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When does an underbite need surgery? The short answer is: when Dr. Barry 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. Barry 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 Tallahassee 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. Barry 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. Barry 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.

Birthdays. Valentine’s Day. Halloween. A trip to the movies. There are just some occasions where a sweet treat is on the menu. Now that you are getting braces, does that mean you have to give up desserts completely? Not at all! The trick to finding the right treat is to know which foods are safe for your braces and which should wait until your treatment is complete.

There are some foods which should always be avoided. They fall into three main categories:

• Hard and Crunchy

Hard candies, peanut brittle, popcorn balls, nutty candy bars—anything that is hard to bite into is hard on your braces, and can damage brackets or even break them.

• Chewy

Caramels, taffy, chewy squares and rolls, licorice and other super-chewy candies can break brackets and bend wires. Not to mention, they are really difficult to clean from the surface of teeth and braces.

• Sticky

Soft foods are generally fine, but soft and sticky candies are another thing entirely. Gumdrops, jelly beans, most gum and other sticky treats stick to your braces, making it hard to clean all that sugar from around your brackets. And even soft sticky candies can bend wires or damage your brackets.

As you have probably noticed, almost all candy falls into one of these categories. Of course, while sugary treats shouldn’t be a major part of anyone’s diet, and careful brushing and flossing are always on the menu if you do indulge, wearing braces does not mean giving up on treats entirely. A better alternative when you are craving something sweet is to choose something that avoids crunchy, chewy and sticky hazards, such as soft puddings, cupcakes or cookies. There are even some candy brands that are safe for your braces.

Talk to Dr. Barry the next time you visit our Tallahassee office about the dos and don’ts of desserts—we have tasty suggestions that will make those special occasions both sweet for you and safe for your orthodontic work!

“Yes,” you’re thinking, “I shouldn’t be chewing sugary, sticky gum while I’m wearing my braces.” Or perhaps, “I should check with my orthodontist to see if this sugar-free gum is safe for my braces.” And these are both great thoughts—but today, we’re thinking about gums of a different sort!

While you’ve been taking care of your teeth with regular brushing and flossing, you’ve also been taking care of your gums. And now that you’re wearing braces, your gums need a bit of special attention to keep them their healthiest.

We tend to think of gum disease as an adult problem. In fact, periodontitis, or serious gum disease, is one of the most common chronic infections in the adult population. But young gums need care, too! Gingivitis, a milder form of gum disease, is unfortunately a common problem for both children and adults.

Gingivitis is an inflammation of the gums caused by the build-up of plaque and tartar. When plaque builds up, it irritates delicate gum tissue. And while gingivitis is not as serious as periodontitis, the symptoms caused by this disease are nothing to smile about:

• Redness
• Tenderness and soreness
• Swelling
• Bleeding
• Bad Breath

If you’re already feeling a little tender or swollen after an adjustment, the added discomfort caused by gingivitis is the last thing you want. But even worse, neglected gingivitis can lead to more serious infections of gum and even bone tissue. Luckily, gingivitis is both preventable and treatable with proper dental care.

So, how to protect your gums? We have some suggestions.

• Brushing Better with Braces

It can be hard to brush around your brackets and wires, but keeping these areas free of food particles and plaque makes for healthy gums—and fewer cavities! There are specially designed manual toothbrushes made for braces wearers, and tiny interproximal brushes that can reach tight spaces. Or, perhaps an electric toothbrush will do a better job for you. Just be sure to brush after each meal for the most complete removal of bacteria and plaque.

• Learn New Flossing Techniques

You might wonder how on earth you’ll get in between your teeth with your wires and brackets in the way. We have the answers! We know the best techniques for flossing your specific braces, and we’ll recommend specially designed flossing tools to make the job easier. Water flossers can also be a great help for cleaning in tight spots. Be sure to make flossing part of your daily routine—you’ll be able to remove plaque from places brushing just can’t reach.

• Rinsing? Recommended.

Talk to Dr. Barry about the best dental rinses for reducing plaque and tartar, or how gargling can help prevent irritation. And drink water! Water helps wash away plaque and bacteria, and is a great way to rinse teeth and braces if you absolutely can’t brush after eating.

• Keep up with Professional Cleanings

Be sure to keep up with your regular dental exams and cleanings. Your dentist or hygienist will be able to remove any plaque or tartar build up that home brushing can’t handle.

We want your time in braces to be as healthy—and comfortable—as possible. If you have any gum discomfort, swelling, or sensitivity, give our Tallahassee office a call. With prompt action, gingivitis can be treated, and with careful attention to your cleaning routine, gingivitis can be prevented altogether. Something to think about!

Invisalign Teen is designed with today’s youth in mind. These clear, removable orthodontic aligners can straighten your teeth without the need for metal wires and brackets. Unlike traditional braces, Invisalign Teen aligners are comfortable, nearly invisible, and removable, which allows you to remove them as you eat your favorite foods and brush and floss your teeth. Invisalign Teen motivates teenagers to enjoy life without restrictions while promoting better overall dental care.

Key features of Invisalign Teen

Teenagers are constantly on the move and require special options when it comes to their braces. Invisalign Teen utilizes the same technology as Invisalign for adults; they consist of a series of clear plastic aligners that gradually move the teeth. Extra features designed especially for teens include:

• Blue wear-indicators on the aligners that gradually fade from blue to clear to help you, and our team, gauge wear time
• Aligners designed to compensate for the growth of molars and new teeth
• Customization to fit your mouth correctly and comfortably
• Removable and nearly transparent to ensure you can eat with freedom and smile with confidence
• Six free individual replacement aligners in the event that your aligners become misplaced or lost

Conditions improved by Invisalign Teen

Between 70 and 80 percent of adolescents in the United States require braces, according to the American Association of Orthodontists (AAO). Invisalign Teen uses advanced technology to treat a broad range of orthodontic conditions. These include overbite, underbite, crossbite, widely-spaced teeth, and overly crowded teeth. Injuries and tooth and jaw problems may also require the use of braces to correct jaw and teeth alignment problems.

How does Invisalign Teen work?

Like any orthodontic treatment, Invisalign Teen requires a customized treatment plan created by Dr. Barry. Generally, each set of aligners is worn for approximately two weeks and removed when you brush, floss, eat, and drink. Your teeth will gradually move with the series of aligners, which typically ranges from 18 to 30 aligners in total. You’ll visit our Tallahassee office every eight to ten weeks to check your progress and make any needed adjustments.

Invisalign Teen introduces a whole new way to make your smile straight without the unappealing look and hassle of traditional metal braces. This revolutionary method of correcting smiles is being used by teens everywhere, including right here at North Florida Orthodontic Specialists, to straighten their teeth with confidence.