Does Jaw Surgery Cause Periodontal Disease? What Research Shows

Orthognathic (jaw) surgery changes jaw position and bite alignment, but a common worry is whether it increases the risk of gum disease. The good news: research shows that jaw surgery itself doesn't cause periodontal disease when you maintain good oral hygiene.

What Surgery Actually Does to Your Gums

Jaw surgery changes how your teeth come together and redistributes the forces across your teeth. In patients who maintain good oral hygiene, these changes do not usually lead to clinically meaningful worsening of overall periodontal status in the first few months after surgery. A prospective study found no significant overall deterioration in plaque levels, gum inflammation, probing depths, or attachment loss at 3-6 months, although some research reports small increases in plaque scores and buccal gum recession shortly after surgery.

However, some patients do experience small increases in gingival recession after surgery, which is why gum margins should be monitored over time during recovery.

The Real Risk Factors: Orthodontics and Hygiene, Not Surgery

The actual risk to gum health comes from two things:

1. Fixed orthodontic appliances (braces) - make plaque control harder and commonly increase gum inflammation during treatment. The critical factor is hygiene: when plaque is kept under control and forces are applied appropriately, studies show that teeth can be moved with fixed appliances without causing clinically meaningful, permanent deterioration of periodontal status.

2. Hygiene challenges - Jaw surgery, together with the orthodontic tooth movements that go with it, changes tooth position and how your teeth contact each other. That means plaque‑retentive areas can shift and some spots may become harder to reach, so new angles and spaces often require adjusted brushing and interdental cleaning techniques to keep plaque under control.

Why Plaque Control is Everything

Periodontal disease is driven primarily by bacterial biofilm and your body’s inflammatory response, not by surgery itself. When plaque control is neglected after surgery, periodontal disease can recur despite technically successful surgical correction. But when meticulous hygiene, periodontal maintenance, and controlled orthodontic forces are prioritized, even periodontally compromised patients can often complete orthodontic and jaw surgery-related treatment without additional periodontal breakdown and may even gain attachment in treated sites.
(Materials, 2018)

Managing Gums During Recovery

Adjust your routine: After surgery, your bite and tooth angles change. Work with your dental team to identify new hard-to-reach areas and modify your brushing and flossing technique accordingly. The Feno Smartbrush can help you monitor coverage in tricky spots that are easy to miss with standard brushes.

Stay on top of recession: Schedule regular periodontal check-ups during and after treatment. Early monitoring of gum margins helps catch small changes before they become problematic.

Maintain plaque control around brackets: If you're wearing fixed orthodontic appliances, interdental brushes and water flossers are non-negotiable. Plaque around brackets is the primary driver of gum issues during orthodontic treatment.

The Bottom Line

Jaw surgery doesn't cause periodontal disease plaque does. Your surgical outcome depends far more on your post-op hygiene habits than on the procedure itself. With exceptional oral care, you can move through jaw surgery and orthodontics with healthy gums.