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What Is An Underbite?

By Lan Pham, Marga Adriano
An untreated underbite may lead to increased tooth wear and pressure on the jaw joints, according to experts. Learn more about corrective options for aligning your bite.

An underbite is a common form of dental misalignment. If you have one, you may have considered treatment in order to address resulting aesthetic or dental health concerns. In fact, a misaligned bite can cause muscle tension, tooth wear, and pain, according to the American Dental Association. Fortunately, there are several underbite treatment options that can improve both your smile and health. Learn more about the characteristics of an underbite and the corrective methods that can address the condition. 

Underbite Definition

An underbite is when the lower jaw sits in front of the upper jaw, according to the American Association of Orthodontists. The condition can arise due to a number of different factors, from hereditary predisposition to childhood habits such as thumb-sucking. 

An underbite can lead to increased tooth wear and cause stress on the joints of the jaw. In severe cases, it can even cause problems with speech. 

Underbite Treatment Options

The right treatment for your underbite will depend on the severity of your condition as well as your age. 

Upper Expander with Reverse Pull Headgear

"If the underbite is due to a skeletal disturbance and the patient is young, prior to puberty, then interceptive orthodontic treatment is often rendered,” Brittany Hazard Fischer, DDS, MS, Orthodontist at Pediatric Dentistry and Orthodontic Specialists, tells WebMD Connect to Care.

The American Association of Orthodontists explains that interceptive treatment, also known as early treatment, occurs while some of the baby teeth are still present. 

“A common interceptive orthodontic treatment plan for a young patient would include an upper expander with a reverse pull headgear to help protract the upper jaw. Limited upper braces are commonly placed during the Phase I treatment as well,” Fischer says. 

This form of corrective treatment addresses an underbite by enhancing the forward growth of the upper jaw during the early interceptive phase, according to Fischer. 

Invisible Aligners

Aligners are a corrective option for some cases of underbite. "If a patient presents with a mild underbite or one that is more dental in nature, then orthodontic treatment alone may be rendered to correct the underbite. This can be done with traditional braces or clear aligner therapy," Fischer says.

"Clear aligner treatment is a series of clear trays that the orthodontist designs digitally and then delivers to the patient and monitors the tooth movement. With clear aligner therapy, the patient changes their trays at home every 1-2 weeks and each tray moves the teeth a small amount,” Fischer explains. 

In some cases, aligners are used in conjunction with tooth attachments. “In order to help the teeth move predictably and keep the tray in place in the mouth, the doctor adds composite attachments to the patient's teeth during treatment and the tray has small bubbles over the attachments to grip the teeth," Fischer says. 

While many prefer aligners over traditional metal braces, braces and aligners are both corrective options for an underbite. "Both braces and clear aligners can be good options and, depending on the ideal mechanics needed for the patient's bite correction, the orthodontist can help guide the patient to the best choice for them," Fischer explains.

Orthognathic Surgery 

Orthognathic surgery, also known as jaw surgery, is another option for treating an underbite. 

"If the patient is beyond puberty and the skeletal growth anomaly is severe, then orthodontics in combination with orthognathic jaw surgery may be recommended. Due to the unpredictable nature of underbite jaw growth, this surgery is typically planned in early adulthood to minimize the risk of outgrowing the treatment result," Fischer says.

The American Association of Orthodontists explains that jaw surgery is recommended for adults with severe cases of misaligned teeth and jaws that cannot be fixed by orthodontic means alone. This treatment method typically involves wearing braces or aligners prior to and/or following the surgery. 

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