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You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

• Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

• Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

• Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Dr. Douglas and Larry Harte at our Sparta or Livingston, NJ office for all the information you’ll need!

When does an underbite need surgery? The short answer is: when Dr. Douglas and Larry Harte 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. Douglas and Larry Harte 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 Sparta or Livingston, NJ 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. Douglas and Larry Harte 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. Douglas and Larry Harte 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.

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! Dr. Douglas and Larry Harte 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 Sparta or Livingston, NJ 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?

It’s the most wonderful time of the year, with the holidays around the corner, and visions of sugarplums and other tasty desserts dancing in everyone’s head.

Except, this year you have braces. This means some of your favorites might be on the naughty list. What to avoid? The same kinds of foods that you avoid now: anything hard, crunchy, sticky, or chewy. This means some of the traditional holiday favorites will have to be postponed for a while:

• Pecan Pies

A festive tradition! But, nuts in a sticky sugar filling? Time to create a new dessert tradition that will be less of a problem for wires and brackets.

• Gum Drops, Caramels, & Toffees

These super-sticky, chewy treats are definitely hazardous for your braces. Find a soft candy alternative instead.

• Candy Canes & Hard Candies

Hard, sticky, and crunchy? Let’s save these candies for decorating the gingerbread house this year.

So what can you eat?

Luckily, there are plenty of dessert options that are nice to wires and brackets! Let’s look at some festive treats that also easy on your braces.

• Cupcakes & Cakes

Soft, moist cupcakes and cakes should be no problem. Fruitcake, with its sticky dried fruits and nuts, should be avoided—which is a perfect excuse if you’re not a fan!

• Pudding

Puddings are a smooth easy-to-eat treat, so enjoy! But know your puddings. Some traditional holiday puddings are more cakelike and contain the same chewy ingredients as fruitcakes, so the same advice applies—if it contains dried fruits and nuts, this is not the dessert for you.

• Soft Candies

The same soft chocolates that you could eat for Halloween are good now, too! If it’s just not the holidays without peppermint, smooth peppermint patties are the way to go.

• Pies & Other Favorites

Pecan pies are a firm no, but velvety desserts like pumpkin pie, cream pies, and cheesecake should be fine. And be sure you pick only the soft cookies in the holiday cookie exchange!

When you visit our Sparta or Livingston, NJ office, ask Dr. Douglas and Larry Harte about these and other holiday treats to make sure they are safe for you and your braces. And one more word before we all dig in—too much sugar in your diet creates the perfect conditions for cavity-causing bacteria. But there’s no need to give up all your holiday treats.

Just as you would brush after any dessert without braces, be sure to brush now that you have them. Be especially careful to remove any sugary residue from around your brackets, between your teeth, and near your gum line. And it’s always best to eat sweet treats as part of a meal, to reduce the effect of sugars and acids on your teeth.

Oh, and about those sugarplums? These candies originally contained no soft, tender plums at all. They were actually tiny treats created by coating a seed or nut center with a hard sugar shell. But you don’t need to worry about missing out on Victorian treats—with all of your delicious and braces-safe dessert choices, you’ll be enjoying a very sweet holiday season!