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When does an underbite need surgery? The short answer is: when Dr. Diaz 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. Diaz 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 Orlando, FL 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. Diaz 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. Diaz 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.

Modern orthodontic technology has changed the way you wear braces. Brackets are smaller and come in a variety of shapes and colors. Wires are more efficient. Clear aligners can eliminate the need for brackets and wires altogether. And your high-tech advantages don’t stop there—today’s digital X-rays make creating your treatment plan even more convenient and efficient.

Why Are X-rays Necessary?

Beautifully aligned teeth and a healthy bite are the visible result of your orthodontic work, but there’s a lot going on above and below the surface that needs to be discovered and taken into account before your treatment even begins. X-rays help Dr. Diaz evaluate:

• The size, shape, and position of your teeth, including impacted teeth and wisdom teeth
• The size, position, and health of your roots throughout treatment
• The size and shape of your jaw bones, and how they affect your teeth alignment and bite
• Your progress during different phases of treatment
• The most effective type of retainer for protecting your beautiful smile after treatment.

How Do X-rays Work?

Traditional X-rays, or radiographs, make use of film just like traditional cameras. When you have an intraoral X-ray, for example, the film is sealed in a moisture- and light-proof packet, and placed inside the mouth to capture images of specific teeth and the bone around them.

The X-ray machine is aligned precisely with the film and an exposure is taken. The image at this point is latent, and won’t show on the film, because, just like photo film, traditional radiographs need to be chemically processed before they produce a visible image.

Digital technology, on the other hand, uses an electronic sensor instead of film. For an intraoral digital X-ray, a small sensor is positioned in the mouth just like a film. When the X-ray is taken, a digital image capture device produces an image which is formed by a matrix of pixels instead of a photo-like film exposure. This format allows the image to be sent directly to a computer for immediate display without requiring processing.

Even though these methods seem very similar, digital X-rays offer some significant advantages over traditional films. Let’s look at how they compare, more or less.

• More Diagnostic Advantages

A traditional X-ray is a fixed image. It cannot be modified or enhanced. Here the digital X-ray offers a clear advantage in evaluating your teeth and the bone structure surrounding them.

Just as you can enlarge certain types of images on your computer without blurring or losing detail, a digital X-ray uses computer software to magnify images while keeping their details sharp. They can also be enhanced through brightness and contrast applications to make details stand out even more.

There is even digital subtraction radiography software available that can be used to compare recent images to older ones, removing (“subtracting”) all the similarities in the two images to display only the changes in the two—even small changes—that have taken place over time.

• Less Exposure to Radiation

Modern technology means traditional X-rays expose patients to less radiation than ever before, but digital X-rays have significant advantages here as well. Radiation exposure can be reduced by an additional 10%, 20%, or more with a digital radiograph.

And while all types of dental X-rays expose you to very little radiation, it’s always best to reduce exposure whenever possible.

• More Convenient for Sharing and Transmitting

If you need to share your X-rays with another dentist or physician, digital technology allows you to simply have them e-mailed to another office or multiple offices. You no longer need to worry about preserving physical copies, either.

• Less Waste

Unlike traditional X-rays, digital X-rays don’t need to be processed, so you save time in the office. And while the processing time is not significant (usually several minutes), if you need to repeat some X-rays for a clearer picture, or require different images for several teeth, this time can add up.

Digital X-rays are also more eco-friendly.  The fact that they don’t need to be developed means that the chemicals used to process traditional films are no longer necessary—which also means that there is no need to dispose of chemical waste products afterward.

Our goal is to provide you with the safest, most efficient, and most effective treatment possible. Digital X-rays are an important tool for orthodontists, helping us to provide you with the best treatment plan possible. If you have any questions about digital X-ray technology, contact our Orlando, FL office. We’re happy to explain the science—and the benefits—behind this high-tech diagnostic tool.

Getting braces comes with a lot of rules. No sticky candies, watch out for popcorn, and steer clear of chips. These rules leave many braces-wearers wondering what they can still eat without hurting their teeth or their expensive orthodontic appliances. Fortunately, constructing a braces-friendly lunch is straightforward once you know which foods to avoid.

Foods to Avoid When Wearing Braces

There are a few food categories to avoid when you have braces. Sticky foods also stick to the metal in your braces, and can potentially break wires or individual braces. For example: bubblegum, candy bars, caramel, licorice, fruit roll-ups, and Starbursts should be avoided. Many of these foods also contain high levels of sugar, which can cause plaque build-up if not brushed away properly.

Also, be wary of hard foods that can harm your orthodontic appliances. Avoid eating hard taco shells, chips, Rice Crispy treats, hard candy, beef jerky, and popcorn. Some healthy foods, such as carrots, apples, corn on the cob, and nuts, are hard on braces. To eat these foods safely, cut them into smaller pieces before eating.

Remember that certain habits may be harmful to your braces. For example, crunching on ice cubes may be a reflexive response when you’re enjoying a cold beverage, but this can significantly harm your braces and extend treatment time. To stay on the safe side, Dr. Diaz and our team at Diaz Orthodontics recommend you drink beverages without ice or add crushed ice whenever possible.

Lunch Recipe

Even with braces, it’s easy to enjoy a healthy, nutritious lunch. For example, make a panini on whole wheat bread with slices of turkey deli meat, a piece of Swiss cheese, and tomato slices. Spread 1 tbsp. of mustard or mayonnaise on the bread before toasting the sandwich in a panini grill. Serve the panini with ½ c. low-fat cottage cheese and a sliced pear or apple for a balanced meal. Then grab a pudding cup or some JELLO for dessert. Wash it all down with water containing a lemon wedge or all-natural fruit juice. Make sure to brush your teeth or rinse with mouthwash after lunch to wash away sugars and food residue that can get trapped in braces and cause decay.

If you have any questions about what you can and can’t eat with braces during your treatment at Diaz Orthodontics, be sure to ask our team during your next appointment at our Orlando, FL office!

Most parents know that routine dental care should begin during their child’s toddler years. And many assume they must wait until their child has all of his or her permanent teeth to visit Dr. Diaz for an initial orthodontic consultation.

The ideal age for an orthodontic evaluation is age seven. At that age, your child will have a mixture of adult and baby teeth for Dr. Diaz and our team at Diaz Orthodontics to make a determination about whether any problems are present. Typically the first molars have come in by the time your child turns seven, giving us an opportunity to check for malocclusion, also known as “bad bite.” Also, by the time your child reaches the age of seven, the incisors have begun to come in, and problems such as crowding, deep bites, and open bites can be detected.

When Dr. Diaz and our team perform an evaluation on your child at an early age, you get one of two positive outcomes. Although treatment usually will not begin until one to five years after the initial evaluation, it’s still helpful in determining whether your child has any problems with the jaw and teeth early when they are still easy to treat. Earlier treatment can also cost less to correct a potential problem than delayed treatment.

Early evaluation, of course, may signal a need for early treatment. For some children, early treatment can prevent physical and emotional trauma. Aside from spurring years of harmful teasing, misaligned teeth are also prone to injury and are detrimental to good oral hygiene.

If your child is approaching age seven, or has already surpassed his or her seventh birthday, it is time to schedule an appointment for an initial examination at Diaz Orthodontics.