Our Blog

When Does an Underbite Need Surgery?

November 25th, 2020

When does an underbite need surgery? The short answer is: when Dr. Grey 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. Grey 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 Bothell, WA 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. Grey 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. Grey 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.

Can You Chew Gum and Wear Braces?

November 18th, 2020

Well, of course you can chew gum and wear braces. But, should you chew gum and wear braces? That can be a sticky question.

For many years, the answer was a firm “No.” Not only did our favorite chewables literally gum up the (dental) works, but they were filled with loads of the sugar that cavity-causing bacteria love to feed on. The result? A much better chance of damage to your orthodontic work, and a higher risk of cavities near your brackets and wires.

But times, and gum recipes, change. Today’s sugar-free gum provides us with some new ideas to chew over.

  • Sugarless gum is much less sticky than regular gum, so it is much less likely to stick to your appliance. If there is any chance that gum will damage your wires or brackets, we’ll let you know that it’s best to wait until your braces are off to indulge.
  • Some orthodontic patients find that their jaws and ligaments are less sore if they chew gum for a few minutes after an adjustment.
  • Most important, studies suggest that chewing sugarless gum might actually help prevent cavities from forming. How is that possible?

Because chewing gum increases our production of saliva! Okay, we don’t normally find saliva an exciting, exclamation-point-worthy topic, but let’s look at the dental benefits:

  • Saliva washes away food particles and bacteria. And because braces can trap food when we eat, it’s great to have some help washing away any meal-time souvenirs.
  • Saliva helps neutralize acids in the mouth. The acids found in foods and produced by oral bacteria lead to cavities, so diluting and neutralizing their effects provide important protection for our enamel.
  • Saliva helps bathe the teeth in minerals that can actually rebuild weakened enamel. Acids in the mouth attack minerals in the enamel such as the calcium and phosphate that strengthen our teeth. Fortunately, saliva provides calcium, phosphate, and fluoride that can actually help rebuild weakened enamel.

So, should you chew gum and wear braces? The real question is, should you chew gum while you’re in braces? Dr. Grey and our team are more than happy to provide the right answer for you! Talk to us at your next visit to our Bothell, WA office about the potential benefits and drawbacks of dentist-approved sugarless gum. Depending on the kind of gum you choose and the kind of orthodontic work you are having done, the answer just might surprise you.

The Best Brush of the Day

November 11th, 2020

Imagine that you’re only going to brush your teeth once tomorrow. Don’t worry, we know you would never skimp on your dental hygiene like that, but let’s just pretend for a moment. When would be the best time to brush? When you wake up? During the day? Or perhaps before you go to bed?

Actually, whenever you choose to brush, you’ll receive important overall dental benefits as well as specific benefits tied to the time of day. Let’s explore your daily schedule to see why.

Brushing in the Morning

Brushing when you first jump out of bed produces several positive results.

  • Cleaning plaque from your teeth

Plaque is a sticky film made up of oral bacteria, food particles, and saliva. As you sleep, these oral bacteria multiply and produce acids which attack the minerals in your enamel, leaving weak spots which, over time, can become cavities. Brushing removes these bacteria and acids from your enamel before they cause serious harm.

Moreover, plaque hardens if it’s left undisturbed, turning into tartar in a relatively short time. And once plaque becomes tartar, it must be removed by a dental professional. Brushing first thing in the morning removes this plaque buildup and helps prevent tartar from forming.

  • Fresh breath

That bacterial growth we mentioned? It’s also responsible for morning breath. If nothing else, brushing when you wake up means greeting a fresh day with fresh breath, and that’s reason enough to pick up your brush in the morning.

Brushing During the Day

Brushing after meals and snacks also has a lot to recommend it.

  • “Leftovers” lead to cavities

Foods, especially foods rich in sugar and carbohydrates, are converted by oral bacteria into acids which weaken enamel and lead to cavities. When food particles remain in the mouth after a meal, bacteria have more time and more fuel to manufacture these acids.

  • Acidic foods also affect your teeth

If you have eaten something acidic, such as citrus fruits, sodas, or pickled anything, the acids from these foods can temporarily weaken the mineral strength of your enamel. But brushing immediately after eating or drinking acidic foods can damage weakened enamel. Better to rinse well with water and brush after half an hour or so.

  • When you wear braces

One of the first things you discover when you get your braces is that you might need to brush more often. In fact, it’s best to brush after every meal and even every snack while you’re in braces.

Why? First, because no one wants to smile with food particles sticking to brackets and wires. Even more important, though, the filmy plaque which sticks to your enamel can be harder to remove with those brackets and wires in the way. Since plaque causes weakened enamel and cavities, brushing thoroughly is more important than ever when you wear braces.

  • When you wear aligners

Wearing clear aligners means you don’t need to worry about food trapped in brackets or cleaning around wires. After all, you take them out when you eat. 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 wash away 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 which remain on your teeth after eating are trapped in your aligners, increasing the risk of enamel erosion and decay.

Whether you wear braces or aligners, you’re especially at risk for food particles sticking around your teeth and in your orthodontic appliances. Talk to Dr. Grey about when to brush your teeth after eating and how to keep your braces or aligners clean throughout the day.

Brushing at Night

Growing up, you probably received regular reminders to brush before bedtime—for several really good reasons:

  • Saliva production slows while you sleep

During the day, saliva helps to wash away food particles and neutralize acidity in our mouths. It also contains proteins and minerals which help keep tooth enamel strong. But as we sleep, saliva production slows dramatically, and our bodies can’t remove bacteria and acids as effectively.

  • Food particles fuel bacterial growth

If you haven’t brushed since morning, you’ve accumulated a whole day’s worth of food particles from meals and snacks. Remember, oral bacteria use the sugars and carbs we eat as fuel to produce the acids which attack our tooth enamel throughout the night.

  • Brushing helps prevent both of these problems

Brushing your teeth before bed not only cleans away the accumulated food particles of the day, but also eliminates the plaque and bacteria which would have a much easier time sticking to your teeth without that daytime saliva flow to wash them away.

So, When’s the Best Time to Brush?

In the morning, during the day, at night—there are solid advantages to brushing any time of day. The question isn’t so much when to brush as how often you should brush.

While many dental professionals consider brushing before bedtime as the most important brush of the day, brushing at least two full minutes, at least twice during a 24 hour period, is a necessity for basic dental hygiene, along with flossing at least once a day.

When you’ve been eating sugary snacks, when you’re showing signs of gingivitis or getting more than your share of cavities, when you want to reduce the chance of plaque and tartar buildup, or when you simply want to make sure you’re doing everything you can to maintain your overall dental health, brushing after meals is also highly recommended.

And when you wear braces or aligners, frequent brushing (and flossing) is the very best way to make sure your teeth stay clean and cavity-free.

Talk to Dr. Grey about your brushing habits at your next appointment at our Bothell, WA office. No need to use your imagination to plan your best brushing schedule. We have all the answers you need to help you brush your way to your best—and healthiest—smile!

Braces Repairs—Should You Try This at Home?

November 4th, 2020

No matter how careful you are, accidents can happen. Perhaps it’s a slice of apple that was a little bit larger than it should have been. Or you were chewing on your pencil while you were trying to work out an algebra problem. Or you tried a piece of candy that your friend really, truly thought didn’t have a caramel center.

No matter the cause, when something‘s wrong with your braces, you know it. And you want to fix it as soon as possible. What can you do to make yourself more comfortable? And which repairs are best left to orthodontic professionals?

First things first. If you have been injured, and suffered a trauma to your mouth or jaw that has damaged your braces, we want to make sure that you get any medical attention you might need before we worry about your appliance. Call Dr. Grey, and your doctor, immediately if you have suffered a medical or dental injury.

Even if your braces are the only injured party, you might need a special appointment if the damage is something that shouldn’t wait and can delay your orthodontic progress. Broken wires, brackets that have fallen off, and loose orthodontic bands, for example, need to be replaced in our office.

But what about minor problems? First, call us to see if it’s something that really is minor, and whether you can do some home repairs to keep you going until your next regular visit.

  • Wayward Wires

One of the most common—and most annoying—problems is a broken or out-of-place wire. If a wire end is poking you, dental wax can be applied to the loose end to protect your cheeks and gums. If that doesn’t work, we can let you know how to apply gentle pressure to move the wire away from delicate tissue. Don’t try to cut a broken wire or remove it without talking to us—small pieces can be swallowed accidentally. We’ll give you suggestions for how to handle a broken or loose wire and protect your mouth until you can see us.

  • Breakaway Brackets

If your bracket becomes loose, this is another good reason to give us a call. Brackets are specifically placed to let your archwire guide your teeth where they need to be. Without a firmly bonded bracket, the wire isn’t doing you much good! If a loose bracket is irritating your cheeks or gums, you can try a bit of dental wax to stick it in place and cover hard edges until we can re-bond it. If the bracket comes off all together, bring it with you to your next appointment.

  • Balky Bands

Spacers are little rubber bands we put between your teeth if we need to create some room between your molars before you get your braces. They have a tendency to fall out after several days. We’ll let you know if their work is done, and you’re ready to start your orthodontic treatment. If you lose one of your ligatures, those colorful bands around your brackets, give us a call and we’ll let you know if replacement can wait.

We’re happy to help you with any braces problems, large or small. It’s best to check with us for even small fixes to make sure you avoid injury. Larger repairs can be handled in our Bothell, WA office—and we can give you tips on how to prevent future ones. Accidents happen, but they don’t need to delay your progress toward a beautiful, healthy smile.

american association of orthodontistsamerican dental associationamerican board of orthodontists invisalign