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When does an underbite need surgery? The short answer is: when Drs. Magda Barnard & Lee Erickson 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. Magda Barnard & Lee Erickson 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 Bedford, NS 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. Magda Barnard & Lee Erickson 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. Magda Barnard & Lee Erickson 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.

If you have been thinking about undergoing orthodontic treatment to straighten teeth or correct jaw alignment, the first step is scheduling an orthodontic consultation at Bedford Orthodontics. During the consultation we will actively listen to your concerns and address all of your questions, as well as discuss a treatment options that would best suit you or your child's situation.

Here are the top five questions that most patients want answered during their initial orthodontic consultation:

• Can I benefit from orthodontic treatment, and if so, how long will it take?
• How frequently will my appointments be scheduled?
• Can I expect any pain when getting braces? (Ask Drs. Magda Barnard & Lee Erickson about the ways we address pain management).
• Will I need to have teeth extracted, headgear, expansion appliance, etc.?
• How much will it cost and what payment options do you offer?

Visit our website for more answers to your questions prior to your initial consultation. Drs. Magda Barnard & Lee Erickson and our team at Bedford Orthodontics are happy to answer all your questions and concerns, and excited to explain all aspects of your treatment plan, as well as the expected outcome. We believe your orthodontic experience should be comfortable, hassle-free, and most importantly, leave you with the smile you've always wanted.

If you’ve been hiding your smile because you have crooked teeth or gaps between your teeth, it’s time to consider orthodontic treatment with Drs. Magda Barnard & Lee Erickson. Preparing for treatment is an important part of getting the smile you want.

Basic exams

The first step of preparation is the examination. An oral exam and X-rays taken at our office are necessary to identify potential problems and ensure the right steps are taken to prepare for orthodontic treatment at Bedford Orthodontics.

Drs. Magda Barnard & Lee Erickson will first examine your teeth and take X-rays to determine if it is necessary to extract any teeth or additional work is necessary before braces are possible. You will be prepared for the next step of treatment after your exam is complete and potential problems are identified.

Model for bite

The next step in preparing for orthodontic is taking a plaster model of the mouth. With the model, Drs. Magda Barnard & Lee Erickson will be able to determine how the jaw is aligned so that appropriate adjustments can be made to the mouth and jaw with braces.

Depending on the situation, the model may be used to help evaluate your jaw and make decisions about appropriate treatment for your specific needs. Drs. Magda Barnard & Lee Erickson can create a model of your mouth with the bite indentation that is taken during preparation.

Extracting teeth

If it is determined that a tooth extraction is necessary, then the final step of preparing for orthodontic treatment is the removal of teeth. Only Drs. Magda Barnard & Lee Erickson can determine if it is necessary to remove any teeth before moving forward with the procedure to put on braces.

When your teeth are crooked, have a gap, or otherwise make you unhappy, orthodontic treatment at Bedford Orthodontics may be an appropriate solution. Although it may take time to prepare for the actual procedure, making the decision to seek treatment can provide the opportunity to show the world a beautiful smile.

For more information about orthodontic treatment and its benefits, or to schedule a consultation with Drs. Magda Barnard & Lee Erickson, please give us a call at our convenient Bedford, NS office!

School can present a few issues when it comes to caring for your braces and mouth, since you won't have the luxury of the time and tools you have at your disposal while you're at home. But if you head to school prepared, you shouldn't have any trouble keeping your braces and mouth in great shape. Below is a list of helpful tips to care for your braces throughout the entire school year.

• Bring a kit that includes all of your oral health care items. This is a seriously smart thing to do and probably the most important of all the tips. Pack things like a toothbrush, floss, wax, retainer case (if needed), a mirror, a small cup for rinsing, a small bottle of water (if you don't already have some water with you), and some OTC pain medicine or a natural pain remedy. Keep the kit in your locker or backpack. Having all these items on hand will save you a lot of trouble and discomfort, and also ensure you don't have anything unsightly stuck in your braces or teeth!
• Take advantage of breaks and lunchtime. After eating lunch is a great time to pop into the restroom and give your braces and teeth a once over to make sure you don't have any food debris caught in them and to tend to any sore spots. If you've just had your braces adjusted, you may have soreness on your gums or cheeks. This is where the wax you packed will come in handy.
• Eat the right food for your braces. Avoid all the foods that wreak havoc on your braces like gum, candy, popcorn, hard chips, apples which aren't cut into wedges, nuts, beef jerky, ice, etc. You know the foods we're talking about; you've heard it enough already. Steering clear of these foods will help you prevent any possible mishaps with your braces, like breaking a bracket or wire, which is the last thing you want happening at school.

If you follow these tips and also keep up on your oral health routine at home, you'll be maximizing the effectiveness of your braces and making them as comfortable as possible. Do you have questions about caring for your braces during the school day? Ask Drs. Magda Barnard & Lee Erickson or anyone in our Bedford, NS office and we'll gladly help you out!