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When does an underbite need surgery? The short answer is: when Dr. Cronin 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. Cronin 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 Langley 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. Cronin 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. Cronin 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.

When you leave on a trip, you probably double-check that evrything’s ready: your clothes are packed, your ticket is handy, and your passport waits patiently on top of your bag or in a special pocket.

The same level of preparedness should apply with regard to caring for your oral health when you’re about to leave home for a while. Whether you’re jumping in the car for a weekend camping trip or flying halfway across the globe for a longer stint, the tips below will help you keep your teeth healthy whil you’re away.

Prepare Ahead of Time

The key to maintaining good oral hygiene during travel is preparation. Schedule a regular dental appointment so your teeth are freshly cleaned and ready before you leave. This can identify potential issues that might cause problems while you’re away.

If you have any items on a dental “to-do” list, such as wisdom tooth removal, replacement of a filling, or orthodontic adjustment, it’s a good idea to get those procedures completed before your trip.

En Route

If you’re stuck on a long flight or trekking far into the woods, you might find yourself where there’s no sink or even a toothbrush at hand. We speak for everyone when we say that nothing is worse than a mouth that feels, shall we say, less than fresh.

A lemon wedge or Granny Smith apple slice can help freshen up your breath when you’re in need of a quick fix. Rinsing your mouth thoroughly with water can help to wash away bacteria that causes cavities and reduce that gritty sensation. If you’ve got toothpaste, put a dot on your finger or a damp washcloth to serve as a makeshift toothbrush.

Nowadays, travel-sized dental products are available at most grocery stores and pharmacies. You can find travel toothbrushes, mini mouthwashes, and pocket-sized floss to slip into your travel bag.

Colgate makes disposable mini-toothbrushes called Wisps that can help you freshen up when you may not have access to a regular toothbrush. Packing a few extra dental supplies may also be a good idea in case one gets damaged or lost.

At Your Destination

Traveling abroad can expose you to unfamiliar conditions. Some countries have compromised water sources that will make you extremely ill if ingested, even from the tiny amount of water with which you wet your toothbrush.

Minimize that risk and keep bottles of water on hand instead for rinsing your mouth and toothbrush. If your toothbrush comes in contact with contaminated water, swapping it out for a new one is the safest option.

Storing your toothbrush properly is necessary to prevent bacteria from growing on it. Place your brush in a Ziploc bag when you’re on the go and allow it to breathe once you get to a temporary destination.

Traveling near or far should be an enjoyable experience. Dental issues shouldn’t be a source of worry on your vacation. As long as you’re prepared and take precautions, your teeth can stay healthy even when they’re out of the country!

Of course, if you have any questions, don’t hesitate to contact our Langley office.

If you’ve never been to an orthodontist before, you might be wary of what to expect during your first visit. Your dentist may have recommended an orthodontic appliance if it could improve the state of your oral health. More often, you may suspect that you or your child should have orthodontic work done if the time is right financially.

Understanding the various options your orthodontist can perform will be helpful to know before your appointment.

Your initial appointment usually lasts at least an hour. It’s common that diagnostic work will need to be done. This might include getting X-rays so Dr. Grant can better understand the overall structure of your mouth. A quick mold of the mouth may also be taken if braces are a possibility.

Your first appointment is intended to find out how we can efficiently give you a great smile! Here’s a list of common questions you might ask during your first visit:

• Is now the right time for treatment, or should it wait?
• What is the estimated length of time for the treatment?
• How much should I expect to pay? What are the payment options?
• What can I do to prevent or minimize pain?
• Is it likely that I will wear extra appliances in addition to braces to correct my overbite, underbite, or other problems?
• Are there specific foods I will need to avoid?
• Will braces prevent me from playing my favorite sport or musical instrument?
• How can I keep my teeth clean with braces?
• How often will I be expected to come in for checkups and other appointments?

Don’t be afraid to ask these and other questions before you or your child commits to getting braces. Dr. Grant and our team are happy to answer any of them before or after your visit.

Once you’ve had your initial consultation, our team will be here throughout the entire process if any problems arise. We look forward to seeing you at your first appointment in our Douglasville or Union City office!

Perhaps you’ve heard from parents or older relatives what braces used to be like years ago—obvious, uncomfortable, hard to clean, and with inevitable tooth extractions to start off the whole lengthy process.

Today, brackets are much smaller and wires are more pliable. You can even choose ceramic brackets or clear aligners for an almost invisible effect. New tools make cleaning your braces easier than ever. And new braces technology means that treatment is often shorter. But what about extractions? Are they still inevitable?

For orthodontists like Dr. Cronin, the objective is saving teeth. And modern practices and technology have made this goal more attainable than ever before. There are several ways that modern treatment procedures can help avoid extractions.

• Early Intervention

We recommend that children visit our Langley office for an orthodontic evaluation by age seven. Because a child’s jaw is still forming at this age, early intervention can lead to orthodontic treatment that expands the jaw in order to make room for permanent teeth, or starts correcting bite problems before they become more serious.

• High-Tech Planning

Today’s technology allows us to map out the progression of your treatment before we begin. Scanners, X-rays, and computer programs help us to design a treatment plan which will accurately predict how best to move your teeth and correct your bite, taking into account the size and development of your teeth and jaw.

• Surgical Options

By the time you reach your late teen years, the jaw bones have stopped growing and it’s no longer possible to expand them without surgery. Oral surgery can treat serious jaw problems that impact your teeth and bite, usually as part of a combined treatment plan designed by your orthodontist and your oral surgeon.

Because we always work to keep teeth intact—using these methods and others—you can be sure that, if we recommend extraction, it is absolutely necessary. What could make an extraction necessary?

• Severe overcrowding. Sometimes, there’s just not enough room in the jaw for all of your teeth.
• A tooth or teeth that prevent us from correcting a problem with your bite.
• Wisdom teeth. Usually, orthodontic work takes place before a patient’s wisdom teeth start to erupt. If yours do make an appearance before or during treatment, we can adapt our treatment plan accordingly.
• An extra tooth. It’s rare, but an extra, or supernumerary, tooth sometimes develops, and your jaw is not designed to accommodate extras!

It’s important that you talk to Dr. Cronin about every step of your treatment, including extractions. We want you to understand the treatment plan which will give you your best outcome. If we recommend extraction, it is because this decision is the best way to achieve a healthy bite and alignment, creating your beautiful smile—and protecting it—for a lifetime.