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If you are a student of Speech or Drama, you know how important it is to be clear and articulate. You’ve worked on pronunciation and projection, and the audience in the back row can understand every word.

And now you’ve gotten braces, and, suddenly, you don’t sound quite like yourself. Why? And, more important, what can you do?

• Don’t Panic!

Many patients see no change at all in their speech after getting braces. With some orthodontic conditions or appliances, you might have problems pronouncing certain sounds, but these changes in articulation are usually quite temporary. 

• Why Are You Sounding Off?

Every consonant is formed in a precise way as tongue, lips, and teeth work together. If you have brackets and wires in the way, or just got a new retainer, or have a set of aligners, you might find that your articulation is a little off, especially for sibilant sounds such as S’s and Z’s. Luckily, we humans are a flexible bunch, and it usually takes a very short time for our tongues and mouths to adapt to orthodontic appliances and return to normal pronunciation.

If your speech is affected at first because your lips and cheeks are sore or sensitive after getting braces, take time to take care of yourself! Use wax as often as needed to cover irritating brackets and wires, eat foods that are low in salt, spice, and acids, and follow your orthodontist’s instructions for taking care of your mouth. You should start feeling better within a few days, and should be fine after a week or two. If pain or discomfort persists, call your orthodontist.

• Practice Makes Perfect

If you want to speed along the process of getting back to your normal pronunciation habits, practice! Read aloud, sing along to your favorite songs, recite lists of words with the specific sounds you want to work on. Oddly enough, to get back to your normal speech more quickly, slow down. Thinking before you speak is never a bad idea, and, in this case, thinking while you speak can help you position your tongue and mouth to verbalize tricky sounds more easily.

You don’t have to be a national debate champion or the world’s most blood-curdling Lady Macbeth to be concerned about clear speech. Talk to Dr. Paul Gates during your next appointment at our Round Rock, TX office if you find you are having problems with pronunciation. Whether your appliance needs an adjustment, or you need a few suggestions for speech exercises, or it’s simply a matter of time, soon you’ll be back on the road to perfect pronunciation—and on the way to your perfect smile.

When does an underbite need surgery? The short answer is: when Dr. Paul Gates 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. Paul Gates 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 Round Rock, TX 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. Paul Gates 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. Paul Gates 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.

There's something special about customizing the elastics on your braces to fit your unique personality. Once you embrace your braces (no pun intended) you'll realize how many color options and combinations there are to choose from. Although you'll have a fantastic smile afterward, you won't have this level of customizability once your braces come off, that's for sure!

Adding flair to your braces isn't what all patients are looking to do (like those opting for clear aligners or ceramic braces), but it's part of the fun of traditional metal braces! Many of our patients ask Dr. Paul Gates to have their elastics match the colors of their favorite sports teams or their school, but how about changing your elastics to match holiday colors?

Here are some options to consider:

• Valentine’s Day – Red and pink
• Easter – Pink, blue, and violet
• Halloween – Orange and black
• Christmas – Red, green, and white
• Saint Patrick’s Day – Green and white

There are a few colors that some people choose to avoid. But if you’re trying to make your teeth stand out in a crowd, the following suggestions need not apply!

• Brown or Green – can be mistaken for food being stuck in your teeth
• Black – might look like a rotten tooth if someone isn't looking hard enough
• White – Some patients think it will make their teeth look whiter, but in fact it can make your teeth appear yellower than they actually are. White elastics can also stain easily.
• Yellow – accentuates the yellowness of your enamel

Since changing the color of your elastics has no effect on the actual orthodontic treatment process, the idea is to have fun and add a personal touch. So, next time you get your elastics changed at our Round Rock, TX office, why not wear your braces boldly and opt for something festive?

A clean mouth is a happy mouth. And when Dr. Paul Gates and our staff see you have a clean mouth, we are happy too. Of course, all of this should make you happy because you’re the one preventing sneaky little food bits from getting trapped under the wires of your braces.

Still, you need to be thorough with your brushing. When you have braces, you’re playing a game of hide-and-go-seek with everything you eat. Here are five tips to keep your mouth (and us) happy.

1. How is brushing with braces like geometry? It’s all about the angles. Brush the tops of your teeth and braces with your brush angled down. Brush the bottom of your teeth with the brush angled up. Pointy brushes, aka interproximal brushes, are good for reaching the tiny spots around braces.
2. Brush after every meal. If those sneaky little food bits hide in your mouth for very long, they’ll turn into plaque. And plaque is a sign of a very unhappy mouth.
3. Brush one tooth at a time for at least ten seconds, and pay close attention to the spots where your braces touch your teeth.
4. Fluoride is your new BFF. Make sure your toothpaste and mouthwash contain this cavity-fighting ingredient.
5. Braces are no excuse not to floss. In fact, saying you can’t floss because you have braces is like saying the dog ate your homework. Dr. Paul Gates and our staff, like your geometry teacher, aren’t going to buy it. Be sure to floss after every meal.