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When does an underbite need surgery? The short answer is: when Dr. Viney Saini 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. Viney Saini 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 Clarksburg, MD and Frederick, MD 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. Viney Saini 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. Viney Saini 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.

Most parents know that routine dental care should begin during their child’s toddler years. And many assume they must wait until their child has all of his or her permanent teeth to visit Dr. Viney Saini for an initial orthodontic consultation.

The ideal age for an orthodontic evaluation is age seven. At that age, your child will have a mixture of adult and baby teeth for Dr. Viney Saini and our team at Viney P. Saini Orthodontics to make a determination about whether any problems are present. Typically the first molars have come in by the time your child turns seven, giving us an opportunity to check for malocclusion, also known as “bad bite.” Also, by the time your child reaches the age of seven, the incisors have begun to come in, and problems such as crowding, deep bites, and open bites can be detected.

When Dr. Viney Saini and our team perform an evaluation on your child at an early age, you get one of two positive outcomes. Although treatment usually will not begin until one to five years after the initial evaluation, it’s still helpful in determining whether your child has any problems with the jaw and teeth early when they are still easy to treat. Earlier treatment can also cost less to correct a potential problem than delayed treatment.

Early evaluation, of course, may signal a need for early treatment. For some children, early treatment can prevent physical and emotional trauma. Aside from spurring years of harmful teasing, misaligned teeth are also prone to injury and are detrimental to good oral hygiene.

If your child is approaching age seven, or has already surpassed his or her seventh birthday, it is time to schedule an appointment for an initial examination at Viney P. Saini Orthodontics.

The weather out there might be frightful for most of us, but not for you! You’ve been waiting all year for a fresh coat of powder and all the outdoor sporting activities winter brings. But before you grab those ski poles, strap into that snowboard, lace up those skates, or dust off that sled, be sure to remember one more essential piece of gear—your mouthguard!

Mouthguards aren’t just for contact sports. While all that lovely new snow looks like powder, it doesn’t feel like it when you land hard. If there’s a chance of a fall or an impact in any sport, there’s a chance you can suffer dental injuries.

Falls or collisions can result in chipped, broken, or dislodged teeth. Your mouthguard will help protect your smile from these accidents, and also works to protect you from biting your tongue and mouth in case of impact. It can even reduce the chance of jaw injuries.

Luckily, finding a mouthguard that works for you is even easier than finding the perfect board or the best wax for your skis. You have several options to choose from:

• Ready-made appliances. These are available in drugstores and sporting goods stores, but come in pre-formed sizes, so they might not provide the best fit.
• The “boil-and-bite” model. This mouthguard form is placed in hot water. You then bite down while it is pliable to shape it to your mouth and teeth.
• Custom mouthguards. These guards can be fabricated just for you. They are molded 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, a custom mouthguard can be your best option for preventing an injury to your mouth and your braces. Talk to Dr. Viney Saini if you are interested in a guard fitted specifically for you.

When you visit our Clarksburg, MD and Frederick, MD office, let’s discuss all the best ways to keep your teeth and mouth protected before you set out for winter sports. And then when you’re ready to go? Let it snow!

Orthodontic braces are used to straighten the teeth, which not only creates a more pleasing appearance, but also helps prevent tooth decay and other oral health problems. Braces are only effective when they are properly cared for, however. Certain foods, for example, are better suited for individuals who have braces, as opposed to hard and sticky foods that can cause damage. So, what types of foods should you or your kids eat to protect dental appliances?

The best foods to eat with braces are those that are not high in sugar and do not require excessive chewing. For breakfast, try eggs, yogurt, bacon, wheat toast, or oatmeal. Lunch may steer toward a banana rather than an apple, a salad without nuts, and a glass of water. If you are looking for some after-school snacks for your kids, consider baked tortilla chips with salsa and guacamole, or try string cheese with fruit.

A healthy dinner can include most types of vegetables, so long as they are cooked to an appropriate softness. Pair that with a lean protein, such as fish or chicken, and follow up with dessert. Just be sure to brush afterward!

Post-Tightening Foods

As braces begin to adjust the alignment of the teeth, our team at Viney P. Saini Orthodontics will periodically tighten them to continue the alignment process. After tightening occurs, the teeth may be sore and sensitive to certain foods. During this time, it is best to eat soft foods. Examples include:

• Pudding
• Mashed potatoes
• Soup
• Ice cream
• Cottage cheese
• Peas
• Pancakes
• Pasta

Foods to Avoid

Anyone who wears braces – whether fixed or removable – should avoid excessive snacking and should aim to eat a healthy and balanced diet. It is also important to avoid foods that could cause damage to the braces, such as:

• Hard candies
• Gum
• Nuts
• Popcorn
• Certain raw vegetables (for example, carrots)

Considerations

Regardless of what types of foods you eat with braces, it is important to keep the crevices between the teeth and around the braces very clean. That means brushing and flossing after meals to prevent the build-up of plaque and decay. Not only can failing to do so damage the teeth, but it can also cause discoloration.

Have more questions about orthodontic treatment? The Viney P. Saini Orthodontics staff is always ready to answer all of your questions and help you get the most out of the treatment plan prescribed for you by Dr. Viney Saini!