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When does an underbite need surgery? The short answer is: when Dr. Betsy Meade 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. Betsy Meade 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 Ypsilanti, MI 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. Betsy Meade 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. Betsy Meade 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.

Your trusty manual toothbrush has been with you from pre-school through high school—well, obviously not the same manual toothbrush, because that would be seriously unhygienic—but it’s the kind of toothbrush you’re used to and comfortable with.

Now, though, you’re off to college, and your lifestyle will be changing. Late night study sessions complete with study session snacks. Getting caught up in a project and making dinner from dorm vending machines. Grabbing fast food on the way to the practice field, or work-study job, or evening class. You get the point—meals can be hectic, unscheduled, and less than tooth friendly.

And if you’re wearing braces or aligners, you know you need to keep on top of brushing more than ever. It’s challenging to brush away cavity-causing plaque when it sticks around brackets and wires. And with aligners, teeth don’t benefit as much from the constant cleansing action of saliva, so it’s really important to brush away plaque and food particles before you replace the aligners after eating.

Maybe it’s time to consider an electric toothbrush. After all, anything that can make your life easier and more efficient during busy college days deserves a spot in your dorm room.

• Electric Brushes Are Effective

The most important reason to switch to an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Electric toothbrushes offer several design options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What these technologies all have in common is the ability to remove plaque far more efficiently than we can on our own, because electric brushes provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, compared to the hundreds we can achieve by hand.

There might be a bit of a learning curve to discover how to use your brush around wires and brackets. Ask us for the best method of using an electric brush with your braces, and check out brush heads specifically designed for orthodontic work.

If you use buttons with aligners, electric toothbrushes should be safe to gently clean around the buttons to remove built-up plaque. It’s usually best to stick with a manual brush for cleaning your aligners themselves—we’re happy to give you your best cleaning options, no matter which brush you choose.

You know by now what your brushing habits are like. If you tend to be a bit cavalier with your brushing and flossing, make sure you set yourself up for success. Because you have better things to do during semester breaks and summer vacations than visiting Dr. Betsy Meade!

• Electric Brushes Can Make Life Easier

Several of today’s electric brushes come with options designed to do more than simply remove plaque. They can let you know if you’ve brushed for the recommended two minutes and remind you when it’s time to replace the brush head. They can even alert you if you’re brushing too hard, which is especially important when you’re wearing braces.

Want more from your electric brush? Some models offer apps that can map out just where you’ve brushed, in case there are a few spots that often get overlooked. Or provide different brushing modes for daily cleaning, deep cleaning, whitening, and more. Or come with a travel case that can recharge while you’re busy exploring the world—or going home for a visit.

In the end, it’s up to you. Do some independent study and research the toothbrushes that will give you the best results for your individual brushing habits. You might not need or want a brush with all the technological bells and whistles.

If you’re comfortable with your manual brush and you get good grades when you visit our Ypsilanti, MI office, stick with it. But if you think you might benefit from the ease and efficiency of an electric toothbrush, if an electric toothbrush makes your teeth and gums healthier and your smile brighter, that’s extra credit worth pursuing.

“Yes,” you’re thinking, “I shouldn’t be chewing sugary, sticky gum while I’m wearing my braces.” Or perhaps, “I should check with my orthodontist to see if this sugar-free gum is safe for my braces.” And these are both great thoughts—but today, we’re thinking about gums of a different sort!

While you’ve been taking care of your teeth with regular brushing and flossing, you’ve also been taking care of your gums. And now that you’re wearing braces, your gums need a bit of special attention to keep them their healthiest.

We tend to think of gum disease as an adult problem. In fact, periodontitis, or serious gum disease, is one of the most common chronic infections in the adult population. But young gums need care, too! Gingivitis, a milder form of gum disease, is unfortunately a common problem for both children and adults.

Gingivitis is an inflammation of the gums caused by the build-up of plaque and tartar. When plaque builds up, it irritates delicate gum tissue. And while gingivitis is not as serious as periodontitis, the symptoms caused by this disease are nothing to smile about:

• Redness
• Tenderness and soreness
• Swelling
• Bleeding
• Bad Breath

If you’re already feeling a little tender or swollen after an adjustment, the added discomfort caused by gingivitis is the last thing you want. But even worse, neglected gingivitis can lead to more serious infections of gum and even bone tissue. Luckily, gingivitis is both preventable and treatable with proper dental care.

So, how to protect your gums? We have some suggestions.

• Brushing Better with Braces

It can be hard to brush around your brackets and wires, but keeping these areas free of food particles and plaque makes for healthy gums—and fewer cavities! There are specially designed manual toothbrushes made for braces wearers, and tiny interproximal brushes that can reach tight spaces. Or, perhaps an electric toothbrush will do a better job for you. Just be sure to brush after each meal for the most complete removal of bacteria and plaque.

• Learn New Flossing Techniques

You might wonder how on earth you’ll get in between your teeth with your wires and brackets in the way. We have the answers! We know the best techniques for flossing your specific braces, and we’ll recommend specially designed flossing tools to make the job easier. Water flossers can also be a great help for cleaning in tight spots. Be sure to make flossing part of your daily routine—you’ll be able to remove plaque from places brushing just can’t reach.

• Rinsing? Recommended.

Talk to Dr. Betsy Meade about the best dental rinses for reducing plaque and tartar, or how gargling can help prevent irritation. And drink water! Water helps wash away plaque and bacteria, and is a great way to rinse teeth and braces if you absolutely can’t brush after eating.

• Keep up with Professional Cleanings

Be sure to keep up with your regular dental exams and cleanings. Your dentist or hygienist will be able to remove any plaque or tartar build up that home brushing can’t handle.

We want your time in braces to be as healthy—and comfortable—as possible. If you have any gum discomfort, swelling, or sensitivity, give our Ypsilanti, MI office a call. With prompt action, gingivitis can be treated, and with careful attention to your cleaning routine, gingivitis can be prevented altogether. Something to think about!

Our grandmothers and grandfathers, our moms and dads—we’ve known them our whole lives. So, why are they so hard to shop for?

If your older family members have all the sweaters, socks, and scents they need, consider a gift that can make life a bit easier and perhaps a lot healthier—an electric toothbrush!

• Easy Efficiency

The most important reason to choose an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Using a manual brush is not just a matter of applying toothpaste and scrubbing. Proper technique means short brush strokes at a 45-degree angle for the outer and inner surfaces of the tooth, thoroughly cleaning the uneven chewing surfaces of the molars, and brushing the inside of the front teeth with gentle vertical strokes. Meticulous cleaning of all these surfaces can be difficult, especially for people with dexterity issues.

Electric toothbrushes offer several options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What they all have in common is the ability to remove plaque far more effectively than we can on our own, because they provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, as opposed to the hundreds we can achieve by hand.

• Comfortable Control

An electric toothbrush can be not only more efficient, but also more comfortable for older brushers. For those with arthritis, limited mobility, injuries, or other health conditions, the larger handles can be easier to control and much more grip-friendly. And, with the work being done by the brush head, users avoid repetitive hand and wrist motion.

Also, the pressure applied to teeth and gums with an electric brush is designed to clean thoroughly while protecting the mouth. Heavy-handed manual brushing can irritate delicate gum tissue and even damage enamel over time. With an electric brush, users only need to guide it along teeth and gums as it supplies all the power needed. There are even pressure sensors available to warn users that their brushing is too vigorous.

• Apps, Anyone?

If your grandfather likes to keep things old school, a basic model with a convenient two-minute timer and several cleaning modes will offer all the bells and whistles he needs. But if your nana has more Instagram followers than you do, consider a more tech-savvy option.

Several of today’s electric brushes come with features designed to make brushing even more effective. They can let her know if she’s brushing long enough, alert her if she’s brushing too hard, and remind her that it’s time to replace the brush head. Some models link to handy apps that will map out just where she’s brushed, in case there are a few spots that get overlooked. Or choose a model which comes with a travel case that can recharge while she’s busy seeing the world.

Okay, all that being said, we’ll admit it—a toothbrush might not be the most glamorous gift your grandparent unwraps on that special day. But helping a favorite family member brush more effectively and comfortably while improving dental health? That’s a gift that keeps on giving!