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When does an underbite need surgery? The short answer is: when Dr. Nicola Crichigno 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. Nicola Crichigno 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 Stoney Creek 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. Nicola Crichigno 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. Nicola Crichigno 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.

Somewhere in a bathroom drawer or medicine cabinet, we all have one—that little plastic dental floss dispenser. And whether you use your floss every day (yay!), or have completely forgotten it was in there (not so good), just how much do you know about that sturdy string? Let’s find out!

• Flossing has been around for hundreds of years.

FACT: It’s been just over two hundred years since Dr. Levi Spear Parmly, a dentist in New Orleans, suggested his patients use waxed silk thread to clean between their teeth. This is considered the first “official” invention of dental floss, although using some form of tool to get rid of food particles between the teeth has been around since prehistoric times.

• Brushing well is the same as flossing.

FICTION: It’s really not. While brushing does a great job of cleaning food particles, plaque, and bacteria from your enamel, there are some places those bristles can’t… quite… reach. Floss was designed to clean plaque and food from between the teeth and close to the gum line where your brush doesn’t fit.

• There’s more than one way to clean between your teeth.

FACT: Indeed there is! Not only are there many varieties of dental floss (waxed, flavored, round, flat, thick, thin, in a dispenser, attached to miniature floss wands), but you have alternatives if using any kind of floss is difficult for you. Water-flossers direct a pulsing stream of water between and around the teeth and gum line to remove food particles and plaque. Another useful alternative is the interproximal brush, a tiny little cone-shaped brush designed to remove food and plaque from those hard-to-reach spots.

• It’s impossible to floss with braces.

FICTION: Untrue—but it can be more challenging! That’s why there are any number of flossing products designed to work with and around your braces. Stiff strands of floss which work like dental picks, floss threaders, water flossers, and interproximal/interdental brushes can both clean between your teeth and remove food particles and plaque where they collect around your braces. Dr. Nicola Crichigno can suggest some great options to work with your individual orthodontic treatment.

• Flossing helps prevent gum disease.

FACT: Scientific studies haven’t provided definitive answers. But dental and periodontal associations strongly recommend daily flossing as one of the most important things you can do to prevent gum disease. Gingivitis, or mild gum disease, is caused by irritated, inflamed gum tissue. Gum tissue becomes irritated and inflamed as a response to the bacteria, plaque, and tartar that stick to your teeth. Anything you can do to help remove these irritants will reduce your risk of gum disease.

• Flossing helps prevent cavities.

FACT: Dentists strongly recommend daily flossing to remove the food particles and plaque that lead to cavities. Brushing removes cavity-causing plaque from the outer surfaces of your teeth. But there’s a lot of enamel between your teeth as well. Flossing removes plaque from these hidden spots, helping to prevent interproximal (“between the teeth”) cavities from forming.

• Bleeding when you floss is normal.

FICTION: Bleeding isn’t a typical reaction to flossing. Bleeding gums could be an early sign of gum disease caused by plaque and tartar buildup. On the other hand, if you floss too hard, or go too deeply below the gum line, you can make delicate gum tissue bleed. Ask Dr. Nicola Crichigno for tips on perfect flossing technique.

• You need to floss after every meal.

FICTION: Dental professionals generally recommend brushing twice a day and flossing at least once each day. But this suggestion comes with some exceptions. Since you have braces, Dr. Nicola Crichigno might recommend flossing whenever you have a meal or snack.

• Your dentist will never know that you haven’t been flossing.

FICTION: Nope. Sure, you can miss flossing a few times and catch up before your appointment at our Stoney Creek office. But built-up plaque between the teeth, red, swollen, or bleeding gums, and gingivitis and interproximal cavities let both you and your dentist know that you’ve been neglecting good dental habits.

• It’s never too late to start flossing!

FACT: Flossing is a simple, quick, and inexpensive way to maintain tooth and gum health. If you haven’t had much luck flossing in the past, ask Dr. Nicola Crichigno for flossing tools and techniques that will work for your specific needs. Start now, and see what a difference it will make at your next checkup!

If you had all these flossing facts at your fingertips, congratulations! But if you didn’t, no need to worry, because the real test of your knowledge is in its application. Flossing properly at least once each day will give you something far more rewarding than blog-quiz kudos—you’ll see that regular flossing rewarded with healthier teeth and gums!

Are you an adult who is considering getting braces? Perhaps you’ve had them before, but over the years that dental work has been reversed. Or maybe you’ve never had any orthodontic work done, but are considering braces for the first time. In either case, Crichigno Orthodontics can help you enjoy straighter teeth, an improved bite, and a more beautiful smile. If you are considering getting braces, here is what you need to know about adult orthodontic work from Dr. Nicola Crichigno.

Can braces work for adults?

Absolutely! Braces work for just about anyone. However, there are several different types of braces, and not all of them may work for you. Different types of orthodontic treatments include:

• Ceramic braces
• Metal braces
• Self-ligating brackets
• Lingual brackets (braces behind the teeth)
• Invisible braces
• Rubber bands for bite correction
• Headgear and other appliances

By scheduling a consultation, we can determine which treatment or combination of treatments would be best for your specific needs.

How do I get started?

Getting braces can be a little bit daunting. At first glance, the process may appear expensive and time-consuming. However, if you take it step by step, getting braces can be a simple and relatively pain-free experience. Here are the first steps you need to take to get on the road to straight teeth:

First, you need information. If you are nervous about getting braces, or are having trouble getting started, learning more about the process can help ease your mind. Here are a few sample questions to ask:

• What kind of braces do you recommend for my teeth?
• How long will the treatment take?
• How often will I need to come in for adjustments?
• What is the total cost of the treatment? Do you accept insurance? Will you require the full amount up front, or do you have payment plans?

Asking these types of questions will help you understand what to expect during the entire process, which can aid your decision on the proper course of action.

The next step is to complete any prerequisite treatment. During your first meeting with Dr. Nicola Crichigno, we’ll need to take some X-rays and molds of your teeth, and then help you determine an appropriate treatment plan. Recommendations may include some preliminary dental work before you get your braces, which can be an important step in making sure your orthodontic treatments are effective.

Once you have completed these steps, you are ready to get started! After you’ve chosen a treatment plan and undergone any necessary prerequisite dental work, you’ll be able to get your braces. Just like that, you’re on your way to a better smile! If you’d like to get started right away, call our Stoney Creek location today!

We all welcome the idea of braces adjustments at our Stoney Creek office—an adjustment, after all, means you have taken another step on the way to your ideal smile! But sometimes the reality of an adjustment can be a little less welcome—you might have a few days of discomfort as you get used to new or different pressure on your teeth. Luckily, there are some menu options that will help you get through these days in a comfortable and tasty way.

Keep Your Cool

If you are feeling a bit sore after your braces have been tightened, a cool treat might be just the thing. Ice cream is the classic choice, but if you are looking for some healthier options, consider yogurt. It generally has less sugar, while still providing soothing, creamy sweetness. A fruit or vegetable smoothie is always a good (and nutritious) choice. Pudding and gelatin cups? Chilly, delicious, and easy to eat.

Comfort Food

Some of our favorite comfort foods mean literal comfort for newly adjusted braces. Creamy soups, soft pastas and noodles, mashed potatoes, and macaroni and cheese are warm, silky options that don’t require a lot of chewing. Just don’t go too hot or too spicy—that might irritate sensitive gum and mouth tissue.

Breakfast All Day Long

Most of our favorite braces-friendly breakfast foods are delicious any time of day. Eggs scrambled, fried, or in an omelet are easy on your braces and packed with protein. Are you an oatmeal fan? Try some oatmeal with mashed fruit for a more flavorful bowl. And you can’t beat the taste and texture of pillowy pancakes.

The discomfort that follows an adjustment is temporary, but treat your teeth—and yourself—gently over the next day or two. Take over-the-counter medication if needed for pain, brush carefully, and eat a comforting, comfortable diet. Soon you will be back to your normal, braces-friendly menu, and one step further on your way to a beautiful smile!