An underbite is a bite condition that can affect both how your smile looks and how your teeth and jaw function.
If you have been told you have an underbite, or if you have noticed that your lower front teeth sit in front of your upper front teeth when you close your mouth, understanding how to fix an underbite is a great first step toward exploring your options.
What Is an Underbite?
An underbite, also known as a Class III malocclusion, occurs when the lower teeth extend in front of the upper front teeth when the jaws are closed. In a properly aligned bite, the upper teeth should sit slightly in front of the lower teeth, when that relationship is reversed, it is classified as an underbite.
Underbites can range from mild, where only one or two teeth are out of position, to severe, where the lower jaw protrudes significantly. The appropriate treatment depends on the type and severity of the underbite, as well as the patient's age.
What Causes an Underbite?
Understanding what causes an underbite is helpful context for discussing treatment. Several factors can contribute to the development of this bite pattern.
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Genetics: Jaw shape and size are largely inherited. If a parent or grandparent had an underbite, there is a higher likelihood that it may appear in subsequent generations.
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Childhood habits: Prolonged pacifier use, thumb sucking, or bottle feeding past infancy can influence jaw development in ways that contribute to bite misalignment.
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Jaw development differences: In some cases, the lower jaw grows more than the upper jaw, or the upper jaw does not develop as fully, resulting in the lower teeth ending up in front.
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Injury: Trauma to the face or jaw can sometimes shift teeth or affect jaw alignment.
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Tumors: In rare cases, growths in the jaw area can affect the position of the teeth and jaws.
How to Fix an Underbite: Treatment Options
The most appropriate underbite treatment depends on the severity of the condition, whether the cause is dental or skeletal, and the age of the patient. Here is an overview of the main approaches.
Braces for Underbite
Can braces fix an underbite? In many cases, yes. Braces work by applying steady pressure to move individual teeth into better positions, and this can include repositioning the lower teeth to sit behind the upper teeth as they should.
For dental underbites, where the problem lies primarily in the positioning of the teeth rather than the jaw structure itself, braces are often very effective.
Clear Aligners for Underbite Correction
In mild to moderate cases, clear aligners can be part of underbite correction. Like braces, aligners use a series of custom-fitted trays to move teeth gradually into better positions.
For more complex underbite cases, especially those involving significant jaw discrepancy, braces may offer more control.
Learn more about whether Invisalign can fix an underbite.
Orthodontic Appliances in Growing Patients
For children and adolescents whose jaws are still developing, an orthodontist may recommend functional appliances designed to influence jaw growth.
Upper jaw expanders can help widen the upper arch and encourage forward growth of the upper jaw. Facemask therapy, sometimes called reverse-pull headgear, applies gentle pressure to the upper jaw to encourage it to grow forward.
These approaches work best during the years when growth is still occurring, which is one reason early orthodontic evaluation is so valuable.
Surgical Options for Severe Underbites
In adults with a significant skeletal underbite, where the jaw relationship itself is the primary issue rather than the teeth alone, orthodontic treatment may be combined with a referral to an oral and maxillofacial surgeon for evaluation.
Orthognathic surgery can reposition one or both jaws when the discrepancy is too large to be addressed through tooth movement alone.
It is worth noting that surgery is not required for most underbite cases; many patients achieve meaningful improvement through orthodontic treatment without any surgical intervention.
Underbite Correction at Different Ages
Children
Addressing an underbite during childhood, ideally between ages seven and ten, offers the greatest range of treatment options because the jaw is still growing and more responsive to guidance. Early treatment does not always eliminate the need for additional care later, but it can prevent the condition from becoming more severe and may simplify eventual treatment.
Teens
Adolescence is one of the most common times for underbite treatment to take place, as the teeth are often fully erupted and the jaw is still growing but approaching its final position. Braces combined with elastics or other appliances are commonly used during this phase.
Adults
Adults can still benefit significantly from underbite treatment. While the jaw is fully developed in adulthood, tooth movement is still very achievable, and many dental underbites can be effectively addressed with braces or clear aligners. More severe skeletal cases in adults may include surgical consultation, but many patients are surprised to find that orthodontic treatment alone produces excellent results.
FAQ
At what age should an underbite be treated?
A: An initial orthodontic evaluation is recommended around age seven. If an underbite is identified early, certain interventions can be used during jaw development that may simplify later treatment. However, underbite correction can be performed successfully at any age.
What Happens If an Underbite Is Left Untreated?
An untreated underbite can lead to a range of concerns over time. These include uneven wear on the teeth, difficulty chewing certain foods, speech challenges in some cases, jaw discomfort, and in more pronounced cases, effects on the appearance of the lower face. Seeking evaluation and treatment not only addresses these concerns but also helps protect long-term oral health.
