Is Surgery the Only Solution to Fix Mandible?

Often the hyperactive tongue is the reason that teeth tilt or flare.  Even if braces are worn, the tongue issue must be addressed.  Consulting with a speach therapist can help and should be considered.

Often the growth of one jaw vs another is so dissimilar that surgery is needed.  Prior to doing so, get at least one more opinion, but it is possible that there is not other way.

I approach bite problems with the "functional jaw Orthopedic" technique.  The best time to influence the dental arches is early in developement as one's face and jaw are still growing.  This gives us time to expand the upper arch (maxilla) and to upright teeth and advance the mandible (lower jaw).  By using expansion appliances, either upper or lower, we can influence facial profile, TMJ position, tooth position, and tongue position which all influence speech, health and self- esteem.  70% of the children I see in my practice have under-developed arches.  This means the arch form is too narrow and the lower jaw is too far posteriorly positioned.( too far back) This is called early interceptive orthodontics and is MUCH MORE EFFECTIVE, stable and painless than surgery. Look for a DDS, pediatric dentist or orthodontist that is trained in functional appliances. You and your kids will be glad you did !!!

From your description it is very difficult to ascertain exactly what the situation is.  Perhaps the lower teeth lean outward because they are overcrowded, or perhaps they do so because of an tongue posture issue.  Also, the degree of lower jaw retrusion is highly variable in "overbites" and often the upper jaw plays a role as well.  There are appliances which are capable of helping the lower jaw adjust it's position forward, and there are new adjuncts for braces which are excellent anchors for pulling protrusive upper teeth back.  The bottom line is that in general surgery is a last resort, we are getting better and better at avoiding surgery, but sometimes it is the only way to get a good result.  You should seek several opinions about your case so that you are confident in making your choice about which way to go.