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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 Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer at our Freehold, Manalapan or Hightstown, NJ office for all the information you’ll need!

Bite problems are so common that most of us know someone who’s worn braces. So perhaps you’re already familiar with the terms “overbite” and “underbite”—but if you’ve been diagnosed with an “overjet,” that just might be an orthodontic diagnosis that is new to you. If so, here are a few questions and answers to help promote overjet understanding.

Just what is an “overjet”?

An overjet is a type of malocclusion, which means that there’s a problem with your bite, the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.”

An overjet is a Class II malocclusion, which means that the upper front teeth project further beyond the lower teeth than they should. Overjets and overbites are both Class II malocclusions, and the words are often used interchangeably, but there’s a notable difference between the two conditions.

An overbite occurs when the top teeth overlap the bottom teeth too far vertically, and you can’t see as much of the lower teeth as you should when you bite down.

An overjet is considered more horizontal in nature, where the top teeth project at an outward angle toward the lips instead of pointing straight down toward the bottom teeth. This condition is sometimes called protruding or buck teeth.

What causes an overjet?

The reason for your overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both.

Overjets can run in families. They can also be caused by the size and position of your jaws and the shape and position of your teeth, all of which affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to overjet development.

How do we treat an overjet?

There are many types of treatment available. Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer will recommend a treatment plan based on the cause and severity of your overjet. Because some treatments are effective while bones are still growing, age plays a part as well.

• Braces and Aligners

If you have a mild overjet, and minor dental issues are the main cause of the malocclusion, braces or clear aligners can effective.

• Functional Appliances

If the overjet 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 forming.

For young patients, there are several appliances which can help correct an overjet. Some, such as the Twin Block and the Forsus Spring appliances, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

• Surgical treatment

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overjet?

A serious, moderate, or even mild overjet can lead to many dental and medical problems, including:

• Concerns about facial and dental appearance
• Front teeth which are more at risk for injury
• Difficulty closing the lips
• Problems speaking or chewing
• Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Freehold, Manalapan or Hightstown, NJ team to correct your overjet, you’re not just correcting a problem. You’re also creating something—a healthy, comfortable bite, and an attractive, confident smile. We can talk about general answers to your overjet questions, but when it comes to understanding your very individual smile, Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer will have all the answers you need to make that healthy bite and that confident smile a reality! 

There are many great reasons to see an orthodontist. For a healthier bite. For straighter teeth. For a more confident smile. So why are you hesitating? If the visibility of traditional braces is what’s holding you back, ask Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer about lingual braces.

With regular braces, brackets are bonded to the front of each tooth with a special adhesive. Ligatures around each bracket or bracket clips grip an archwire, which does the work of moving the teeth. The gentle pressure from the wire guides the teeth into alignment in gradual stages. Every adjustment moves the teeth to their perfect positions. These braces are quite effective—and they are usually quite visible.

Lingual braces, on the other hand, are virtually invisible. Lingual means “toward the tongue,” and this placement is the difference between lingual braces and more traditional types of orthodontic braces.

Lingual braces are custom designed to be applied to the inside of your teeth. Specially designed brackets are attached to the backs of the teeth. Individually crafted archwires are used to guide your teeth to their best alignment.

Lingual braces can be the solution to many orthodontic concerns:

• If you need or want invisible braces for personal or professional reasons, lingual braces are a great option. Because they are behind your teeth, they are even less noticeable than clear aligners—and you don’t need to keep track of your hours wearing them.
• Lingual braces keep the front of your teeth braces-free for playing a brass or reed instrument, or for participating in sports. (Just remember, a mouthguard is always a good idea for athletic activities, and especially when you wear braces.)
• Both brackets and wires can be customized to fit your teeth perfectly, and new lingual brackets and wires are more comfortable than ever.

You might be a good candidate for lingual braces if:

• You have a large enough tooth surface to place a bracket. Adults with small teeth—or children—might not be have enough room on the back of each tooth to hold a bracket.
• You don’t have a major malocclusion (bite problem) which would make lingual braces impractical. A deep overbite, for example, could cause the wires and brackets behind the upper teeth to come loose or detach as they come in contact with lower teeth.
• You are dedicated to keeping up with your oral hygiene. Because wires and brackets are behind the teeth, it can be harder to keep them free from food particles and plaque.

Finally, even if lingual braces aren’t the perfect match for your orthodontic needs, there are other options that can work for you. Smaller metal brackets, ceramic brackets that blend in with your enamel, and clear aligners mean today’s orthodontic work is more subtle and discreet than ever before.

For a healthier bite, for straighter teeth, for a more confident smile—don’t hesitate. Contact our Freehold, Manalapan or Hightstown, NJ office to discuss the many great options you have available to give you the smile you’ve always wanted—front and center.

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

• When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

• Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

• Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Brad Elkin, Dr. Joshua Epstein, Dr. George Sargiss, Dr. Martin Epstein, Dr. Sonalee Kapoor and Dr. Carly Kinzer for a recommendation.

• Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!