For the cases that need more than aligners or braces
Most patients can be treated with Invisalign or braces alone. Some cases require surgical orthodontics, MARPE or surgically assisted expansion, multidisciplinary treatment, or cosmetic finishing such as bleaching. At Bella Smile, we diagnose first, then recommend the approach that best fits your anatomy, bite, goals, and long-term stability.
The same four steps as every case, with more time spent on the plan.
01
Complimentary consultation
Digital scan, full exam, and a straight assessment of what the case actually needs.
02
Three-doctor planning
Complex cases are reviewed by all three doctors, and with your surgeon or dentist where relevant.
03
Staged treatment
Appliances, anchors, or surgery sequenced with aligners or braces so each stage sets up the next.
04
Long-term stability
A personalized retention plan, which may include nighttime retainers, bonded permanent retainers, and first-year follow-up.
Why it matters
Knowing when not to operate is part of the expertise.
Many of our patients arrived having been told they needed jaw surgery or extractions. Anchors, appliances, and acceleration let us treat a good share of them without either. When surgery is the right answer, we plan it with the surgeon and say so plainly.
Non-surgical alternativesOpen bites and Class II corrections treated without jaw surgery
Extraction-free planningAnchors and expansion used to make room instead of removing teeth
Airway-awareGrowth and breathing considered in every child’s plan
Options
Appliances and approaches we use.
Each solves a specific problem. Which, if any, applies to you is decided at the consultation, not from a menu.
For significant jaw discrepancies, we coordinate with an oral and maxillofacial surgeon, planning orthodontics and surgery together for the best bite, balance, and smile.
For a narrow adult or teen jaw, we recommend MARPE, TAD-supported expansion, or surgically assisted expansion — whichever safely achieves the needed width.
Complex smiles often need several specialists — dentist, prosthodontist, periodontist, oral surgeon — working toward one final result we plan and sequence.
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Results with complex and surgical cases
Before and after
Patients treated at Bella Smile. Shared with permission.
Class I malocclusion with retained maxillary primary canines, palatally impacted UR3, and mesially angulated #11. Moderate overbite with adequate spacing in both arches.
I was told I need jaw surgery. Is that always true?
Not always. Whether surgery is needed depends on how far the jaws are out of position and whether growth is complete. We treat many cases referred for surgery without it, using anchors, appliances, and acceleration. Your consultation gives a straight answer either way.
When should my child first see an orthodontist?
Around age seven, as the American Association of Orthodontists recommends. Most children will not need treatment then, but the ones who do benefit most from starting early. Our evaluation is complimentary.
When needed
Adult expansion
Smile design
