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Overbites (buck teeth or deep bite) are class II malocclusions. It occurs when the upper jaw overlaps the lower jaw. It is usually a difference in jawbone alignment, when the lower teeth and jaw are back too far. This form of malocclusion is common but less common than a class I malocclusion (crowded anterior teeth).
Overbites develop in childhood and can either be genetic, due to long-term childhood habits, or both. These habits include tongue thrusting, excessive pacifier use, and finger or thumb sucking.
There are two types of overbites, including:
The most common cause of an overbite is due to the size and shape of a child’s teeth and jaw (genetics). A person’s mouth can either be too large or have too little space to fit teeth properly. If left untreated, this form of malocclusion can also result in overcrowding, crooked teeth, or spaced teeth.
Childhood habits that involve pushing the tongue against the back of the teeth can cause an overbite. This includes long-term pacifier and bottle use, finger sucking, and thumb sucking. If a child already has an overbite due to genetics, these habits can worsen the condition. Breathing disorders, such as sleep apnea, are also linked to this form of malocclusion.
Other common causes of an overbite include, but are not limited to:
An underbite is the opposite of an overbite and occurs when the lower jaw is pushed forward, rather than backward. Although, underbites develop due to similar factors, such as genetics.
Overbites should never go uncorrected. If children do not receive overbite treatment early, they are more likely to need jaw surgery as adults. Severe pain, jaw problems, and dental conditions can also result over time. Common complications of an untreated overbite include:
In a severe anterior overbite, the lower front teeth usually contact the gum line in the back of the upper front teeth. This can result in gum recession, which is when the gum tissue wears away and exposes more of a tooth or a tooth’s root. Gum disease, such as gingivitis or periodontal disease, is more likely to develop.
TMD causes severe pain and dysfunction in the jaw and muscles that control jaw movement. Without overbite treatment, TMD can form over time. Common symptoms include extreme jaw, neck, and face pain, stiffness, lockjaw, headaches, and earaches.
Other complications of untreated overbites include:
The type of treatment depends on the patient’s age, the severity of misalignment, and whether the overbite is skeletal or dental. The earlier an overbite is corrected, the less likely cavities, gum disease, and TMD will develop. Orthodontists recommend waiting until a child turns seven years of age to seek treatment (once the primary teeth begin to shed and permanent teeth erupt). Treatment is still possible for adults, but options are limited since the teeth and jaw are fully developed. Depending on the patient, surgery is typically necessary for adults.
Common treatment options for overbites include:
Baby tooth extractions are a common overbite treatment option for young children. If a child has a smaller jaw, extracting teeth makes room for permanent teeth to grow in straight. Orthodontists do not recommend removing permanent teeth in adults. Although, in extreme cases, extractions may be necessary to allow the teeth to move easily.
Dental braces that incorporate brackets, elastics, and wires successfully treat most overbites. The devices carefully apply pressure to adjust the teeth into the correct alignment. Braces treatment lasts for 18 months to three years. The use of adjunctive intraoral appliances (Herbst appliance) in conjunction with braces, is also common.
If you are looking for a less noticeable overbite treatment option, Invisalign (or another clear aligner brand) might be a good option for you. Talk with your dentist to see if you are a candidate for treatment and compare costs.
In addition to braces, cervical pull headgear may be necessary. This type of headgear consists of a strap that is worn around the neck and attaches to the patient’s braces. The appliance holds a patient’s upper teeth and jaw in place while the lower jaw shifts forward.
Jaw surgery for an overbite is the most expensive treatment option (up to $40,000). Adults who have severe overbites and fully developed jaws typically require surgery. Overbite surgery consists of an exam, X-rays, and general anesthesia administration. Then the jawbone is cut, reshaped, and repositioned by an oral surgeon. This type of jaw surgery, called orthognathic surgery, requires orthodontic treatment and coordination between the orthodontist and oral surgeon.
Cobourne, Martyn T., and Andrew T. DiBiase. Handbook of Orthodontics. Elsevier, 2016.
“Orthodontic Treatment Options.” American Association of Orthodontists, www.aaoinfo.org/orthodontic-treatment-options/.
Proffit, William R., et al. Contemporary Orthodontics. Elsevier/Mosby, 2019.
Recognizing and Correcting Developing Malocclusions: a Problem-Oriented Approaches to Orthodontics. Wiley, 2015.
Sterling, Evelina Weidman. Your Childs Teeth: a Complete Guide for Parents. Johns Hopkins University Press, 2013.