Our Blog

When does an underbite need surgery? The short answer is: when Dr. Allen 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. Allen 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 San Diego 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. Allen 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. Allen 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 beginning orthodontic treatment, most patients ask Dr. Allen and our team a lot of questions about what to expect, while others choose to just "go with the flow" and leave it to us to build for them a beautiful smile. And for our team at Davis Orthodontics, that's understandable.

But for those who do ask questions, two of the ones we frequently hear are "Will my braces hurt?" and "How long will these be on?"

We explain to our patients that despite what they've heard, braces do not hurt when they're initially put on. Yes, you will experience soreness after your braces are placed and when your teeth start to move. Too often, our patients hear horror stories about how much it hurts to get the braces on, so they tend to over-worry. The truth is, after their braces are on, almost all patients say "that's it?" because it's actually easy and painless!

At Davis Orthodontics, we answer most of your other questions during your initial exam. When a patient visits our office for the first time, we give him or her a time estimate of how long it will take to achieve their ideal smile. All other questions are answered at the bonding appointment when the braces are placed. We cover all the topics, everything from eating to brushing with braces, but we also know that after your initial appointment, it's natural for you to have questions about your or your child's treatment. And we are always here for you; we are thorough and always try to answer any questions or concerns you may have. As a patient, that's one thing you never have to worry about. You will always know what's going on throughout your orthodontic experience.

We’ve probably all seen that unhappy kid or frazzled parent sifting through trash for a lost retainer. If we’re really unlucky, we might have been that unhappy kid or frazzled parent sifting through the unpleasant remains of third period lunch hour. But getting tossed isn’t the only risk these appliances face. Read on for ways to keep your retainer (and your parent!) happy.

• Keep Your Retainer With You

Always carry a retainer case. If you automatically put your retainer in its case when you’re eating, you are much more likely to remember it then if it has been wrapped up in a napkin on your lunch tray. And, if the worst happens, much more likely to recover it in one piece.

Choose the brightest colored case you can live with, so you will have an easier time locating it if need be, and discuss how to label the case to get it back safely to you--just in case.

• Keep Your Retainer Intact

You might think if you put your retainer in your backpack, or purse, or saxophone case, or athletic bag, it will be safe. It will not. Retainers are designed to be tough enough for everyday wear, but being tossed on the floor while inside a backpack is not everyday wear. Always put your retainer back in its (brightly colored) case before packing it away.

Retainers can warp if they are exposed to heat, so keep them away from potential heat sources like stoves, microwaves, and washers and dryers. Even your car dashboard can become hot enough to warp your retainer. And never use boiling water to clean them.

Finally, your dog might find your retainer to be the #bestchewtoyever, so be sure to put it in a spot pets can’t reach when you’re not wearing it.

• Keep Your Retainer Clean

Just like plaque can build up on your teeth, minerals and calcium can build up on your retainer. Different types of retainers require different cleaning methods, so talk to Dr. Allen about how to keep your retainer clean and bacteria-free. We will be happy to give you instructions on the best way to take care of your particular appliance. And don’t forget to clean your case regularly!

Accidents will happen, of course. If your retainer is lost or damaged, call our San Diego office as soon as possible. We might be able to fix minor damage, and, if needed, we can replace a lost retainer quickly.

Your time in braces is over, but your teeth are still stabilizing in their new, healthy positions. Wearing your retainer regularly is the final step in producing the beautiful smile you’ve worked so hard for. Keep your retainer clean, keep it safe, and keep it with you, and you can enjoy that smile now and for years to come!

Traditionally, January is a great time to choose some bad habits you’d like to lose, and some good habits you’d like to develop. If one of your goals this year is to help make your orthodontic treatment as efficient and successful as possible, we have the perfect resolutions for your New Year.

• Brush after every meal

If you’ve grown up brushing for two minutes twice each day and flossing regularly, you have been doing everything right! But now that you have braces or aligners, you should plan on brushing after every meal and each snack.

Food particles can stick to wires and brackets, which is nothing to smile about. Worse, plaque can be easy to miss around your braces, which can lead to enamel erosion and possible cavities. Brushing after eating is the best way to eliminate food particles and plaque from braces and enamel, but if you can’t brush, be sure to rinse well with water.

Patients with aligners benefit from brushing, too, to keep food particles and sugary or acidic beverages from remaining trapped around the teeth after the aligners are replaced. If you absolutely can’t brush, remember to rinse carefully with water after eating and drinking and before replacing your aligners.

• Watch your diet

Changes to our diets are probably one of the most common resolutions, so it’s no surprise we have recommendations for your dental diet. Dr. Allen and our team are happy to provide you with a comprehensive list of the foods that can harm your wires and brackets, or which are especially difficult to keep from sticking to your appliance and enamel. No tempting caramels or buttery ears of corn are worth damage to your braces! Follow the guidelines for braces-friendly foods, and you’ll help keep your treatment problem-free and on track.

• Do your part

Wearing braces or aligners can require some interactive work on your part. If you are supposed to wear your aligners for 22 hours a day, be sure to follow those instructions to keep your treatment plan on schedule. If you have bands that you need to wear with your traditional braces to help correct your bite, wear them as directed. And never try to make up for lost time by doubling your bands—this can actually be harmful to your teeth.

If we can help demonstrate or explain anything you need to do at home, don’t be afraid to ask!

• Keep your retainer case handy

When you finish orthodontic treatment, you will probably have a retainer to help your teeth maintain their new, healthy alignment. Keep your retainer healthy by making sure to use your case whenever you’re not wearing it. Bent, broken, or lost retainers should be repaired or replaced as soon as possible to avoid changes in that smile you’ve worked so hard for.

• Keep your appointments

The more you stay on schedule, the faster you will achieve your ideal smile. And if you have a problem between appointments, call our San Diego office! Broken braces and aligners aren’t effective and can delay your progress, so let us know if you think you might need to see us earlier than scheduled. Finally, don’t forget your regular exams and cleanings at your dentist’s office.

Traditionally, the beginning of the year is a great time to choose some bad habits you’d like to lose, and some good habits you’d like to develop. But you needn’t wait for that New Year’s Eve countdown clock.  Adopting these orthodontic resolutions at any time of year will keep you on track for a lifetime of beautiful, healthy smiles.