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When does an underbite need surgery? The short answer is: when Dr. Syrah Quraishi 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. Syrah Quraishi 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 Indianapolis 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. Syrah Quraishi 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. Syrah Quraishi 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.

If you’ve been following your dentist’s advice, you know that you should be devoting two minutes twice a day to gentle, thorough brushing, and floss carefully at least once a day. It’s automatic. It’s habit. You’re in the zone. Now that you have braces or aligners, though, it’s time to step up your game!

Removing Food Particles

No one wants to worry about food particles stuck in braces right after lunch—or, worse, noticed hours after lunch! Because food tends to stick around brackets and wires, Dr. Syrah Quraishi and our Indianapolis team recommend brushing after a meal. Not only will you be confident in your smile, you’ll be improving your dental health.

But why?

Better Plaque Removal

Plaque is a sticky film containing acid-producing bacteria. These acids lead to weakened enamel and, eventually, cavities. Careful brushing with a fluoride toothpaste helps eliminate plaque. But as you may have discovered, it can be more difficult to clean around brackets and wires. Brushing after eating will help keep plaque from forming on your enamel, and using the right tools (floss made for braces and interproximal brushes) will help clean plaque more effectively.

But what about aligners?

If you wear clear aligners, you take them out when you eat. This avoids the problem of food particles trapped in brackets and difficulty brushing around wires. But this doesn’t mean you are home free. Brushing after every meal is also a good idea when you wear aligners.

Our teeth have an organic way to help remove food particles, acids, and bacteria between brushings—saliva! Your aligners, while covering your teeth, decrease their exposure to saliva. It’s really important, then, to make sure you brush after eating. Otherwise, food particles and acids can remain on your teeth after you replace your aligners, increasing the risk of enamel erosion and decay.

Brushing helps keep your aligners clear as well. If you notice aligner discoloration, this could be the result of food residue such as tomato sauce or coffee that remained on the teeth after a meal. Anything that stains your enamel can stain your aligners. And don’t forget about plaque. Plaque can stick not only to your enamel but to your aligners as well. If you notice that your aligners are cloudy, or have an unpleasant odor, talk to us about the best way to keep them their cleanest.

Make a Plan

So, what can you do to make brushing more convenient during a busy day? Be prepared! Keep a small kit with you containing a travel brush, a small tube of toothpaste, floss, and an interproximal brush for quick cleanings when you’re out and about, and you’ll never have to worry about your smile.

Of course, there are occasions when it’s just not possible to brush. At times like this, whether you have traditional braces or aligners, it’s a good idea to rinse well with water after meals or snacks, and brush as soon as you can.

Start your new dental routine now, and soon it will be automatic. An everyday habit. Your new comfort zone. After all, taking a few extra minutes from your day to brush after every meal will be well worth it when you end your orthodontic treatment with a smile that is as healthy as it is beautiful!

If this is your first winter with braces, you might be wondering how to make the best of the holiday season. Dr. Syrah Quraishi and our team have some suggestions for happy and healthy holiday smiles.

Treat Yourself

Winter means tasty holiday treats, and just because you wear braces doesn’t mean you need to step away from the holiday table! You can enjoy your favorites if you remember to check your list for the usual problem foods. Hard, crunchy, chewy, and sticky items? Naughty list.

• Crunchy vegetables on the appetizer plate
• Nuts
• Hard rolls
• Candy canes and other hard sugar treats
• Caramels, Toffee and other sticky candies
• Pecan pie
• Fruit cake

Luckily, there are plenty of nice alternatives.

• Turkey and ham—remember, small pieces are best
• Dressing and stuffing
• Mashed potatoes
• Soft breads and rolls
• Pumpkin pie—but skip a tough crust!
• Cheesecake
• Soft cookies and cakes
• Soft chocolates

We’re happy to provide recommendations for braces-friendly holiday foods. And we don’t expect you to turn down every sweet treat this season.  Just be sure that if you enjoy something sugary, brush carefully after indulging.

Express Yourself

While you’re decking the halls, or pinning up the New Year’s balloons and streamers, or even choosing a great holiday outfit, don't forget that your ligatures can be decorative as well as functional.

• Celebrating Christmas? Red and green bands around your brackets are jolly and traditional.
• How about Hanukkah? Try blue and white!
• Love the season? Icy silvers and pale blues are a frosty statement—and can have the benefit of making your teeth look whiter, as well. Snowy white? The arctic idea is great, but white bands can sometimes make teeth look more yellow, or become stained themselves.
• Glam New Year? Gold adds sparkle to your smile, but can bring out any yellow tones in your teeth. Silver might be the perfect choice, because it is generally neutral with enamel shades.

Check out our ligature colors for the best possible choices for your teeth and coloring. Take advantage of these options to create a fresh, confident look for the season. Give others the gift of your smile!

Look After Yourself

Winter comes with some special reminders about your dental health.

• Winter sports are a great way to celebrate the snow and ice, but be sure to protect your teeth and braces. If you enjoy skiing, snowboarding, ice skating, hockey, or any other winter activities, talk to us about why a mouth guard is so important.
• While you enjoy your winter break, don’t forget to keep up with your dental routine. And because ‘tis the season for holiday treats, be especially careful to clean your teeth and braces after sweet desserts and snacks. Don’t forget to floss!
• What do cold breezes and hot chocolate have in common? They can both trigger tooth sensitivity! While some sensitivity is normal after an adjustment, if you find you are experiencing tooth sensitivity more often or more strongly than you usually do, give us a call. It might be something as simple as brushing habits, or you might need to see your dentist.

If you have any questions about your braces, in this season or any other, just ask when you visit our Indianapolis office. Your beautiful, healthy, and confident smile can make this the most wonderful time of the year!

Getting your child excited about braces is a lot like: A) convincing a grumpy toddler that it’s time to take a nap? B) convincing a teenager to stop texting during dinner? C) convincing your husband to eat his peas? The answer, obviously, is all of the above.

And that’s why you may need a few thoughtful ways to get your child on board with braces.

1. Throw a pre-braces party. It can’t be just any party, however, but a Willy Wonka celebration of candy, chips, gum, and all the sticky and sweet foods your child won’t be able to indulge in during the time he or she is wearing braces. Promise a post-braces celebration, too, and watch as your child’s eyes widen at the thought of an all-you-can-eat junk food buffet.
2. Encouraging phrases like “braces aren’t eternal, but your straight smile will be” can go a long way.
3. If your daughter is worried about getting picked on because of braces, then name-drop some A-list celebrities who have worn them. The list includes Cameron Diaz, Kelly Clarkson, Dakota Fanning, and Gwen Stefani.
4. Emphasize that braces today aren’t the same as they were in the Stone Age. From clear ceramic braces to different-colored braces, more options are available. Braces can be cool accessories to express a personal style.
5. To get your child to embrace braces, you need to sing the praises of beautiful teeth, even if that means pointing out how crooked your teeth are because you never got braces.