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When does an underbite need surgery? The short answer is: when Dr. Tony Skanchy 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. Tony Skanchy 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 Sandy, UT 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. Tony Skanchy 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. Tony Skanchy 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.

Sometimes food that’s good for your body isn’t necessarily the best for your teeth. Dr. Tony Skanchy and our team want you to know which healthy foods can harm your teeth and gums, and what steps you can take to continue enjoying these foods, even when you’re dieting.

When you begin to substitute empty calories with whole foods, make sure you also remember to focus on your dental health. The majority of people tend to switch out sugary foods in favor of fruits and vegetables when they diet.

It’s worth knowing that most fruits are highly acidic and composed of natural sugars. Some of the highly acidic fruits to watch out for include apples, grapes, strawberries, pineapples, blueberries, oranges, and grapefruit. Moderation is key here, as with all other things. Fruits can be a great source of energy to help you through your day, but try not to overdo them.

Often, people also incorporate more leafy greens into their diets, which mean plenty of salads. Salad dressing is another item you’ll want to watch out for. Many dressings are filled with vinegars and sweeteners that include harmful acids, which change the pH of your mouth. When your mouth shifts from alkaline to acidic, your smile also turns to a higher risk for erosion and decay.

Rather than get rid of these foods altogether, simply change what you do after you eat them. Rinse your mouth out with water, brush your teeth, or eat alkalizing foods after consuming these acidic foods. Healthy alkalizing foods include dairy products such as eggs and yogurt, or any type of vegetable.

If you have questions regarding your current diet and its effect on your oral health, please contact our Sandy, UT office and speak with a member of our staff. If you’ve begun to make changes in your diet toward a healthier lifestyle, we hope these tips can help your make positive changes to your oral health. Our team at Alta View Orthodontics wants a healthy lifestyle to be a top priority in your life.

Now that you’re a teenager, you have a lot more responsibility and independence. Choosing high school classes and electives. Getting a driver’s license. Landing your first job. And those new responsibilities extend to your dental health as well!

• Braces

If you’ve just gotten braces, you might feel a bit overwhelmed. Learning how to brush and floss effectively, attaching rubber bands several times a day, keeping track of your hours if you’re wearing clear aligners—it can seem like a lot. But you can do it! With time and practice, caring for your braces will become just another part of your daily routine. Dr. Tony Skanchy and our team are here to make sure you have all the information and tools you need to succeed. The most important thing to remember is that the better you follow our instructions, the quicker and more effective your orthodontic treatment will be.

• Retainers

If you’ve successfully completed your orthodontic treatment, dealing with your retainer should be a piece of cake! We will give you clear instructions on how long each day you should wear your retainer. Sticking to this schedule is really important--if you don’t wear the appliance as directed, you can undo some of the progress you’ve worked so hard to make. And when you’re not wearing your retainer, be sure it has a safe life outside your mouth. Keep it in a protective case, and keep it someplace where the puppy/the washing machine/the cafeteria trash bin won’t find it.

• Mouthguards

If you have a mouthguard for sports or athletic activities, wear it! Whether you have an over-the-counter device or a custom fabricated guard, it won’t do you any good hiding in your locker. A mouthguard cuts down on tooth and facial injuries caused by falls, physical contact, or other accidents that might happen in your active life. And if you wear braces, ask about a mouthguard designed to fit around them. These custom devices protect your braces and your mouth.

Finally, remember that sticking with your dental routine—two minutes of brushing morning and night and thorough flossing each day—will keep your gums and teeth healthy throughout your teen years. And, if you have any questions about your dental health in general, or a specific dental concern, give our Sandy, UT office a call! We’re here to work with you for a lifetime of beautiful smiles.

After all your hard work, and months of orthodontic treatment, the big day is finally here—your braces are coming off! What you want to see: beautiful, straight teeth perfectly aligned to create a comfortable, healthy bite. What you don’t want to see: a collection of whitish spots dotting the enamel around your gum line or outlining the spot where your brackets used to be.

What are these spots? Can they be removed? And, most important, how do you avoid them?

Decalcification

Those white spots are caused by decalcification, or the removal of the minerals, especially calcium and phosphorus, that strengthen our enamel. How does this removal take place? When bacteria and plaque remain on the teeth, they produce acids that eat away at these minerals. The result is a weakened, discolored white spot in the enamel. Unfortunately, because many orthodontic patients don’t brush thoroughly around their braces, decalcification is an all-too-common problem.

Treating Decalcification

You might need cosmetic dentistry to eliminate or reduce white spots on the enamel. In some cases, they will fade over time, or teeth whitening can help. In more stubborn cases, tooth bonding or veneers can cover the affected enamel.

Preventing Decalcification

But, obviously, prevention is always better than treatment. Here are some of the ways to keep your enamel healthy and looking its best:

• Brush thoroughly after every meal.

Getting rid of the bacteria and plaque on your enamel and around your gum line will greatly reduce your chances of decalcification—and cavities. Brush after every meal, and talk to us about the best products and techniques for cleaning your teeth and appliances. And be sure to spend the extra time you’ll need for brushing around your braces.

• Floss

Even though it can be more difficult to floss with brackets and wires, it’s essential for removing plaque. We have suggestions for special flosses designed for braces wearers, and how best to use them. A water flosser can be helpful for reducing plaque if other flossing methods aren’t working.

• Use fluoride toothpaste

Fluoride actually helps remineralize our teeth, replacing the important minerals that have been lost to acid attacks. We might also suggest remineralizing toothpastes or a fluoride rinse.

• Watch your diet

Acidic foods increase the acidity levels in your mouth, sugars give bacteria the fuel they need to produce acids, and sticky foods allow bacteria to remain on teeth and braces longer. We’ll give you suggestions on the best foods to keep your teeth healthy (and your braces intact) while you’re undergoing treatment.

• Have your teeth cleaned regularly

Your dental professional will be able to remove plaque and tartar that home brushing has missed.

• Work with us!

If we let you know that you need to spend more time on your cleaning routine, or that you need to be more thorough when you brush and floss, take our suggestions to heart. We are happy to show you the most effective way to clean around your braces. Dr. Tony Skanchy can recommend the best dental products for your specific needs. We can suggest rinses and toothpastes that will help. We’ll let you know how much time you should spend brushing and how often.

If you have any questions at all about keeping your teeth and braces their cleanest, we are here to help. Always feel free to talk to our Sandy, UT team about concerns you might have about decalcification, discoloration, or any other potential problems. We are want to make sure that when your braces come off, you have every reason to smile!