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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.

If this is your first winter with braces, you might be wondering how to make the best of the holiday season. Dr. Gina Pinamonti and our team have some suggestions for happy and healthy holiday smiles.

Treat Yourself

Winter means tasty holiday treats, and just because you wear braces doesn’t mean you need to step away from the holiday table! You can enjoy your favorites if you remember to check your list for the usual problem foods. Hard, crunchy, chewy, and sticky items? Naughty list.

• Crunchy vegetables on the appetizer plate
• Nuts
• Hard rolls
• Candy canes and other hard sugar treats
• Caramels, Toffee and other sticky candies
• Pecan pie
• Fruit cake

Luckily, there are plenty of nice alternatives.

• Turkey and ham—remember, small pieces are best
• Dressing and stuffing
• Mashed potatoes
• Soft breads and rolls
• Pumpkin pie—but skip a tough crust!
• Cheesecake
• Soft cookies and cakes
• Soft chocolates

We’re happy to provide recommendations for braces-friendly holiday foods. And we don’t expect you to turn down every sweet treat this season.  Just be sure that if you enjoy something sugary, brush carefully after indulging.

Express Yourself

While you’re decking the halls, or pinning up the New Year’s balloons and streamers, or even choosing a great holiday outfit, don't forget that your ligatures can be decorative as well as functional.

• Celebrating Christmas? Red and green bands around your brackets are jolly and traditional.
• How about Hanukkah? Try blue and white!
• Love the season? Icy silvers and pale blues are a frosty statement—and can have the benefit of making your teeth look whiter, as well. Snowy white? The arctic idea is great, but white bands can sometimes make teeth look more yellow, or become stained themselves.
• Glam New Year? Gold adds sparkle to your smile, but can bring out any yellow tones in your teeth. Silver might be the perfect choice, because it is generally neutral with enamel shades.

Check out our ligature colors for the best possible choices for your teeth and coloring. Take advantage of these options to create a fresh, confident look for the season. Give others the gift of your smile!

Look After Yourself

Winter comes with some special reminders about your dental health.

• Winter sports are a great way to celebrate the snow and ice, but be sure to protect your teeth and braces. If you enjoy skiing, snowboarding, ice skating, hockey, or any other winter activities, talk to us about why a mouth guard is so important.
• While you enjoy your winter break, don’t forget to keep up with your dental routine. And because ‘tis the season for holiday treats, be especially careful to clean your teeth and braces after sweet desserts and snacks. Don’t forget to floss!
• What do cold breezes and hot chocolate have in common? They can both trigger tooth sensitivity! While some sensitivity is normal after an adjustment, if you find you are experiencing tooth sensitivity more often or more strongly than you usually do, give us a call. It might be something as simple as brushing habits, or you might need to see your dentist.

If you have any questions about your braces, in this season or any other, just ask when you visit our Pittsburg, KS office. Your beautiful, healthy, and confident smile can make this the most wonderful time of the year!

Let’s talk about mouthguards.

We could talk about how important wearing a mouthguard is when you lead an active life. If you play sports, ride bikes, skateboard, or participate in many other kinds of exercise, mouthguards protect your teeth, mouth tissue, and jaws from accidents. 

Or we could talk about how wearing a mouthguard while you’re wearing braces has extra benefits. Besides its normal protection, your guard helps protect your brackets and wires from damaging contact, and your delicate mouth tissue from impact with your braces.

But we’re not going to talk about any of these important topics today. Instead of looking at how your mouthguard protects you, today we’re going to look at how you can protect your mouthguard.

If you want your guard to last longer, work better, and stay (and smell!) cleaner, some basic tips make all the difference.

• Keep your guard clean.

This can’t be stressed enough. Without a good cleaning routine, your guard can become discolored, develop an unpleasant odor, and even cause illness. Not very appealing, right? Happily, keeping your mouthguard clean isn’t difficult.

When you wear your guard, the same plaque that is present in your mouth makes itself at home in your appliance. And when your guard is in its case, that dark, moist environment makes it a perfect breeding ground for all kinds of bacteria, viruses, and fungi.

As soon as you take your mouthguard out, rinse it off. Brush with a soft toothbrush to remove all the plaque, saliva, or food debris that might be lingering in your appliance. (If you are on the playing field, in the park, or at some other inconvenient location, rinse it and brush as soon as you can.) Toothpaste can help get your guard its cleanest, but can be too abrasive for some appliances.

Once you’ve cleaned it, let your guard air dry in a clean spot for about 30 minutes. Air drying helps prevent bacterial growth. After your guard has dried, return it to its case.

Once a week, you might need to give your mouthguard a good soak in a mouthwash or other dental cleaning solution.

Since cleaning instructions can be different depending on which type of mouthguard you have, be sure to follow our instructions if you have a custom guard, or clean as directed by the manufacturer if you have a store guard.

• Keep it safe.

When your mouthguard isn’t in your mouth, it should be in its case. Floating loose in your locker or tumbling around in your gym bag puts your guard at risk for breakage and bacteria.

And don’t forget to clean your case thoroughly every few days and air dry it as well. Bacteria, viruses, fungi, mold, and other unwelcome guests can collect in your case, too.

• Keep it only as long as it’s in good condition.

You can purchase mouthguards from sporting or drug stores, or Dr. Gina Pinamonti can make you a mouthguard designed to fit your teeth and braces perfectly. These appliances are made to be strong and durable, but they’re not indestructible. Over time they can wear down or become damaged, especially if you treat them carelessly.

Bacteria can lurk in dents and cracks, and you can cut your mouth on rough, sharp, or broken edges. But if your mouthguard isn’t fitting properly, don’t resort to self-help! Trying to repair, reshape, or trim your appliance yourself is not a good idea, because it might affect its fit and protective ability.

Any sign that your guard isn’t fitting properly or shows signs of wear and tear could mean it’s time for a replacement. You can replace a store model, or see Dr. Gina Pinamonti about replacing or repairing your custom guard. A mouthguard that doesn’t fit, doesn’t keep you safe.

Take care of your guard, and it will take care of you. The reward for the small amount of time and effort you put into caring for your mouthguard is braces that will last through your treatment at our Pittsburg, KS office and a smile that will last you for a lifetime. Those are benefits we can talk about all day!

When you get braces as a child, you usually present the orthodontist with a blank canvas—newly erupted, perfect permanent teeth, just waiting to be aligned. But if you are a bit older, your canvas might already be a bit busy, with fillings, crowns, perhaps even a missing tooth. Can Dr. Gina Pinamonti still work with that more complicated picture? Yes!

• Fillings

Many of us have acquired a filling or two. Normally, an old filling shouldn’t interfere with new braces. Large fillings, however, might call for spacers. These small rubber bands are inserted between two teeth as needed to create enough room for bands and brackets, and are generally put in place a week or two before you get your braces. They frequently fall out on their own as the space between the teeth gets a bit wider.

• Crowns

If you have had a root canal or any other dental treatment that left you with a crowned tooth, no need to be concerned. A special dental adhesive can be used to adhere brackets to crowns.

• Implants

If you have or would like to get an implant, this is a time to coordinate with your orthodontist and dentist or oral surgeon. Sometimes an implant can anchor your appliance, and sometimes it’s best to keep the spot open until your orthodontic work is completed. Once in place, an implant will not have the mobility of a tooth, so it’s always best to make sure your doctors can create a schedule that will work for both the installation of the implant and the positioning of your braces.

• Healthy Teeth and Gums

Before you begin orthodontic work, talk to your dentist. If you need a filling or crown, are considering a dental implant, have symptoms of gum disease, or are looking at any other dental concerns, you should work with your dentist first. Healthy teeth and gums are the very best foundation for orthodontic treatment at any age.

If you are wondering whether Dr. Gina Pinamonti can help you achieve the smile you’ve always wanted, talk to us when you visit our Pittsburg, KS office! Your past dental work will be just one of the many variables we take into consideration when we’re planning your future of picture-perfect smiles.