Our Blog

When does an underbite need surgery? The short answer is: when Dr. Iwei Huang 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. Iwei Huang 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 Chicago 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. Iwei Huang 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. Iwei Huang 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.

It’s the most wonderful time of the year, with the holidays around the corner, and visions of sugarplums and other tasty desserts dancing in everyone’s head.

Except, this year you have braces. This means some of your favorites might be on the naughty list. What to avoid? The same kinds of foods that you avoid now: anything hard, crunchy, sticky, or chewy. This means some of the traditional holiday favorites will have to be postponed for a while:

• Pecan Pies

A festive tradition! But, nuts in a sticky sugar filling? Time to create a new dessert tradition that will be less of a problem for wires and brackets.

• Gum Drops, Caramels, & Toffees

These super-sticky, chewy treats are definitely hazardous for your braces. Find a soft candy alternative instead.

• Candy Canes & Hard Candies

Hard, sticky, and crunchy? Let’s save these candies for decorating the gingerbread house this year.

So what can you eat?

Luckily, there are plenty of dessert options that are nice to wires and brackets! Let’s look at some festive treats that also easy on your braces.

• Cupcakes & Cakes

Soft, moist cupcakes and cakes should be no problem. Fruitcake, with its sticky dried fruits and nuts, should be avoided—which is a perfect excuse if you’re not a fan!

• Pudding

Puddings are a smooth easy-to-eat treat, so enjoy! But know your puddings. Some traditional holiday puddings are more cakelike and contain the same chewy ingredients as fruitcakes, so the same advice applies—if it contains dried fruits and nuts, this is not the dessert for you.

• Soft Candies

The same soft chocolates that you could eat for Halloween are good now, too! If it’s just not the holidays without peppermint, smooth peppermint patties are the way to go.

• Pies & Other Favorites

Pecan pies are a firm no, but velvety desserts like pumpkin pie, cream pies, and cheesecake should be fine. And be sure you pick only the soft cookies in the holiday cookie exchange!

When you visit our Chicago office, ask Dr. Iwei Huang about these and other holiday treats to make sure they are safe for you and your braces. And one more word before we all dig in—too much sugar in your diet creates the perfect conditions for cavity-causing bacteria. But there’s no need to give up all your holiday treats.

Just as you would brush after any dessert without braces, be sure to brush now that you have them. Be especially careful to remove any sugary residue from around your brackets, between your teeth, and near your gum line. And it’s always best to eat sweet treats as part of a meal, to reduce the effect of sugars and acids on your teeth.

Oh, and about those sugarplums? These candies originally contained no soft, tender plums at all. They were actually tiny treats created by coating a seed or nut center with a hard sugar shell. But you don’t need to worry about missing out on Victorian treats—with all of your delicious and braces-safe dessert choices, you’ll be enjoying a very sweet holiday season!

Why do you chew gum? Perhaps because it’s a habit that comes with some healthy benefits. Chewing a stick or two reduces the urge to snack between meals. It’s a substitute for behaviors like nail biting that you’d like to change. It might even give you fresher breath after those tuna sandwiches in the cafeteria.

And, as it happens, chewing sugarless gum actually offers a few dental benefits as well! The act of chewing increases saliva production. Saliva washes away food particles, neutralizes acids in the mouth that can damage enamel, and even bathes the teeth in essential minerals that help strengthen weakened enamel. We’re talking about sugar-free gum here, of course, because regular gum will just bathe your teeth in sugar—no one’s idea of a dental benefit!

So why not open that pack and enjoy? Because, despite the many positive reasons you can think of for chewing gum, sometimes gum can have a negative impact on your braces.

• A Sticky Situation

Keeping your braces clean can be a bit of a challenge. That’s why you have special toothbrushes, flosses, and interproximal brushes to get rid of food particles that stick around after you eat. And, while any food can get caught in your braces, sugared gum, because it is so sticky, can stick to appliances much more easily and much more thoroughly than even sugar-free gum. You might be able to remove gum residue with regular brushing and flossing, but, worst case scenario, you might be looking at gum firmly stuck in the brackets or between the brackets and wires.

• Gumming Up the Works

Chewing gum can also affect your treatment time if the action of chewing causes your arch wire to bend. When your wire isn’t providing the proper shape or the right amount of tension, your teeth won’t get to where they need to be as quickly and efficiently. No piece of gum is worth discovering at your next appointment that you haven’t made any progress for weeks due to a damaged wire. And since chewing gum can also lead to loose brackets and bands, you might wonder if this sticky habit is ever worth the trouble it can cause.

• Something to Chew Over

Before you decide, talk to Dr. Iwei Huang! Chewing sugarless gum increases saliva production, which can help wash away food particles from your mouth and your braces. As an added benefit, the action of chewing for a few minutes after an appointment has been shown to reduce the discomfort of an adjustment. Because today’s braces are stronger and more durable, and sugarless gum much less likely to stick to them, we can let you know if chewing gum might be acceptable or even desirable depending on your specific treatment plan and your appliance.

Talk to us at your next appointment at our Chicago office about gum chewing, and we’ll give you the very best recommendations for keeping your teeth healthy, your braces clean, your appliance intact, and your treatment plan on track. Even if gum needs to be off the menu for a while, what you’ll get in return—the best and fastest path to your beautiful smile—will be well worth it!

When you’re busy at school or work, when you’re on vacation, when you’re on the road to adventure—preparation helps everything go smoothly. Especially when the unexpected happens! So, how can you be prepared for any orthodontic and dental situations which might arise? By creating these useful—and portable—travel kits.

Everyday Basics Kit

Dentists recommend brushing twice a day and flossing at least once each day for clean and healthy teeth. But after a long day at school or work with no time to head home before your date, or a garlic-heavy lunch in the cafeteria, or a dash from the classroom to after-school activities, you might feel like there’s no time like the present to give your smile a bit of a boost.

Be prepared with a small travel bag filled with these easy-to-carry basics to get you through your busy day with clean teeth, fresh breath, and a confident smile:

• Toothbrush and case—and do make sure your case is ventilated so your brush can air dry. Bacteria love a closed, damp environment!
• Toothpaste
• Mini-bottle of mouthwash
• Small mirror—to check for any lunch leftovers
• Dental floss—to remove any lunch leftovers. Use braces-friendly dental floss if you have traditional braces.
• Dental Wax—to cover any uncomfortable wires or brackets
• Interproximal brushes—to remove food particles from around your braces and between your teeth
• Extra rubber bands
• Aligner/Retainer case—keep your aligner or retainer safe and clean while you’re eating

Flight Gear

Getting set to travel by air again after this long lay-over? Your basic kit will do the job with just a few minor additions and alterations.

• A travel version of your manual or electric toothbrush and travel case
• Plug adapter or voltage converter as needed for your electric brush if you’re visiting another country
• Quart size, resealable plastic bag to hold your carry-on supplies. Toothpaste and mouthwash are included in the list of items which need to fit carry-on guidelines.
• Travel-size toothpaste—3.4 oz (100 ml) or smaller tube size. (And an almost-empty regular size tube doesn’t count!)
• Travel-size mouthwash—also in a 3.4 oz (100 ml) or smaller container
• Our Chicago office’s phone number. In case of emergency, Dr. Iwei Huang can give you advice on how to handle any problem which might arise when you’re far from home.

Looking for Adventure?

If you’re camping in the forest, leaving for the lake, going for a road trip, or heading out on any travel adventure, you’ll be bringing the dental care basics, of course. We’d also like to recommend some items to take along in the event of a dental emergency while you’re away from home:

• Dental mirror
• Cotton rolls
• Over-the-counter pain relief—including a tube of oral pain relief gel
• Ice pack
• Dental wax—this handy item not only protects against sharp wires, it can cover the sharp edges of a broken bracket
• Temporary fillings—to protect your sensitive tooth if a filling or crown is lost
• Tooth preservation kit—to protect a dislodged tooth in case it can be reimplanted. (This means seeing a dentist very quickly, usually within 30 minutes of the accident.)

And, if you’ll be mountain biking, water skiing, or enjoying any activity where there’s potential for impact, don’t forget to pack your mouthguard!

Preparation is key to eliminating a lot of stress in our daily lives, and who couldn’t use a bit of stress-relief these days? Make room in your bag, locker, desk, luggage, or backpack for some portable, lightweight dental necessities. Be prepared to share your confident, healthy smile no matter what life has in store!