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When does an underbite need surgery? The short answer is: when Drs. Hutcheson, Train, Goodall, Lewis 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. Hutcheson, Train, Goodall, Lewis 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 Richardson or Carrollton 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. Hutcheson, Train, Goodall, Lewis 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. Hutcheson, Train, Goodall, Lewis 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.

Nowadays, many adults are taking advantage of getting straighter teeth with braces. Drs. Hutcheson, Train, Goodall, Lewis and our team love to help patients create the dazzling, confident smile they’ve always wanted.

Our adult patients usually fall into two categories: some had braces in the past but didn’t wear their retainers, while others are brand-new to wearing braces. Either way, both groups want the same thing: straighter teeth and a beautiful smile!

You will have several options for getting braces, depending on your financial situation and how quickly you would like your treatment to finish. Traditional metal braces are a less-expensive option and can help people who have severely crooked teeth. But many adults may not prefer this option because they dislike the appearance of metal brackets.

If you’re concerned about how you’ll look, we offer clear ceramic braces that aren’t as visible. These are more expensive than metal braces, and patients need to be careful with colored drinks that can stain them, such as coffee or red wine.

Another popular option is a clear aligner treatment called Invisalign®. This type is practically invisible; it uses a series of aligners that are customized to fit your teeth. The process of straightening your teeth can last anywhere from three to 18 months. For people who have extreme bite problems or crowded teeth, a different method may work better.

Don’t hesitate to call our Richardson or Carrollton office today to set up a consultation. Drs. Hutcheson, Train, Goodall, Lewis will help you choose the best option so you can be on your way to a straighter, more confident smile!

September is National Childhood Injury Prevention Month, and Drs. Hutcheson, Train, Goodall, Lewis and our team at Children's Dental Specialists are excited to share some tips to keep your child safe. Childhood is a time when dental injuries are common. Even a simple fall on the playground at recess can lead to a lost or broken tooth. What can you do as a parent to protect your child’s teeth in addition to his or her head and bones? These tips will help you prevent mouth and dental injuries to your kids.

First, use common sense when your children play sports. An estimated 13 to 39 percent of oral-facial injuries occur when children are playing sports. Make sure your child wears a face guard, mouthguard, and helmet as appropriate. Contact sports, such as football, require this gear, so insist that it gets worn.

Next, teach your children not to walk or run with things in their mouths. This is particularly difficult for toddlers and preschoolers, who love to explore the world orally. Insist that items are removed from the mouth whenever the child is in motion, and try to redirect the child to softer items for oral stimulation.

For small children, be careful when you put a spoon or fork in the mouth. While this won’t damage teeth, it can damage the delicate skin between the lips and gums or under the tongue. Allow your child to direct his or her own feeding; never shove a spoon in your child’s mouth if he or she is not interested, to avoid this type of injury.

Finally, make sure your children are seen regularly by Drs. Hutcheson, Train, Goodall, Lewis. Regular dental checkups will keep the teeth clean, strong, and healthy, and limit the risk of injuries.

If your child is injured in spite of your best efforts, contact our Richardson or Carrollton office right away. Quick action may be able to save a missing tooth, and a quick response on your part will limit the long-term effects of the injury.

It's the end of summer, and fall is just around the corner. Soon the temperatures will cool down, the leaves will start to change, and Drs. Hutcheson, Train, Goodall, Lewis and our team at Children's Dental Specialists are sure that you’ll soon be thinking about Halloween costumes and Thanksgiving plans in no time. But wait! First, we want to know about your favorite parts of the summer! Did you go on a wonderful family trip? Did you pick up a new hobby? Did you try to spend as much time outside and in the sun as possible?

Share your favorite memories, stories, or photos with us by leaving a comment below or on our Facebook page.