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When does an underbite need surgery? The short answer is: when Dr. Frech 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. Frech 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 Wichita Falls, TX 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. Frech 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. Frech 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.

Getting your child excited about braces is a lot like: A) convincing a grumpy toddler that it’s time to take a nap? B) convincing a teenager to stop texting during dinner? C) convincing your husband to eat his peas? The answer, obviously, is all of the above.

And that’s why you may need a few thoughtful ways to get your child on board with braces.

1. Throw a pre-braces party. It can’t be just any party, however, but a Willy Wonka celebration of candy, chips, gum, and all the sticky and sweet foods your child won’t be able to indulge in during the time he or she is wearing braces. Promise a post-braces celebration, too, and watch as your child’s eyes widen at the thought of an all-you-can-eat junk food buffet.
2. Encouraging phrases like “braces aren’t eternal, but your straight smile will be” can go a long way.
3. If your daughter is worried about getting picked on because of braces, then name-drop some A-list celebrities who have worn them. The list includes Cameron Diaz, Kelly Clarkson, Dakota Fanning, and Gwen Stefani.
4. Emphasize that braces today aren’t the same as they were in the Stone Age. From clear ceramic braces to different-colored braces, more options are available. Braces can be cool accessories to express a personal style.
5. To get your child to embrace braces, you need to sing the praises of beautiful teeth, even if that means pointing out how crooked your teeth are because you never got braces.

If you are planning on taking a vacation this summer, we ask that you let us know ahead of time so that we may schedule your summer appointments more efficiently. We also encourage patients and their parents to be proactive in determining when they make their summer appointments.

If you will be gone for an extended period (more than six weeks), we recommend you visit Wichita Falls Orthodontics prior to leaving and schedule another visit shortly after your return. Lastly, please remember not to indulge in hard, sticky, and chewy treats while enjoying your vacation. We look forward to seeing you soon and hearing about your adventures!

School’s out. The barbecue’s fired up. T-shirts and shorts are back in style. Sandy beaches and sidewalks are sizzling. Summer’s officially here, and it’s time to get back into hot weather mode. This means getting back into some healthy summer habits.

Be Ready to Hydrate!

Warm weather can lead to dehydration before you know it. And water does more than hydrate—it rinses away food particles after eating or snacking, neutralizes enamel-eroding acids in the mouth, and helps us keep up healthy levels of saliva. 

• A reusable water bottle is a summer shopping list must. When you’re out walking, hiking, exercising, or camping, you can’t always be sure you’ll have fresh water available. Fill your water bottle before you leave home—you’ll help yourself stay hydrated, save money, and protect the environment, too!
• When you’re on the go, rinse with water after snacking to help remove food particles from teeth and braces.
• Go light on the sports drinks and sodas when planning your summer menus. They’re often filled with sugars and acids—two very unhealthy ingredients for your teeth. 

Restock Your Sunscreen

Sunscreen helps protect skin of all shades and all ages. Exposure to ultraviolet rays is known to cause skin cancer and premature aging. Lip tissue is thin and delicate, especially at risk from the sun’s damaging UV rays. 

• Check your sunscreen for its expiration date. Protective sunscreens and lip balms lose effectiveness once that date has passed.
• Some sunscreens are designed for use on lips. If yours isn’t, look for a protective lip balm. All of your sunscreens and balms should have an SPF (Sun Protection Factor) of 30 or higher.
• Bring your sunscreen and balm with you when you’re out and about, and reapply every two hours, or sooner if you’re eating, drinking, or getting wet.

Prep for Summer Adventures

If you’re travelling this summer, make sure the right dental and orthodontic supplies are part of your gear. A travel size toothbrush and toothpaste, a well-ventilated toothbrush case, and your orthodontist’s and dentist’s emergency contact information are basic necessities. If you wear braces, add dental wax and extra rubber bands. If you have aligners or a retainer, don’t forget your case.

Once you have the basics, you can tailor your kit to your summer plans:

• Flying? Make sure every liquid, gel, or aerosol you’ll need is the proper size for carry-on flight rules, 3.4 oz (100 ml) or less. Toothpaste and mouthwash are included in these categories, so look for travel sizes in your favorites. 
• Going overseas? Don’t forget plug adaptors or voltage converters if needed for your electric toothbrush.
• Camping? An emergency kit with cotton rolls, over-the counter pain relief, oral pain relief gel, dental wax (for damaged braces or a broken tooth), and even temporary fillings and a tooth preservation kit can be crucial in case of unexpected dental injuries.

Make Sure Dental Care Is on Your Summer Calendar

Laid-back summer days are the best, but laid-back dental care really isn’t! Follow your healthy dental routine even during the lazy days of summer.

• Keep up with your brushing and flossing. Brush two minutes twice each day with a fluoride toothpaste, and floss at least once a day—or more often as your orthodontist recommends.
• If you’re planning a trip, don’t ignore warning signs. If you have tooth pain or sensitivity, see your dentist to treat any problems before you’re cruising at 30,000 feet or enjoying a remote campout miles from anywhere.
• See your orthodontist as scheduled, and make sure to let the office know if you have travel plans which might disrupt your regular treatment schedule.
• Keep your appointments for dental exams and cleanings to ensure year-round dental health.

Whether you’re basking in the warm outdoor weather, relaxing in the shade with a cool drink and a good book, on the road to adventure, or wherever your summer plans take you, we hope these easy tips will help you create a summer filled with bright, healthy smiles.