An underbite is clinically known as mandibular prognathism. This malocclusion or ‘bad bite’ occurs when the lower teeth overlap the upper teeth. Some cases of underbite are severe, especially when the lower teeth extend significantly far forward.
An underbite is a noticeable dental issue. It can create a bull-dog-like appearance in the mouth and face, affecting a person’s self-esteem. An underbite can also give the impression of expressing emotion that isn’t intended. Most people who have an underbite want to correct the problem due to these reasons.
Early intervention is recommended for correcting the problem without surgery.
Underbites are often hereditary. However, poor chewing habits, thumb sucking, and pacifier use can also contribute to an underbite. While some people live happily with mild underbites, severe cases can lead to dental health problems.
These dental health issues include:
There are several methods for correcting an underbite. These range from jaw surgery to using a selection of orthodontic treatments and devices. If treatment is performed while the patient is young, an orthodontic appliance can often resolve the problem.
Children should visit the orthodontist by age five. The earlier underbite treatment starts, the simpler and less expensive it will be.
Invisalign uses advanced technology to help fix an underbite. Patients wear customized clear aligners for two weeks at a time for a minimum of 22 hours a day.
They are only taken out to eat, drink, brush, and floss. With time, the jaw and teeth gradually move into a straighter position.
However, correcting underbites with Invisalign is very complicated and difficult to achieve. Traditional orthodontics is much more successful.
Braces are the most common way to correct an underbite. Traditional braces are made up of several components. Metal brackets fix directly onto the front of a tooth.
Metal brackets hold the wires that shift the teeth into the correct position. Braces can also include separators or spacers that create room between the teeth.
Rubber ties hold wires to the metal brackets, and rubber bands attach to both the upper and lower brackets to apply pressure. This helps create a perfect bite.
Children can opt for colorful dental braces or traditional metal braces.
The reverse-pull face mask wraps around a child’s head. It slows down the growth of the lower jaw in an attempt to allow the upper jaw growth to “catch up.” It connects the face mask to the teeth using metal bands fixed to the upper back teeth.
The headgear is a metal, vertical bar. It fixes to pads that fit comfortably against the forehead and chin. Metal bands are cemented on the top molar teeth (back teeth) and braces are fixed to the top four incisors (front teeth).
Elastic bands fix to the vertical bar and bands. These help to shift the top jaw outward. The reverse-pull face mask is usually worn for at least 12 hours a day. The headgear is most effective when worn between the ages of five and seven.
An upper jaw expander is a wire-frame appliance that orthodontists fit across a patient’s palate. At prescribed intervals, a key is used to widen the expander a small amount. The upper jaw expands gradually until the lower teeth no longer sit outside of the upper teeth.
Patients usually wear the upper jaw expander for a year. It’s often replaced with a retainer afterward.
Baby tooth extractions are a standard underbite treatment for children. With the early extraction of the teeth, there is room for permanent teeth to grow straight.
Orthodontists try to avoid extracting a child’s permanent teeth. However, in severe underbite cases, treatment may be required for free movement of the teeth.
Adults with an underbite require different orthodontic treatment than a child with the same condition.
Invisalign clear aligners can also fix some adults’ underbites. However, severe underbites may require Invisalign treatment as well as surgery. Speak with a dentist or oral surgeon to discuss possible treatment plans.
Dental braces are commonly used to treat underbites in people of all ages because they are very effective in doing so.
Adults who do not want metal braces can opt for transparent and rubbery braces. Clear braces can help boost confidence and self-esteem.
Most certified oral surgeons can successfully correct underbites.
Common types of underbite surgery include reshaping to lengthen the upper jaw or shortening the lower jaw. In some cases, wires, plates, or screws are also used to help maintain the proper position of the jawbone.
The underbite surgery correction method involves breaking the lower jaw. Some of the bone is extracted, and then the jaw bone is repositioned into the correct position. Once the jaw shifts to proper alignment, the upper and lower jaws are held in place with elastics or wires. Patients must follow a liquid diet until the jaw heals.
During recovery after underbite surgery, jaw pain and discomfort can develop. Patients must wear braces for approximately a year to align the teeth. Underbite surgery also comes with some risks, including general anesthesia reactions, chances of infection, bleeding problems, and scarring.
For most adults, surgery is the only option for straightening the teeth and correcting an underbite.
In children, severe underbites sometimes require surgery. However, this is rare. For adults, surgery to correct an underbite is almost always necessary because the jaw has fully developed by this stage of life.
Common orthodontic treatments can often be used to treat an underbite. These include Invisalign clear aligners, traditional metal braces, and a range of dental appliances.
If an underbite is untreated, it may lead to temporomandibular joint disorder (TMD). This is a misalignment that causes pressure on the jaw point. TMD can cause head and cheek pain.
An untreated underbite can also lead to premature wear and tear on the teeth.
Underbites can be corrected as young as 5 years old. This is an excellent age to address an underbite because the bones have not fused yet. Once the bones fuse in adulthood, underbite surgery is often the only option.
Malocclusion of teeth, MedlinePlus, 2020, https://medlineplus.gov/ency/article/001058.htm
Underbite, Invisalign, https://www.invisalign.com/treatable-cases/underbite
Tran K, Picheca L. Orthodontic Treatment for the Management of Pain or Impacted Teeth in Patients with Malocclusion: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Jun 5, https://www.ncbi.nlm.nih.gov/books/NBK519547/
Dental braces and retainers, Health Direct, https://www.healthdirect.gov.au/dental-braces-and-retainers
Extractions (removal) of baby teeth, Queensland government, 2017, https://www.health.qld.gov.au/__data/assets/pdf_file/0026/364652/dental_07.pdf