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When does an underbite need surgery? The short answer is: when Dr. Todd Hamilton and Dr. Bryan Whitecotton 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. Todd Hamilton and Dr. Bryan Whitecotton 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 Denver, NC 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. Todd Hamilton and Dr. Bryan Whitecotton 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. Todd Hamilton and Dr. Bryan Whitecotton 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.

Plaque is a sticky subject! It sticks to the enamel of our teeth above and below the gum line, and it collects around braces. Plaque is one of the major causes of tooth decay and gum disease, and our teeth are under daily attack by this filmy menace.

What are the facts about plaque, and how can we fight back? Read on for some effective strategies!

What Is Plaque?

Plaque is a sticky film that builds up on our teeth, largely made up of millions of different types of oral bacteria. Plaque is a colorless biofilm at first, but as it collects, it takes on a white or yellow tint. If you haven’t brushed for a few days, that fuzziness you feel on your teeth is plaque build-up. Unless it’s removed, plaque hardens within a matter of days to become tartar.

• Tip: You can remove plaque with careful brushing and flossing, but it takes a dental professional to remove tartar. Be proactive!

Why Does Plaque Cause Cavities?

Bacteria in plaque use our food as their food, especially sugars and carbs. They can then transform these nutrients into acids, which attack our tooth enamel, weakening it and leaving it vulnerable to further erosion and eventual decay.

• Tip: Cavities aren’t the only damage caused by accumulated plaque. Plaque also collects along and below the gum line. If tartar forms here, it irritates delicate gum tissue, leading to gingivitis and more serious gum disease. Make sure you don’t forget your gums when you brush and floss.

When Does Plaque Build Up?

The short answer? Plaque is always forming, because oral bacteria are a natural part of our biology. (In fact, there are even oral bacterial which are beneficial.) Plaque starts building up within minutes after eating, and during the night as we sleep.

That’s why we recommend brushing for two minutes at least twice a day, and flossing at least once a day. When you wear braces or aligners, brushing more often is a good idea. Food collecting around braces or inside aligners is a feast for plaque! Ask Dr. Todd Hamilton and Dr. Bryan Whitecotton for suggestions for your best brushing schedule.

• Tip: Just because plaque is unavoidable, that doesn’t mean we need to give the bacteria in plaque any additional encouragement. Every time you have a meal or a snack that’s heavy in carbs and sugars, you are providing more fuel for acid production. Cutting down on foods like sugary desserts and sodas is not only nutrition-healthy, it’s tooth-healthy!

Where Does Plaque Collect?

Plaque builds up all over tooth surfaces, at the gum line, and even below the gum line. It’s especially easy to miss in hard-to-reach places like the irregular surfaces of molars, between the teeth, behind our front teeth, and near the gum line. Plaque also collects around your braces, and requires special care to make sure your teeth don’t suffer cavities or the white spots caused by demineralization.

• Tip: One of the ways plaque avoids detection is its invisibility. Fortunately, if you’re having trouble brushing away all your plaque, there are plaque-disclosing toothpastes and chewable tablets available in the dental aisle which reveal the plaque hiding between, behind, or around your teeth by tinting it with a can’t-miss color. Just brush the color away, and you’ve brushed the plaque away as well.

How Do We Clean Away Plaque?

Use the Right Tools

Floss at least once a day. There are different materials, sizes, and coatings for floss, so you can find one that’s comfortable for you. Floss reaches those spots in between teeth and around the gum line that brushes miss.

Choose a soft toothbrush (soft bristles are better for your enamel) and change it every three to four months, or as soon as the bristles show wear. Make sure the head is the right size—too big, and it’s not only uncomfortable, but you won’t be able to reach all the surfaces you need to.

• Tips: There are special dental flosses created just for your braces. You can also use interproximal brushes water flosser to clean around wires and brackets. If you have trouble removing plaque around your teeth and braces with a manual toothbrush, consider an electric model. Several studies have shown a reduction in plaque with the use of an electric brush.

Use the Right Toothpaste

There are many toothpastes specifically formulated to fight plaque and tartar. And fluoride toothpastes not only fight cavities, they can strengthen your enamel.

• Tip: Studies have shown that toothpastes with baking soda, in particular, are effective in reducing plaque. Ask Dr. Todd Hamilton and Dr. Bryan Whitecotton for a recommendation the next time you’re at our Denver, NC office.

Use the Right Technique

What not to do?  A forceful, horizontal sawing motion is awkward, hard on your enamel, and misses plaque and debris between the teeth. Technique is important—not for style points, but for cleaner teeth!

Hold your toothbrush at a 45-degree angle, especially at the gum line, to gently remove plaque from teeth and gums. Use short strokes or a circular motion to clean as much of the surface and between the teeth as possible. Brush the inside of your front teeth with careful vertical strokes—remember, that’s one place where plaque is easy to overlook. The same holds true for the tops of your molars, so thoroughly clean those uneven surfaces.

If you wear braces, be sure to clean thoroughly around brackets and wires, where plaque can accumulate quickly.

• Tip: If you wear clear aligners, don’t forget to give them a gentle brushing as well! Plaque can stick to aligners, causing discoloration and odors, so follow our cleaning instructions carefully.

Who Can Help You Fight Plaque?

Even when you do your best at home, plaque can still be a sticky problem. That’s why we advise regular professional cleanings, which not only remove any plaque that’s hiding away, but also eliminate any built-up tartar around your braces. And, of course, there you can learn all about how to keep your teeth their cleanest.

True, you’re fighting plaque every day, but you have all the tools you need to make sure your teeth and gums stay healthy. You’re winning the battle with plaque every time you eat a nutritious meal, and every time you brush and floss. With that kind of strategy, plaque doesn’t stand a chance. And your bright smile and healthy teeth and gums? That’s a victory worth celebrating!

Despite the common assumption that braces are for kids, more and more adults are choosing to pursue orthodontics to correct their smiles. Just hearing the word “braces” and picturing a mouth full of metal can cause many grownups to hesitate about getting treatment for a straighter smile.

We’re here to give you the information you need to evaluate your treatment options and make the right choice for yourself. Whatever your personal history, wearing braces as an adult is an excellent way to create the straight, confident smile you’ve always desired.

What are my options?

Recent advances in orthodontic medicine have created numerous options for adults who need braces.

These are best for individuals who have severely crooked teeth or a significant bite problem, or who require other major orthodontic changes. The greatest drawback to wearing metal braces as an adult is the visible appearance of metal and wires.

Clear ceramic braces offer a solution to that, though they cost more. They’re are a good alternative for correcting highly crooked teeth or bite issues. Smoking or drinking red wine, soda, and other dark beverages may stain the adhesive that binds the brackets to your teeth, so you have to commit to being mindful and taking good care of them.

Another popular option for adults who need braces is a clear-aligner treatment, such as with Invisalign®. This system works in a different way from traditional braces by using a series of clear, retainer-like aligners.

In general, the Invisalign process lasts anywhere from three to 18 months. Keep in mind, however, that Invisalign is not as effective as traditional braces in treating bite problems or severe overcrowding.

The prospect of getting braces as an adult can be intimidating, but you should not let your fears prevent you from obtaining the smile of your dreams. A consultation at our Denver, NC office with Dr. Todd Hamilton and Dr. Bryan Whitecotton will address your concerns and provide more information about the best course of treatment!

You waited for this movie all year. You got your tickets early, and you’ve got the best seats in the theater. Whether you paid to see the latest action flick or the most romantic comedy in the history of romcoms, it’s not as nearly as much fun if the trip to the snack bar is a horror story. Perhaps Dr. Todd Hamilton and Dr. Bryan Whitecotton can help!

If you’re wearing traditional braces, the usual suspects, chewy, sticky, hard, and crunchy foods, are still off limits even when the lights go down. Let’s look at some alternative casting.

• The Candy Counter

Licorice, caramels, taffy, and candy with nuts can make any film a disaster movie—and can make your next visit to our Denver, NC office an emergency one. Stick with soft chocolates, chocolates with creamy fillings, ice cream, and ice cream bars (without nuts or caramel, of course).

• The Soda Fountain

Sodas won’t break your braces, but they will damage your teeth, so try to brush as soon as you can or rinse with water after enjoying one of those titanic servings. And no crunching on ice! That can damage your braces.

• The Popcorn Machine

Sorry, we can’t help you here. Popcorn, with or without that tempting flood of melted butter, is off limits. The kernels can get lodged between your teeth and braces, and can be very hard to remove. They can also cause breakage to wires and brackets.

If you still crave something salty, check with us to see if soft pretzels or baked potato chips might be an option for you.

Movie treats contain a lot of starches and sugars, which stick to braces and feed cavity-causing bacteria, so it’s always best to go easy on the snacks. But you don’t have to give up the concession counter completely—just enjoy in moderation and be sure to brush thoroughly when you get home.

And if you wear clear aligners? You can remove your aligners, eat what you like, and clean your teeth carefully before replacing them. But do remember—you’re supposed to wear your aligners for a set number of hours each day. If you’re looking forward to a four-hour epic, make sure to take into account your treatment schedule.

We don’t know if your movie was worth the wait. But we do know that the results of your orthodontic treatment will be! Take care of your teeth and braces, and you’ll be on the fastest, healthiest track to an award-winning, red carpet smile.