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When does an underbite need surgery? The short answer is: when Dr. Kathleen Chan and Dr. Ivy Chen 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. Kathleen Chan and Dr. Ivy Chen 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 Andover 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. Kathleen Chan and Dr. Ivy Chen 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. Kathleen Chan and Dr. Ivy Chen 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.

Well, of course, they already are working for you—as an essential part of the alignment process. Rubber bands, also known as elastic ligatures, are used to secure the wires inside your brackets. But bands can be more than functional. Since the ligatures around each bracket are replaced when you visit our office, why not use that opportunity to choose a new color scheme as well?

• Make a Statement

Bands offer a chance to coordinate your braces to an interest, team, or event. Are you a swimmer? Maybe cool blues and turquoises appeal to you. Batman forever? Black and yellow. (That will work for beekeepers, too.) Have a favorite sports team? Choosing team colors will support your team with every smile. Love your school? Show your spirit by wearing bands in your school colors. Favorite time of year? Celebrate by selecting festive bands in holiday colors.

• Suit Your Mood

Fiery reds and oranges, tranquil blues and greens, millennial purples and pinks, or exuberant neon—you know that there are just some colors that suit your personality. Showcase that personality with your choice of band color. And if your mood changes, choose shades that express a completely different side of you.

• Coordinate Your Colors

Match your bands to your eye color, your makeup, or the clothing colors you choose most often. If there’s a color profile that works for you, make your bands a part of it. If you don’t want everything matching, complement your coloring or clothing with a different but coordinating shade for a cohesive effect.

• Keep a Low Profile

Most adults will stick with a monochromatic set of bands, and this might be a look that appeals to you as well. Grey and silver bands will blend nicely with silver braces. If you have clear or white brackets, you might want to test out which bands will be least noticeable. Clear bands can become discolored, and white bands can make teeth look darker. If there’s a band which mimics your own tooth color, this will be the choice for you.

• Make Color Theory Work for You

Certain colors and tints bring out the best in your tooth color and work with your skin tones. White and yellow bands might make teeth appear duller, and any shade combination that resembles food particles (greens, browns, and black) is probably not a look you’re going for. Have fun with a color wheel and decide which colors you find most flattering.

Make your bands more than a tool—make them an accessory. There are so many colorful options available that you are bound to happen on a color scheme that just suits you. And if you change your mind? Change it up during your next visit to our Andover office!

Sports are great for children for a variety of reasons. Children can develop their motor skills, learn how to solve conflicts and work together, and develop their work ethics. As a parent, you may recognize the benefits of sports, but also naturally worry about your child’s health and safety. Your job goes beyond providing a water bottle and making sure your child follows the rules of the game.

Although you may not think of your child’s teeth first when you think about sports, accidents can happen that affect your children’s teeth. A stray hockey stick, an errant basketball, or a misguided dive after a volleyball are examples of ways a child could lose a tooth. In fact, studies show that young athletes lose more than three million teeth each year.

Becoming a Better Athlete to Protect Teeth

Becoming a better athlete involves refining skills, learning the rules of the game, and being a good sport. These components are not just about winning. They are also about safety. Young athletes who are better ball-handlers and who are careful to avoid fouls and penalties are less likely to have harmful contact with the ball, teammates, or opponents. Children who are better roller-bladers are less likely to take a face plant into the blacktop, and more likely to save their teeth. Being a good sport and avoiding unnecessary contact is one way to protect teeth.

Proper Protective Equipment for Teeth

If your child is in a sport that poses a high threat to teeth, it is essential for your child to wear a mouthguard. Mouthguards fit your child’s mouth and consist of soft plastic. Dr. Kathleen Chan and Dr. Ivy Chen can custom fit a mouthguard if generic ones are uncomfortable. While children may resist wearing a mouthguard initially, your persistence in insisting that they wear it should be enough to convince them. A helmet or face mask provides additional protection.

While prevention is best, rapid treatment can improve the situation if your child does happen to lose a tooth during sports. Rapid implantation can work in about ten percent of cases. To learn about ways to save a lost tooth, contact our Andover office.

Orthodontists and dentists both help patients improve their oral health, but in different ways. Dentistry is a broad medical specialty that deals with the teeth, gum, nerves, and jaw, while orthodontics is a specialty within dentistry that focuses on correcting bites, occlusion, and the straightness of teeth. One important difference is that all orthodontists like Dr. Kathleen Chan and Dr. Ivy Chen are dentists, but not all dentists are licensed orthodontists.

How are they similar?

The main similarity between a dentist and orthodontist is that they both focus on oral care. An orthodontist can work in a dental office and provide the same care as a dentist. So in this respect, they are quite similar. They are both considered doctors, and deal with the teeth and gums.

How are they different?

There are more differences than similarities. An orthodontist requires additional schooling as a dental specialty; the situation is similar to a doctor who obtains additional schooling to become a surgeon. Another difference is that orthodontists specialize in helping patients with the alignment of their teeth, improving their bite, or fitting them for corrective braces and devices. If a patient has an overbite, a dentist will refer him or her to an orthodontist.

Dentists typically encourage good oral hygiene and provide services related to:

• Tooth decay
• Root canals
• Gum disease
• Crowns
• Bridges
• Veneers
• Teeth whitening

Orthodontists are dentists that specialize in the alignment of teeth, and provide services related to:

• Misaligned teeth
• Crowded teeth
• Overbite
• Underbite

What an orthodontist can help with

Orthodontists help with crooked teeth, but they assist patients with other issues as well. These include overbites and underbites, crossbites, spaces between teeth, overcrowding of teeth, and the treatment of temporomandibular disorders (TMD). Additional problems with the jaw also need to be treated by an orthodontist.

While a dentist may be trained to provide orthodontic care in addition to extractions, TMJ treatments, and fillings, trusting your smile to an orthodontist can better balance the different procedures you require.

To learn more about the difference between dentists and orthodontists, or to schedule an initial consultation with Dr. Kathleen Chan and Dr. Ivy Chen, please give our team at Chan & Chen Orthodontics a call at our convenient Andover office.