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When does an underbite need surgery? The short answer is: when Roger Elton 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?

Roger Elton 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 Parker or Aurora, CO 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 Roger Elton 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 Roger Elton 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.

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

• Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

• Floss threaders are flexible hoops that help you thread floss behind your wires easily.
• Precut floss strands use a stiff tip at one end for threading floss through wires.
• Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
• Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Parker or Aurora, CO office, Roger Elton can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

It’s the season of giving and the start of a new year. What better time to gift yourself with the orthodontic treatment you’ve always wanted?

Orthodontic treatment isn’t just for children and teenagers. In fact, adults make up a significant—and growing—number of new patients looking forward to beautifully aligned teeth and a healthy bite.

And because today’s orthodontic treatments are more comfortable, take less time, and are less visible than ever before, they are a great fit for your busy adult life. You also have many more options from which to choose, including:

• Traditional Braces

Traditional braces are a proven method of aligning your teeth and bite, can be more economical than other options, and are often most effective in treating complicated orthodontic issues.

If traditional braces are best for your needs, you’ll be happy to hear that today’s braces are better than ever. Brackets are smaller. Innovative wire technology makes the orthodontic process even more efficient. And with self-ligating brackets, there’s no need for those colorful little bands around each bracket to hold those wires.

• Ceramic Braces

If you’re looking for something more inconspicuous, consider ceramic brackets. These ceramic or porcelain brackets are color-matched to your teeth, and, especially used with clear bands and lighter wires, create a less visible profile.

• Lingual Braces

This is your most discreet option, because these braces are located on the inside of the teeth. Lingual braces are custom designed, so they can be more expensive, and treatment can take a bit longer, but they are perfect for those who want invisible braces for personal or professional reasons.

• Clear Aligners

Clear aligners can treat many orthodontic conditions, including some complicated malocclusions. Your orthodontist can let you know if these removable, comfortable, and subtle aligners will work for you.

Adult orthodontics can give you the confident smile you’ve always wanted, which is reason enough to seek orthodontic treatment at our Parker or Aurora, CO office. And perfectly aligned teeth and a healthy bite have dental benefits as well as mental benefits!

• Reduce the Risk of Cavities and Gum Disease

Crooked and overlapping teeth are harder to keep clean. Getting in between the teeth to remove all the food particles and plaque can be difficult even with the most careful brushing and flossing. Built up plaque increases your risk of cavities, irritates delicate gum tissue, and causes gum disease.

• Prevent Tooth and Jaw Injuries

If your jaws have never fit together properly, you’ve probably experienced at least some of the consequences of a malocclusion, or bad bite. Worn and cracked teeth, damaged fillings and crowns, jaw pain, headaches, difficulty breathing—all of these problems can be caused by a misaligned bite.

If you’ve always wanted orthodontic treatment, talk to Roger Elton to discover the possibilities. A more confident appearance, reduced risk of cavities and gum disease, a comfortable, pain-free bite—there’s no better gift to give yourself than a lifetime of healthy smiles!

Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Roger Elton decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Roger Elton will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

• Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
• Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
• Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Roger Elton will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our Parker or Aurora, CO team about which retainer option will be best for making sure that this smile lasts a lifetime.