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When does an underbite need surgery? The short answer is: when Dr. Jeff Loveless 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. Jeff Loveless 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 Faribault, Zumbrota, or Owatonna, MN 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. Jeff Loveless 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. Jeff Loveless 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.

Our grandmothers and grandfathers, our moms and dads—we’ve known them our whole lives. So, why are they so hard to shop for?

If your older family members have all the sweaters, socks, and scents they need, consider a gift that can make life a bit easier and perhaps a lot healthier—an electric toothbrush!

• Easy Efficiency

The most important reason to choose an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Using a manual brush is not just a matter of applying toothpaste and scrubbing. Proper technique means short brush strokes at a 45-degree angle for the outer and inner surfaces of the tooth, thoroughly cleaning the uneven chewing surfaces of the molars, and brushing the inside of the front teeth with gentle vertical strokes. Meticulous cleaning of all these surfaces can be difficult, especially for people with dexterity issues.

Electric toothbrushes offer several options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What they all have in common is the ability to remove plaque far more effectively than we can on our own, because they provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, as opposed to the hundreds we can achieve by hand.

• Comfortable Control

An electric toothbrush can be not only more efficient, but also more comfortable for older brushers. For those with arthritis, limited mobility, injuries, or other health conditions, the larger handles can be easier to control and much more grip-friendly. And, with the work being done by the brush head, users avoid repetitive hand and wrist motion.

Also, the pressure applied to teeth and gums with an electric brush is designed to clean thoroughly while protecting the mouth. Heavy-handed manual brushing can irritate delicate gum tissue and even damage enamel over time. With an electric brush, users only need to guide it along teeth and gums as it supplies all the power needed. There are even pressure sensors available to warn users that their brushing is too vigorous.

• Apps, Anyone?

If your grandfather likes to keep things old school, a basic model with a convenient two-minute timer and several cleaning modes will offer all the bells and whistles he needs. But if your nana has more Instagram followers than you do, consider a more tech-savvy option.

Several of today’s electric brushes come with features designed to make brushing even more effective. They can let her know if she’s brushing long enough, alert her if she’s brushing too hard, and remind her that it’s time to replace the brush head. Some models link to handy apps that will map out just where she’s brushed, in case there are a few spots that get overlooked. Or choose a model which comes with a travel case that can recharge while she’s busy seeing the world.

Okay, all that being said, we’ll admit it—a toothbrush might not be the most glamorous gift your grandparent unwraps on that special day. But helping a favorite family member brush more effectively and comfortably while improving dental health? That’s a gift that keeps on giving!

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. Jeff Loveless and our team are more than happy to provide the right answer for you! Talk to us at your next visit to our Faribault, Zumbrota, or Owatonna, MN 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.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Jeff Loveless can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Faribault, Zumbrota, or Owatonna, MN office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.