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When does an underbite need surgery? The short answer is: when Dr. Gina Pinamonti 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. Gina Pinamonti 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 Pittsburg, KS 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. Gina Pinamonti 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. Gina Pinamonti 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.

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 Dr. Gina Pinamonti 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 Pittsburg, KS 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.

Nowadays, many adults are taking advantage of getting straighter teeth with braces. Dr. Gina Pinamonti 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 Pittsburg, KS office today to set up a consultation. Dr. Gina Pinamonti will help you choose the best option so you can be on your way to a straighter, more confident smile!

Just because it’s cold out there doesn’t mean you’ll give up keeping fit and active! Winter is the season for some of our favorite team sporting activities, and when you’re donning your protective gear, don’t forget to protect your teeth as well.

• Basketball

This sport actually tallies one of the highest counts of dental injuries. Running, jumping, and diving for the ball on an unforgiving court can lead to tooth and jaw injuries.  And for every ten men on the floor, it seems like there at least 50 flailing elbows in the paint.

• Hockey

Notorious for the toll it takes on teeth, hockey is a game of sticks, ice, and whizzing pucks. And when your sport’s penalties include the terms hooking, slashing, and tripping, the more protection, the better.

• Skiing

When you are flying down the slopes, combining powdery snow and speed, mouth protection is a good idea. This also applies to snowboarding and other snow sports.

• Wrestling

Grappling and pinning in close quarters can lead to unintended injuries after accidental contact with the mat or your opponent.

Different uniforms, different equipment, and different playing fields, but all these sports have one thing in common—the easiest way to protect your teeth while playing them is with a mouth guard.

Mouthguards generally come in three forms:

• Over the counter, ready-made appliances. These are available in drugstores and sporting goods stores, but might not be a comfortable fit as they are pre-formed sizes.
• The “boil-and-bite” option is a mouthguard form placed in hot water. You then bite down to shape it to your mouth and teeth.
• Custom mouthguards can be fabricated just for you through our Pittsburg, KS office. These appliances are designed to fit your individual mouth and teeth, so provide a better fit and better protection. They are also usually more durable and more comfortable. If you wear braces, you definitely need a custom mouthguard to prevent an injury to your mouth or braces caused by an ill-fitting appliance.

Whether you play on a team or pursue individual athletic activities, keeping safe as you keep fit is your first priority. We would be happy to discuss your mouthguard options for any sport, any time of year.