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When does an underbite need surgery? The short answer is: when Dr. Groisser 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. Groisser 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, Gaithersburg, and Hagerstown 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. Groisser 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. Groisser 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.

One exciting part about wearing braces from Village Orthodontics is getting to choose the colors of your rubber bands. Orthodontists place elastic bands, or ligatures, over each bracket to secure the archwire in place. These rubber bands may be individual or connected, depending on your mouth’s needs. From Dr. Groisser, you have the option of choosing the color of your elastics, which are changed about once every month at every visit. Our offices keep a color wheel handy to help you choose which ones suit you best!

Children and teens often enjoy picking different colors each month to express their creativity and coordinate their braces with outfits. Decorating your mouth with your favorite colors is fun for kids and takes some of the stress out of wearing braces. Adults who wish for subtlety have color options that blend in with the metal brackets and archwire. Common choices for adults include silver, clear, and gray tones.

Common Color Combinations for Rubber Bands

With individual ligatures for each bracket, you may choose different color combinations for special events. You can have alternating colors or place an entire rainbow over your teeth. Here are a few options to consider:

• School spirit colors
• Favorite sports team colors
• Patriotic colors
• Holiday themes

Some patients choose only one color to match their mood, personality, or favorite outfits. The palette of choices allows you to make bold statements with your braces or go for subtler tones that blend in with the metal structures. Keep in mind that bright colors make your teeth look whiter, while lighter shades, such as yellow and white, may cause your teeth to appear less bright.

What Your Rubber Band Color Says About You

• Red tones indicate that you are ready for action and take charge of your life with aggressive, forward-thinking steps.
• Blue tones are calm and relaxing. You are conservative and exhibit integrity when dealing with situations.
• Green tones represent growth and balance. You are level-headed and look for opportunities to grow emotionally and spiritually.
• Purple tones attract creative energies. You like to have fun and use your imagination in every aspect of your life.
• Orange tones indicate that you are optimistic and thrive in social situations where communication is open.
• Pink is a romantic color that represents a caring personality. You also enjoy having fun with silly games and endless laughter.

A vital step in your oral health routine is flossing. We hope our patients at Village Orthodontics maintain good oral hygiene, including daily flossing between each visit to our Clarksburg, Gaithersburg, and Hagerstown office. A toothbrush is not always enough to get to the hard-to-reach areas of your mouth. When food remains between your teeth, bacteria starts to grow and will break down your enamel. This is where flossing comes in!

Should you floss before or after brushing?

Whatever your personal preference, you may floss before or after you brush your teeth. When you floss first, you can brush away any leftover dislodged food debris from your teeth. On the other hand, when you brush first, you will loosen the plaque between your teeth, which makes flossing more effective.

The essential aspect is that you floss thoroughly by using a fresh strand of floss and make sure to get between every tooth. Even if your teeth look and feel clean, don’t skip flossing or plaque will begin to build up on your teeth.

When is the best time to floss?

Although you should brush your teeth at least twice a day, Dr. Groisser and our team recommend flossing your teeth thoroughly once a day. Many people prefer to floss before bed, so that plaque doesn’t sit between their teeth all night.

What kind of floss should I use?

You may choose between interdental cleaning picks or flexible floss strands to perform your daily flossing routine. If you have permanent oral appliances or restorations, be sure to follow the flossing instructions provided to you.

Do you need help flossing?

If you’re having trouble flossing or have questions about which floss is best for your teeth, contact our Clarksburg, Gaithersburg, and Hagerstown office and we can provide you with support. Be sure to keep up with your daily flossing routine, and we will see you at your next appointment!

You’re going to the game! And no matter which sport you follow, there’s so much to enjoy—the best athletes, exciting play, hometown pride—and those delicious concession stands! But if you’re wearing braces, your team spirit might be flagging. Here are a few ideas to help keep your food choices out of foul territory.

You know that you should avoid the foods that can damage braces or stick around your wires and brackets. This means any snacks that are sticky, chewy, hard, or crunchy are benched. So most of the traditional game foods—peanuts, popcorn, nachos, licorice—are just not safe for traditional metal or ceramic braces. Let’s save those for next season.

So what is on the program? You still have many great choices.

• Ice Cream. A favorite that’s easy on your braces (no nuts or caramel, please). If you want a healthier option, try frozen yogurt or a smoothie.
• Hearty Snacks. Pretzels and pizza can be too thick and chewy. Go for the mac and cheese, chili, or deli meats on soft bread. And remember, small bites! Check with us to see if hamburgers and hot dogs are safe for your braces.
• Soft Candies and Cookies. Licorice, caramels, and crunchy cookies are out, but soft chocolate bars and moist, tender cookies are still on the menu.
• Sodas and sports drinks can create a sugary and/or acidic environment which can damage enamel over time. If you do indulge, try to rinse with water ASAP.

Stadium and arena menus contain a lot of starches and sugars, which stick to braces and fuel cavity-causing bacteria. So it’s best to go easy on the snacks. But you don’t have to give up a half-time treat entirely—just enjoy in moderation and be sure to brush thoroughly when you get home.

If you wear clear aligners, your choices are simpler. You can remove your aligners, eat normally, and clean your teeth thoroughly before replacing them. But one flag on this play—remember that you’re supposed to wear your aligners for a set number of hours each day. You don’t want to be putting your treatment behind schedule if the game goes into triple overtime. Keep your eye on the clock, and you should be fine.

Dr. Groisser and our Clarksburg, Gaithersburg, and Hagerstown team are always happy to recommend the best food options for your individual orthodontic treatment, and we can help you select a roster of safe and healthy choices. You might miss out on a few of your favorite sports snacks right now, but let’s remember the true fan’s motto: There’s always next year! Taking care of your braces and teeth means faster treatment and healthier teeth. Your All-Star smile will be worth it!