems.
• Requires regular maintenance.

For whom are non-surgical options better?

Non-surgical options are ideal for:

• Mild skeletal discrepancies where the alignment of the teeth may mask the underlying problem.
• Patients who are not ready for surgery but want to improve their smile or function.
• Growing patients who may benefit from a jaw growth guide.
• Adults seekingtemporary solutions or aesthetic improvements.

When surgery is the best option

If you have moderate to severe skeletal malocclusion, non-surgical treatments may not provide satisfactory results. Surgery, such as orthognathic surgery, can:

• Correct jaw size and position.
  Improve facial symmetry and esthetics.
  Address functional problems such as difficulty chewing or breathing.

At Birbe Clinic, we adapt the treatments to your needs.

We believe that every patient deserves a personalized treatment plan. During your consultation, we will evaluate your specific case and discuss the best options for you, whether surgical or non-surgical. Our goal is to help you achieve a healthy, functional and confident smile.

Book your consultation today

Let us guide you through the options and help you make an informed decision. Contact us at +34 93 212 47 37 to schedule your appointment and begin your journey to a better smile!

Article written by Birbe’s Editorial Board