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When does an underbite need surgery? The short answer is: when Drs. Gregory Hummon and Thomas Gebeck 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?

Drs. Gregory Hummon and Thomas Gebeck 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 Birmingham 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 Drs. Gregory Hummon and Thomas Gebeck 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 Drs. Gregory Hummon and Thomas Gebeck 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.

The best way to avoid orthodontic emergencies is to know how to take care of your braces properly throughout your entire treatment. However, emergencies are … well, emergencies, and sometimes no matter how cautious you are or how well you take care of your braces, the wires loosen, the bands pop, or you experience orthodontic discomfort.

Common orthodontic emergencies include broken braces, poking wires, lost or broken retainers, mouth sores, and mouth injuries sustained playing sports, which often happens when you don’t wear a mouthguard to protect your teeth and appliance.

Food

It’s important to avoid foods that can damage your braces. Most people wear braces for about two years. All chewy, sticky, crunchy, and hard foods should be avoided during that time. While this may seem like a long time to go without popcorn or bubble gum, hard foods can break the brackets of your braces and sticky foods can bend the wires. If you have a loose wire, don’t try to fix it yourself. Call Dr. Hummon & Dr. Gebeck Orthodontic Associates PC. In the meantime, if a wire is poking into your cheek or lip and causing irritation, put wax or a wet cotton ball over it to dull the sharp edge.

Pain and Discomfort

Some discomfort is a normal part of orthodontic treatment, especially in the hours after the braces are placed on your teeth or after a recent tightening or adjustment. However, if the pain doesn’t subside in three to five days, it’s a good idea to schedule an appointment at Dr. Hummon & Dr. Gebeck Orthodontic Associates PC. Until then, try dissolving a teaspoon of salt in an eight-ounce glass of water and gargling with the solution. Over-the-counter pain medication will relieve discomfort, too.

Playing Sports

Just because you wear braces doesn’t mean you can’t play sports. You just need to take some extra precautions. Sports-related injuries to the mouth and jaw are common. The best way to protect your mouth and your appliance is to wear a mouthguard. There are several different types of mouthguards available, so be sure to ask Drs. Gregory Hummon and Thomas Gebeck what’s best for you.

Brushing and Flossing

In order to keep your braces in good condition and avoid orthodontic emergencies, it’s important to brush and floss thoroughly after every meal. It’s easy for small particles of food to get trapped in your braces, and if the food isn’t removed, it gets wedged between the teeth and gums and causes plaque.

Need more tips on how to avoid orthodontic emergencies? Just ask any member of our Birmingham team.

Summer means sun and heat and delicious, frosty treats to keep you cool while you’re enjoying the sun and heat. If you’re wearing braces this summer, not to worry! Drs. Gregory Hummon and Thomas Gebeck and our team have plenty of ideas for icy treats to help you beat the heat.

• Fruit Smoothies

Low on refined sugars, high on vitamins and minerals, refreshing, delicious, easy on brackets and wires—what’s not to like about fruit smoothies? And if you want to up the nutritional value by adding some green vegetables to the blender, even better!

If you’re buying your smoothie instead of making it yourself, watch out for added sugars in ingredients like ice cream, sherbet, frozen yogurt, and sweetened fruit juice. It can be more challenging to keep your teeth clean with braces, so watching your sugar intake is more important than ever. Try a smoothie made with low-fat yogurt, fruits and/or vegetables, and 100% fruit juice instead. Just as delicious, without extra tablespoons of added sugar.

• Iced (Herbal, Green, or White) Tea & Frozen Coffee Treats

Coffee and black tea contain compounds called tannins, which can stain tooth enamel and braces. Using a straw can help you limit your enamel’s exposure. If you enjoy a cold, iced beverage occasionally, consider green, white, or herbal iced teas. They don’t stain as much, and many contain healthy antioxidants and other health benefits.

And if you can’t resist that creamy iced coffee beverage? Use a straw to avoid bathing your teeth in the stain-causing tannins and enamel-weakening acids found in coffee. Because these drinks can be full of added sugars, consider reduced-sugar options and skip the toppings.

• Frozen Treats

When you hear that familiar tune coming from the neighborhood ice cream truck, do you have to stand on the sidewalk, sadly watching it disappear into the distance? Not necessarily!

Milk shakes, ice cream, and frozen yogurt are a refreshing choice in a braces-friendly form—and they contain calcium. Popsicles and fruit bars can be a safe choice if you don’t bite into solid ice. You wouldn’t chew on ice because it could damage your braces, so make sure your frozen bar softens a bit before you enjoy it.

What kinds of frozen treats to avoid? If your favorite flavor of ice cream or your go-to ice cream bar contains hard or chewy additions like nuts and pieces of candy, choose another item from the menu. Surrounding nuts and candies with ice cream doesn’t actually make them any safer for your brackets and wires, and may lead to an unplanned visit to our Birmingham orthodontic office to fix a broken bracket.

We don’t recommend a steady diet of sweet treats, because you want a cavity-free smile when your braces come off. And water is always an excellent summertime choice for both hydration and health. But an occasional frosty dessert is cool and tasty and soothing, especially if you’ve just had an adjustment. Just be sure to brush—or rinse with water if you can’t brush—after indulging. Now, what’s on the menu for fall?

One of the many benefits of your clear aligners is that you can remove them to eat. You should brush after every meal, just like you would with traditional braces, but cleaning your teeth is much easier without having to work around and between brackets and wires.

But when you wear your aligners 22 hours a day, you might be tempted to leave them in when you’re just having a sip of something when you’re thirsty. Unless you’re drinking water, please don’t.

What’s the problem with a can of cola or a cup of coffee?

• Staining

The virtue of your clear aligners is that they are, well, clear! Probably one of the reasons you decided on this method of treatment was because you liked the idea of an inconspicuous appliance.  Unfortunately, dark beverages such as colas, coffee, tea, and red wine can stain your aligner, making it more visible.

• Warping

Very hot beverages might actually affect the shape of your aligners. Since they are formed using heat, it makes sense that heat can also de-form them. If hot teas and coffee drinks cause a change in the shape of your aligners, they will not move your teeth the way they were meant to.

• Affecting Tooth Health

Even though our enamel is very strong, sugary and acidic drinks can damage it. Acidic foods can erode enamel, and the sugars in our diet provide food for cavity-causing bacteria, which then produce acids that erode enamel.

Normally, saliva provides some protection from acids and sugars by diluting them and washing them away from the teeth. When you drink a cola or an orange juice with your aligners on, some of the liquid will get in them, and can stay in them until the aligners are removed. You will actually give these problem beverages the opportunity to bathe your teeth in sugar and acid over a longer period of time, without exposure to saliva to help offset potential harm. And after all your work to create a beautiful smile, you certainly don’t want new cavities!

How to protect your aligners and keep them their cleanest—and most invisible?

• Take your aligners out before drinking beverages that can stain them, or, if you can’t, try using a straw. Clean your aligners according to Drs. Gregory Hummon and Thomas Gebeck and our team’s instructions to keep them as clear as possible.
• Don’t drink very hot beverages with your aligners in place. Try icing your coffee and tea if you can’t remove your aligners. And if you think your aligners have changed shape, please give us a call.
• Drink water! Water hydrates you, doesn’t damage enamel, and keeps your aligners clean. Tap water is your best option, as even bottled waters can be acidic.

If your aligners should become stained, remember that you change them frequently, so the staining can be a temporary problem. If you do have a drink of something hot and your aligners feel “off,” give our Birmingham office a call. We’ll let you know if you need to replace them.

But prevention is always best! Avoid staining from the start by removing your aligners before you drink dark beverages. Don’t expose your aligners to heat. Think about replacing unhealthy drinks with water. And certainly brush right away, or rinse with water if that’s not possible, if you drink a sugary or acidic beverage. These simple precautions will help keep your aligners, and, most important, your teeth, looking their best.