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When does an underbite need surgery? The short answer is: when Dr. Adam Hoybjerg 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. Adam Hoybjerg 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 Yuba City 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. Adam Hoybjerg 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. Adam Hoybjerg 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.

Traditional braces and oral piercings—does the inevitable meeting of metals pose any risks? Let’s look at some of the potential problems with oral piercings, and you and Dr. Adam Hoybjerg can decide if you should take a break from jewelry while you’re in treatment.

• Tooth Damage

Enamel is the strongest substance in our bodies, but when up against constant contact with metal? It’s not a fair fight.

Tongue piercings, especially, cause problems for your teeth. Whenever you speak or eat—even while you’re sleeping!—your tongue is making contact with your teeth. This continual tapping of metal on enamel can chip and crack teeth and damage fillings. A serious fracture could mean a root canal.

You’re getting braces to create a more attractive, healthy smile, so keeping your teeth intact is a priority.

• Gum Problems

Your gums are affected by orthodontic treatment. As the teeth move, the gums, ligaments, and bone around them adapt and even reshape over time. You might notice when you first get your braces, or when you go in for an adjustment, that you have a few days of swollen, sensitive gums afterward. You might also find that you are at greater risk of gingivitis, because it can be harder to keep plaque away from your gumline until you perfect your brushing and flossing skills.

Oral piercings bring their own gingival dangers. Jewelry in the tongue or lip can rub against gum tissue, especially around your lower front teeth. As the gum tissue continues to be irritated and inflamed, it pulls away from the teeth. This process is called gum recession.

Receding gums expose the tops of your roots to cavity-causing bacteria. They make you more sensitive to hot or cold foods. Pockets between gums and teeth can harbor infections that threaten the tooth itself.

Caring for your gums during braces is important for your dental health. Since people with oral piercings have a much higher rate of gum recession that those without, why add one more risk factor to your oral health?

• Metal vs Metal

Lip and tongue piercings can make contact with traditional brackets and wires, especially if you have a habit of playing with them. And let’s not forget lingual braces! Lingual braces are almost invisible because their brackets and wires are custom fitted to the back of your teeth. Whenever you speak or eat, you’ll be taking the chance that a tongue piercing will damage these custom-made appliances.

Dr. Adam Hoybjerg can tell you if your piercings are in any danger of interfering with your braces, but even if you’re planning on aligners, there are additional reasons to consider retiring your oral jewelry. Dental associations and medical associations discourage oral piercings because they can damage teeth and gums. And there’s more. Oral piercings can lead to swelling, bleeding, allergic reactions, infection, and nerve damage.

The reason you’re considering braces is because you want a healthy, attractive smile. Don’t let a tiny piece of jewelry make your life and your treatment more difficult! Do some research and talk to our Yuba City team about your oral piercings, and come up with a solution that’s best for your health and best for your smile.

What does the month of October mean to you? For people in the northern hemisphere, October is when the weather starts to get a little chilly: heavy jackets might come out of storage and the summer clothing gets packed away. You might start making plans for the upcoming holidays or looking at the beautiful and changing autumn scenery. October means something a little different to our team at Hoybjerg Orthodontics because this is National Orthodontic Health Month. During October, orthodontic clinics all over the country work together to promote their services and inform the community about the important work we do.

National Orthodontic Health Month is an awareness campaign created cooperatively by orthodontists and other dental health professionals. During this month, we make a special effort to promote dental health and orthodontic health in particular. This is a great time to get your questions answered by dental professionals in your community and to learn more about exactly what an orthodontist can do for you and your family. Events held in connection with National Orthodontic Health Month are also an opportunity for us orthodontists to come out and meet community members. If you have never been to an orthodontist before, you might not know what to expect. Meeting one of us in person before your checkup is a great way to find out what kind of person you’ll be seeing during your appointment.

Meeting Dr. Adam Hoybjerg in a relaxed “meet and greet” atmosphere can be especially helpful for any young orthodontic patients in your family. Kids of all ages–and their parents!–can feel anxiety about going to the dentist. Getting to know the person you have an appointment with can make the experience a lot less stressful for everyone. We don't want anyone to avoid seeing a dental professional for regular checkups just because they don't know who we are. Just meeting and talking with the orthodontist you'll be seeing may be enough to make you feel more comfortable about your upcoming appointment.

Dental health is something that affects everyone; healthy teeth and gums contribute to a healthy smile and a lifetime of comfort and well-being. Orthodontists are just one of the various dental practitioners you could visit at some point in your life, so taking a little time to learn who we are and what we do is certain to be a helpful experience. We look forward to seeing you and your family this October at our Yuba City location!

Breakfast is called the most important meal of the day for many reasons. Children need to refuel after a long night’s sleep, and studies suggest that school kids who eat a good breakfast have more energy, better attendance and behavior, and even higher test scores than kids who don’t.  

But sometimes, especially with new braces or braces that have just been adjusted, the last thing on your child’s mind is breakfast. Fortunately, Dr. Adam Hoybjerg can recommend many early morning options that will be both gentle on braces and healthy for growing bodies!

• Yogurt

Soft, creamy, and filled with calcium and vitamin D, yogurt is an easy and nutritious choice. Try different fruit flavors or Greek yogurt for variety.

• Eggs

Packed with protein, scrambled eggs are delicious on their own, or with the addition of cheese or soft veggies. If you’d like to add a bit of flair to the table, a cheese omelet is another great choice. Any egg option is a good one—just remember to skip the crunchy toast on the side.

• Smoothies

Not only a great way to start your day, but a great way to get vitamins and minerals in one delicious meal. And with a flavor base of banana, mango, berries, or apple, no one will notice if some spinach or kale make their way into the blender!

• Oatmeal

Unfortunately for the cereal lover, crunchy cereals and even granola are potentially damaging to wires and brackets. But oatmeal is a healthy alternative that can be made even tastier with the addition of soft fruits such as mangos, berries, and bananas.

• Breads and Pastries

Crunchy and chewy breads and pastries can lead to broken brackets and wires. Soft breads, pancakes, non-crunchy French toast, and soft pastries are much kinder to braces. Because so many of these options are rich in sugar (especially with syrup!), it’s best to go lighter on foods like this and be sure to brush carefully afterward.

• Fruit

Bananas, peaches, nectarines, berries—if it’s soft, it’s good to go! Cut larger fruits into bite-sized pieces. Dried fruits like raisins, dates, and cranberries can be chewy, sticky, and sugary, so best to take them off the shopping list for the time being.

It’s described as the most important meal of the day for many good reasons. With some of these easy-to-prepare breakfasts, you can add delicious, healthy, and braces-friendly to that description! If you stumble on a delicious recipe, don’t forget to share it the next time you visit our Yuba City office!