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When Does an Underbite Need Surgery?

September 23rd, 2020

When does an underbite need surgery? The short answer is: when Dr. Sal Carcara 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. Sal Carcara 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 Westwood, NJ 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. Sal Carcara 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. Sal Carcara 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.

What is the AcceleDent® System and how can it help you?

September 9th, 2020

Dr. Sal Carcara and our team know most of our patients at Carcara Orthodontics would probably welcome the idea of speeding up the time they wear braces. And now they can, thanks to AcceleDent, a treatment option that has been shown to increase tooth alignment by 106 percent and reduce the time you spend wearing braces, anywhere from 38 to 50 percent.

By using this pain-free, simple appliance for 20 minutes a day, you will accelerate your orthodontic treatment time using patented technology that gently vibrates the teeth and surrounding bone, allowing teeth to move more freely and creating an ideal bite faster than with braces alone.

AcceleDent is championed as a safe and comfortable option for patients of all ages. When you first begin wearing the light appliance, you may experience a small tingling sensation, much like that of an electric toothbrush, but it should diminish after you become accustomed to wearing it. You may even forget you’re wearing the appliance!

To learn if the AcceleDent system can help you achieve the dazzling smile you’ve always wanted, please give us a call at our Westwood, NJ office to schedule an appointment with Dr. Sal Carcara.

Is Damon® Smile right for you?

September 2nd, 2020

Dr. Sal Carcara and our team at Carcara Orthodontics are pleased to offer Damon Smile to our patients. This treatment is a faster and more comfortable way to straighten teeth and can improve your smile at any age, often without tooth extractions. Damon Smile braces not only help straighten your teeth, but their use can also lead to greater confidence, a better self-image, as well as personal and professional advancement.

Traditional orthodontic treatment often requires the removal of healthy teeth and/or the use of palatal expanders to make space for braces, which usually means treatment takes longer, is more uncomfortable for the patient and can leave a narrower arch and a flat profile.  

When using Damon Smile, however, straight teeth are achieved with light, biologically-sensible forces, and are specifically designed to improve each patient’s overall facial result. The system uses unique self-ligating braces, in which a specialized clip with a “door” replaces elastics or other ties. The “door” guides the archwire and allows the teeth to move gently into the proper position. Because of the increased flexibility of the self-ligating brace, it exerts less pressure on the individual tooth; this means you won’t have to get adjustments as frequently.

Another advantage is the gentler, low-friction force means you won’t experience the long-term discomfort from intense pressure on your teeth, or the tight wires that are so common with traditional braces.

If you have been thinking about an orthodontic procedure, come see us at Carcara Orthodontics for an assessment to see if Damon Smile is right for you! Give us a call today at our convenient Westwood, NJ office!

AcceleDent®: A Safe Way to Expedite Your Orthodontic Treatment

August 26th, 2020

Congratulations! You are already on your way to your best smile now that you have decided on orthodontic treatment. And while any amount of time it takes to create your beautiful smile is worth it, the sooner that process is completed, the better. With AcceleDent®, you can actually speed up the orthodontic process safely and effectively!

What is AcceleDent?

The AcceleDent device is a hands-free, lightweight appliance that is inserted around your braces or aligners and held in place by your teeth. When you turn on the Activator, gentle vibrations, or micropulses, are sent through the teeth and their roots into the bone surrounding them. It takes only 20 minutes each day, and patients notice not only faster tooth movement, but often less orthodontic discomfort as well.

How Does AcceleDent Speed Up My Treatment?

When you have braces or aligners, slow and steady pressure is put on your teeth to move them to their desired positions. This pressure affects the bone surrounding each tooth, and the body responds by changing the shape of the bone tissue. You end up with teeth held securely in their new, aligned position by the remodeled bone. This process is also slow and steady. Changes in the bone take place on the cellular level, and gradually develop over time. The micropulses created by the AcceleDent appliance actually stimulate this cellular activity, which can lead to faster progress in the repositioning of your teeth and therefore a shorter treatment schedule.

How Safe is AcceleDent?

The AcceleDent appliance delivers precise vibrations to the teeth with a patented process called SoftPulse Technology®. These micropulses provide the gentle stimulation that increases cellular activity. The vibrations produce less force than using an electric toothbrush, and 200 times less force than we apply to our teeth with normal chewing!

AcceleDent is available at our Westwood, NJ office. The process has undergone numerous clinical trials, and has been shown to be safe and reliable. AcceleDent has been cleared by the FDA as a single-user prescription device, and has been prescribed to thousands of patients since it was introduced.

Our most important goal is to provide you with a beautiful, healthy smile. Talk to Dr. Sal Carcara about AcceleDent if you would like to explore a gentle option for achieving this goal as quickly and safely as possible.

Clinical Excellence, Caring,
Cooperation, Comfort

Carcara Orthodontics is "committed to caring for your smile" by making quality treatment, patient satisfaction and personal comfort our priority. We summarize this commitment in the our values of Clinical Excellence, Caring, Cooperation, and Comfort.

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