You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

• Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

• Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

• Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Drs. Cartsos and Zavras at our Chestnut Hill, Massachusetts office for all the information you’ll need!

Pediatric dentists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or perhaps there is a baby tooth which has simply overstayed its welcome and is blocking its adult replacement.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Drs. Cartsos and Zavras will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our Chestnut Hill, Massachusetts office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot which forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Your dentist might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your dentist or oral surgeon right away.

An extraction can be worrying for both patient and parent, so talk to Drs. Cartsos and Zavras for the best ways to make this experience a positive one for your child before, during, and after treatment.

Pediatric dentists are experts in children’s extractions, while ensuring that the procedure is as stress-free and as comfortable as possible for your child. Follow their instructions for aftercare, and you’ll ensure your child’s recovery is as stress-free and comfortable as possible, too.

Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Drs. Cartsos and Zavras and our team at Convivial Dental want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Chestnut Hill, Massachusetts office if you have any questions about water picks, or ask Drs. Cartsos and Zavras during your next visit!

How long? Well, a beautiful smile is both science and art—proper teeth and jaw alignment united with aesthetically pleasing results. Orthodontists achieve both these outcomes with a careful analysis of any dental and facial problems, a treatment plan designed specifically for each patient’s needs, and adjustments through each phase of treatment to carefully bring about that beautiful smile.

And that’s a long way of saying, there’s no one, standard answer as to how long a patient will wear braces because there is no one, standard patient. Often, treatment takes from 18 to 24 months, but it can be months shorter or months longer depending on a variety of different circumstances.

• Different Needs

Your orthodontic needs and goals will generally determine your treatment time. Some patients need only a bit of alignment, which can lead to a fairly short orthodontic experience. Some have malocclusions such as crossbites and open bites that require more complex and lengthy treatment.

And, while we used to think of orthodontics as a teenage rite of passage, that’s certainly no longer the case. Some children will need two-phase orthodontic treatment, where early procedures before the adult teeth even come in ease the way for any necessary second stage treatment when the permanent teeth arrive years later. And some adults will want orthodontic work later in life, where denser bone tissue might lead to (somewhat) longer treatment.

• Different Appliances

Today’s orthodontics offers you many choices in appliances. Lingual braces are an almost invisible option, with brackets and wires on the inside of the teeth. Aligners use clear, custom molded trays to move the teeth into a better position with each new tray. Even traditional braces are smaller and sleeker today, with metal or less visible ceramic brackets. Depending on the orthodontic goals you want to achieve, there might be a small difference in the amount of time each appliance will take to get you to those goals. Talk to us about all your options and what they mean for treatment time.

• Different Levels of Participation in the Process

This is one area you can make a real difference! If you follow our instructions for using your appliances most effectively, you’ll make progress as quickly as possible. If you have aligner trays, be sure to wear them for as long as directed each day. If you have rubber bands attached to brackets on your upper and lower teeth, wear them for as many hours as required, because these little bands are actually the tools that are moving your teeth into alignment. If you don’t wear your braces or aligners as directed, not much is going to happen, and certainly not on schedule.

Give our Chestnut Hill, Massachusetts office a call, and we can discuss your goals for creating your very best smile. Once we’ve decided on a treatment plan, Drs. Cartsos and Zavras can give you a fairly good estimate as to how long your particular treatment will take. And, when you get to share that beautiful, healthy smile, the time you’ve spent achieving it will be well worth it!