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When does an underbite need surgery? The short answer is: when Dr. Grant and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Grant will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Douglasville or Union City office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Grant to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Grant and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Cronin Orthodontics is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Cronin Orthodontics strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Cronin and our team at Cronin Orthodontics will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

Well, of course you can chew gum and wear braces. But, should you chew gum and wear braces? That can be a sticky question.

For many years, the answer was a firm “No.” Not only did our favorite chewables literally gum up the (dental) works, but they were filled with loads of the sugar that cavity-causing bacteria love to feed on. The result? A much better chance of damage to your orthodontic work, and a higher risk of cavities near your brackets and wires.

But times, and gum recipes, change. Today’s sugar-free gum provides us with some new ideas to chew over.

• Sugarless gum is much less sticky than regular gum, so it is much less likely to stick to your appliance. If there is any chance that gum will damage your wires or brackets, we’ll let you know that it’s best to wait until your braces are off to indulge.
• Some orthodontic patients find that their jaws and ligaments are less sore if they chew gum for a few minutes after an adjustment.
• Most important, studies suggest that chewing sugarless gum might actually help prevent cavities from forming. How is that possible?

Because chewing gum increases our production of saliva! Okay, we don’t normally find saliva an exciting, exclamation-point-worthy topic, but let’s look at the dental benefits:

• Saliva washes away food particles and bacteria. And because braces can trap food when we eat, it’s great to have some help washing away any meal-time souvenirs.
• Saliva helps neutralize acids in the mouth. The acids found in foods and produced by oral bacteria lead to cavities, so diluting and neutralizing their effects provide important protection for our enamel.
• Saliva helps bathe the teeth in minerals that can actually rebuild weakened enamel. Acids in the mouth attack minerals in the enamel such as the calcium and phosphate that strengthen our teeth. Fortunately, saliva provides calcium, phosphate, and fluoride that can actually help rebuild weakened enamel.

So, should you chew gum and wear braces? The real question is, should you chew gum while you’re in braces? Dr. Cronin and our team are more than happy to provide the right answer for you! Talk to us at your next visit to our Langley office about the potential benefits and drawbacks of dentist-approved sugarless gum. Depending on the kind of gum you choose and the kind of orthodontic work you are having done, the answer just might surprise you.

These days, fewer and fewer braces show up in school yearbook photos. Invisalign clear aligners have become a popular choice for our adolescent patients because it enables them to display metal-free smiles while straightening their teeth!  

Dr. Grant can help you determine whether Invisalign treatment is right for you, but below are a few reasons why so many teens are choosing it today.

More Free Time

Invisalign Teen aligners require fewer appointments, which is pretty important to teens who value their free time. Invisalign treatment gives you straight teeth without having to miss activities or skip hanging out with your friends. It’s a win-win!

Eat, Brush, and Floss Easily

Traditional braces can make eating, brushing, and flossing both difficult and tedious. Invisalign aligners are easily removable for all these important activities, and give you freedom to live your life as usual.

Metal-Free Braces

Possibly the best perk of Invisalign aligners is that you can’t see them! The Invisalign system uses a clear plastic device that fits directly over the teeth. This means no metal parts to mar the appearance of your smile, so your Invisalign aligners will straighten while allowing your pearly whites to shine through. People don’t even have to know you’re straightening your teeth with Invisalign aligners.

To learn more about Invisalign Teen treatment, feel free to reach out to our Douglasville or Union City office!