New patients to our practice sometimes present with complaints about their “overbite.” More often than not, they actually have a condition known as “overjet.”
Let’s clear up the confusion by explaining the two types of malocclusion. Then I’ll explain several methods that orthodontists use for correcting overjet.
Overbite is a term used to describe the overlap of your upper front teeth in relation to your lower front teeth. A normal overbite is where your upper teeth overlap your lowers about a third of the way. An excessive overbite could cause your lower front teeth to touch the gum area behind your upper front teeth, and perhaps even cause gum recession in that area.
Overjet describes the distance in which the upper front teeth sit forward of the lower front teeth. You’ve probably also heard it called “buck teeth.” This is what most people actually are referring to when they say they have overbite.
Overjet can prevent you from being able to comfortably close your lips together. It also can make you more susceptible to injury. That’s right. Correcting overjet is about more than simply improving aesthetics and boosting self-confidence. There’s an unfavorable relationship between overjet size and an increased prevalence of traumatic dental injuries.
Children who have an overjet greater than 3 millimeters are about twice as likely to suffer traumatic dental injuries to their front teeth as those with overjet of less than 3 millimeters, according to a study published in the European Journal of Orthodontics in 1999. The greater the overjet, the greater the risk.
The American Association of Orthodontists recommends that children be evaluated by an orthodontist at age 7. Overjet is just one type of malocclusion that is most effectively treated when diagnosed early. We can guide a child’s tooth eruption and use growth to our advantage to correct overjet. But if you’re an adult seeking treatment, don’t despair. Orthodontic treatment can improve overjet at any age.
The patient’s age and unique orthodontic needs determine the treatment approach, which can include bite correction devices, braces and removable appliances, tooth removal, or even surgery.
Following is more detailed information regarding several types of treatments that may be used to correct this common condition.
Herbst ApplianceHerbst Appliance
Emil Herbst developed this appliance in the early 1900s, and Dr. Hanz Pancherz reintroduced it in the 1970s. It has evolved into what some dental laboratories call one of the most popular functional appliances used in the U.S. today. It is a fixed appliance – meaning patients can’t remove it – that delivers highly predictable results.
I have found the Herbst Appliance to be a powerful tool in an orthodontist’s tool chest when it comes to advancing the lower jaw, which often needs to be done in cases of overjet. Advancing the lower jaw decreases the distance in which the upper front teeth sit forward of the lower front teeth.
I use the Herbst Appliance on children who require dental and skeletal alterations to improve overjet. The Herbst also can be equipped with additional appliances, such as expansion screws to widen the dental arches.
Headgear Activator
Headgear is the butt of many jokes, but there’s no question that it is effective at improving overjet in patients who are compliant and wear it for the prescribed length of time.
Headgear achieves similar results to the Herbst Appliance, according to a study published in 2009 in the American Journal of Orthodontics and Dentofacial Orthopedics. That study found that patients treated with a Herbst Appliance followed by braces, and those treated with headgear, braces and elastics each experienced success rates of nearly 93 percent.
Elastics
True, they come in a rainbow of colors that our patients love, but these tiny rubber bands serve a greater purpose than helping you show your school spirit or represent your favorite sports team. Elastics come in different lengths and are used to apply additional forces to the teeth to achieve specific movements.
We use them by bonding special brackets with hooks to certain teeth. You loop the elastics onto the hooks. For example: overjet improvement sometimes is achieved by connecting an elastic from the upper incisors to the lower molars. This configuration helps slow upper jaw growth while prompting forward lower jaw growth to reduce the forward distance between your upper and lower front teeth.
This graphic from AskAnOrthodontist.com demonstrates what I’m talking about.
Twin Block Appliance
This removable appliance typically is worn for nine to 12 months to promote lower jaw growth. The appliance consists of upper and lower plates and is commonly used in children who are still growing. It also has a screw that gets turned weekly to help position the jaw forward. It may be used as an initial phase of treatment before your child gets braces.
Invisalign
Invisalign has long been a favorite for patients seeking aesthetic treatment options, but its technological improvements continue to make it a powerful tool in treating a variety of alignment and bite issues in adolescents and adults.
This system of clear, plastic removable aligners can be used to correct minor overjet by applying proper forces to the appropriate teeth.
Extraction
In some cases, removing some teeth is an option for correcting overjet. This is more common in adult cases. Examples when this treatment approach would be considered are:
- The patient’s upper jaw isn’t large enough to accommodate all the adult teeth.
- The patient’s lower jaw has a shorter arch, due to missing teeth or underdevelopment.
We may refer you to your family dentist or an oral surgeon for tooth removal. Then we would use that additional space created to shift your upper front teeth back to reduce the size of your overjet.
Orthognathic Surgery
Some patients’ jaw discrepancies cannot be corrected with orthodontic treatment alone. In cases where an adult patient’s lower jaw didn’t grow forward enough, jaw surgery may be necessary to achieve the desired result. Surgery may also be necessary for children if developmental issues exist.
Call for an Evaluation
Do you or your child have overjet, and you’re curious to learn what treatment option would best correct it? I invite you to call us and schedule an appointment for a consultation. We will conduct a thorough evaluation, which includes a complete set of photographs and digital X-rays to help us develop a treatment plan designed to meet your individual needs.
Overbite Options in 2018
Over time, more and more options have come available for overbite or overjet. No matter what you decide, we strongly suggest seeking the professional advice of an orthodontist. While we suggest Invisalign there are a few alternatives available. Feel free to stop by our office or give us a call if you would like more information on overbite and overjet. We have some amazing resources and documentation that will help you with your final decision.