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When does an underbite need surgery? The short answer is: when Dr. Mugford 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. Mugford 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 Halifax 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. Mugford 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. Mugford 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.

Kids can be picky eaters. How many times have you seen your child try to hide the peas under a mound of mashed potatoes?

At Metro Orthodontic Specialists, Dr. Mugford and our team understand how hard it can be to get your child to eat the recommended daily allowance of fruits and vegetables. The task of providing fun, nutritious meals becomes even more challenging if he or she wears braces. It's an age-old saying that breakfast is the most important meal of the day. These five braces-friendly recipes are not only nutritious, but they will have little Jimmy flashing his “tin grin” when he sits down at the kitchen table in the morning.

1. Scrambled eggs are soft and easy to eat if you have braces. If you drown them in ketchup (which many kids love to do), eggs become even mushier. Minimal chewing is required, and that’s the key to a braces-friendly recipe.
2. A healthy breakfast provides energy and jump-starts metabolism. A smoothie is not only a good source of fruit, but it’s also gentle on braces. More importantly, smoothies are fun to create. You can toss anything in the blender (bananas, mangoes, strawberries, spinach) and create a drink that’s loaded with vitamins and antioxidants.
3. If you wear braces, eating crunchy cereals or granola for breakfast is out of the question: Bite down the wrong way and you might snap the wires or dislodge the brackets. However, you can get your grains and oats by substituting oatmeal for cereal. This mushy breakfast treat has a host of health benefits.
4. Pancakes are not the healthiest breakfast choice. Still, this Sunday morning favorite is braces-friendly. The idea is to make it healthier by hiding blueberries in the pancake batter just like your child hides peas in the mashed potatoes.
5. Toast with jam is ok, but skip slathering peanut butter on the bread. If you have braces, the general rule of thumb is to steer clear of foods that are hard or chewy. These types of foods can break wires. Of course, most kids will agree that toast isn’t the most exciting breakfast recipe. Make it a Pop-Tart instead!

For more braces-friendly recipes, please give us a call at our convenient Halifax office!

When you get braces as a child, you usually present the orthodontist with a blank canvas—newly erupted, perfect permanent teeth, just waiting to be aligned. But if you are a bit older, your canvas might already be a bit busy, with fillings, crowns, perhaps even a missing tooth. Can Dr. Mugford still work with that more complicated picture? Yes!

• Fillings

Many of us have acquired a filling or two. Normally, an old filling shouldn’t interfere with new braces. Large fillings, however, might call for spacers. These small rubber bands are inserted between two teeth as needed to create enough room for bands and brackets, and are generally put in place a week or two before you get your braces. They frequently fall out on their own as the space between the teeth gets a bit wider.

• Crowns

If you have had a root canal or any other dental treatment that left you with a crowned tooth, no need to be concerned. A special dental adhesive can be used to adhere brackets to crowns.

• Implants

If you have or would like to get an implant, this is a time to coordinate with your orthodontist and dentist or oral surgeon. Sometimes an implant can anchor your appliance, and sometimes it’s best to keep the spot open until your orthodontic work is completed. Once in place, an implant will not have the mobility of a tooth, so it’s always best to make sure your doctors can create a schedule that will work for both the installation of the implant and the positioning of your braces.

• Healthy Teeth and Gums

Before you begin orthodontic work, talk to your dentist. If you need a filling or crown, are considering a dental implant, have symptoms of gum disease, or are looking at any other dental concerns, you should work with your dentist first. Healthy teeth and gums are the very best foundation for orthodontic treatment at any age.

If you are wondering whether Dr. Mugford can help you achieve the smile you’ve always wanted, talk to us when you visit our Halifax office! Your past dental work will be just one of the many variables we take into consideration when we’re planning your future of picture-perfect smiles.

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Mugford and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Halifax office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.