IN Better Health
by Mimi Greenwood Knight
with Dara Ruhlman DARA RUHLMAN IS A CONFIDENT, vivacious college student—and she has the smile to prove it. But that wasn’t always the case. Born with a severe underbite, Dara grew up with the knowledge that corrective jaw surgery was in her future. “The dentist told us when she was only six that she’d need more than braces,” her mother, Eileen, says. “She’d require surgery to break her jaw and reset it correctly, but surgery would have to wait until her facial structure finished growing, around age 18. So we started talking to her about it at a young age.” An underbite, a specific type of malocclusion, is a dental condition where the lower jaw protrudes up and outward 42
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abnormally, partially overlapping upper teeth. While overbites are extremely common, underbites only affect five to 10 percent of the world’s population. An underbite can be hereditary or can be caused by poor chewing habits, abnormalities in the jawbone or thumbsucking. Unlike most forms of overbites, underbites usually can’t go untreated. They can lead to serious jaw problems and medical conditions such as TMJ disorder or other jaw pain, headaches, increased wear and tear on tooth enamel and increased chance of tooth decay and gum disease (periodontal disease). An underbite can interfere with speech and change the structure and appearance of the face, mouth and smile, all of which can lead to low self-esteem. In short, an underbite is more than just a cosmetic issue. Dara’s parents turned to a family friend, orthodontist Mike Macaluso of Brown Family Orthodontics, who concurred with the dentist’s diagnosis. Three years later, Dr. Macaluso fit Dara, age 9, with her first set of braces. “I wore them a year and a half,” says Dara. “Then, when I was 16 and a junior in high school, I wore a second set to prepare me for the surgery I had last December.” Oral surgeon Michael Ferguson performed the surgery, which Dara reports wasn’t as bad as she’d feared. “We scheduled it while I was out of
photo: CANDRA GEORGE mycreativereality.com
Health Concern: Severe underbite. Treatment: Braces and jaw surgery.