Underbite Teeth: Understanding Causes, Symptoms, and Treatment Options

What is an Underbite? Definition and Overview

An underbite occurs when your lower jaw and teeth protrude beyond your upper teeth, creating a misalignment in your bite. Unlike a normal bite where upper teeth slightly overlap the lower teeth, an underbite creates a distinct facial profile where the chin appears more prominent. This dental condition, also known as a Class III malocclusion, ranges from mild to severe cases.

In mild underbites, the lower teeth may only slightly overlap the upper teeth, creating minimal aesthetic concerns but potentially causing functional issues over time. Severe underbites present more noticeable facial asymmetry, with a significant gap between upper and lower teeth that prevents proper contact when biting.

Understanding your specific underbite severity is crucial for determining the most effective treatment approach. At Belmar Orthodontics in Lakewood, CO, Dr. Timothy Hardy and Dr. Cierra Randall specialize in diagnosing and treating underbites of all severities, using advanced orthodontic techniques tailored to each patient’s unique needs.

Common Causes of Underbite Development

Genetic Factors

Genetics plays a significant role in underbite development, making this condition often run in families. Your inherited jaw structure, tooth size, and tooth formation patterns can predispose you to developing an underbite. Some people are simply born with disproportionate jaw sizes or teeth that are positioned improperly.

Genetic factors can lead to several dental issues that contribute to underbites, including crowded teeth, impacted teeth, hypodontia (missing teeth), irregularly shaped teeth, or teeth that don’t properly align. If your parents or siblings have underbites, you may have a higher likelihood of developing this condition as well.

Understanding your family’s dental history can help predict potential orthodontic issues and allow for earlier intervention, which often leads to more successful treatment outcomes with less invasive procedures.

Childhood Habits and Environmental Factors

Many childhood behaviors contribute significantly to underbite development when continued past the appropriate developmental stage. These include:

• Prolonged pacifier use (especially after age 3)
• Tongue thrusting against front teeth
• Persistent thumb sucking
• Extended bottle feeding
• Nail biting
• Poor oral hygiene practices

These habits can exert abnormal pressure on developing jaw bones and teeth, gradually pushing the lower jaw forward and contributing to underbite formation. The earlier these habits are identified and addressed, the better the chances of preventing underbite development or reducing its severity.

Injury and Medical Conditions

Traumatic injuries to the jaw can permanently alter jaw alignment and contribute to underbite development. Even after surgical repair, jaw fractures may heal imperfectly, causing the lower jaw to sit too far forward relative to the upper jaw.

Additionally, certain medical conditions can affect jaw development:

• Tumors in the mouth or jaw can cause abnormal growth patterns
• Cleft lip and palate often affect jaw development and tooth alignment
• Hormonal imbalances may influence bone growth and development
• Certain syndromes affecting facial development

These conditions require specialized care that addresses both the medical condition and the resulting dental issues, often involving collaboration between medical specialists and orthodontists.

Types of Underbites: Understanding Your Condition

Dental Underbites

Dental underbites primarily involve tooth misalignment rather than jaw structure issues. In this type, the teeth themselves are angled improperly, causing the lower front teeth to sit in front of the upper teeth when biting. This is essentially an anterior crossbite, where the misalignment occurs in the front of the mouth.

While the lower jaw itself doesn’t necessarily protrude in dental underbites, the positioning of the teeth creates the appearance of a protruding lower jaw. This type of underbite is generally more responsive to traditional orthodontic treatments like braces or clear aligners, as the underlying bone structure is normal.

Dental underbites often develop due to environmental factors like the childhood habits mentioned earlier, making early intervention particularly effective for this type.

Skeletal Underbites

Skeletal underbites occur due to a fundamental misalignment of the jaw bones. This condition develops when the lower jawbone (mandible) is either oversized or positioned too far forward, or when the upper jawbone (maxilla) is underdeveloped. This creates a structural imbalance that causes the lower teeth to protrude beyond the upper teeth.

Being primarily genetic in origin, skeletal underbites often require more comprehensive treatment approaches. While early intervention with orthodontic appliances can guide growing jaws into better alignment, fully developed skeletal underbites in adults may require a combination of orthodontics and orthognathic (jaw) surgery for optimal correction.

Identifying whether your underbite is dental or skeletal is crucial for determining the most effective treatment approach, which is why a thorough evaluation by an experienced orthodontist at Belmar Orthodontics is an essential first step.

Health Consequences of Untreated Underbites

Functional Challenges

Underbites create significant functional challenges that affect daily life in numerous ways:

• Speech Difficulties: The abnormal jaw position can interfere with proper tongue placement, leading to pronunciation difficulties with certain sounds, particularly “s,” “z,” and “th” sounds.
• Chewing Problems: Improper tooth alignment makes proper chewing difficult, potentially leading to inadequate food breakdown, digestive issues, and nutritional challenges.
• Jaw Pain: The misalignment forces your jaw to work harder during normal functions, often resulting in temporomandibular joint (TMJ) pain, headaches, and facial discomfort.

These functional issues tend to worsen over time as the teeth and jaw joints compensate for the misalignment, making early intervention particularly valuable.

Oral Health Implications

Beyond functional challenges, underbites can lead to serious oral health problems:

• Uneven Tooth Wear: The abnormal bite pattern causes certain teeth to bear excessive pressure, leading to premature and uneven enamel wear.
• Increased Tooth Decay Risk: Misaligned teeth create difficult-to-clean spaces where food particles and bacteria accumulate.
• Gum Disease: The same cleaning challenges increase the risk of gum inflammation and periodontitis.
• Tooth Fracture or Loss: Improper bite distribution increases the risk of tooth damage or premature tooth loss.
• Sleep Apnea: Severe underbites can contribute to airway issues and sleep-disordered breathing.

Regular dental check-ups are especially important for underbite patients to monitor and address these potential complications.

Psychological Impact

The visible nature of underbites can have significant psychological effects, particularly in children and adolescents:

• Self-confidence Issues: The altered facial appearance may lead to self-consciousness about smiling or speaking in public.
• Social Anxiety: Concerns about appearance or speech difficulties may lead to social withdrawal.
• Bullying Risk: Unfortunately, visible dental differences can make children targets for teasing.

Addressing underbites isn’t just about physical health—it’s also about supporting overall well-being and quality of life. At Belmar Orthodontics, we understand the emotional aspects of orthodontic issues and strive to create a supportive environment throughout the treatment process.

Treatment Options for Underbites at Belmar Orthodontics

Non-Surgical Treatment Approaches

Braces and Clear Aligners

Traditional braces remain one of the most effective methods for correcting underbites, especially dental underbites or mild skeletal cases. At Belmar Orthodontics, we offer various braces options:

• Traditional Metal Braces: Highly effective for complex bite issues, these have become more comfortable and less noticeable than in the past.
• Clear Aligners (Invisalign®): For mild to moderate underbites, Invisalign offers a nearly invisible alternative that can be removed for eating and cleaning.
• Clear Ceramic Braces: These work like traditional braces but blend with your natural tooth color for a more discreet appearance.

Each option has specific advantages and limitations, which Dr. Hardy or Dr. Randall will discuss based on your unique case during your consultation.

Specialized Orthodontic Appliances

For growing children and adolescents with underbites, specialized appliances can guide jaw growth and development:

• Reverse-Pull Facial Mask: Similar to headgear, this appliance gently pulls the upper jaw forward to correct its position relative to the lower jaw. It’s typically worn at night and for several hours during the day.
• Upper Jaw Expanders: These devices widen the upper jaw and dental arch using a central screw mechanism, creating better alignment with the lower teeth. They’re particularly effective before the mid-palatal suture fuses.
• Chin Caps: For some growing patients, devices that restrict lower jaw growth while allowing normal upper jaw development can be effective.

Early intervention with these appliances often prevents the need for more invasive treatments later in life, highlighting the importance of early orthodontic evaluation.

Surgical Options for Severe Cases

For adult patients with severe skeletal underbites or cases that don’t respond adequately to orthodontic treatment alone, surgical options may be recommended:

• Orthognathic Surgery: This highly customized procedure involves separating and repositioning the jawbones to achieve proper alignment. It’s typically performed by an oral surgeon in collaboration with your orthodontist.
• Combined Surgical-Orthodontic Approach: Most surgical cases involve braces before and after surgery—before to align the teeth properly for surgery, and after to fine-tune the final bite.

At Belmar Orthodontics, we work closely with skilled oral surgeons when surgical correction is needed, ensuring comprehensive care throughout the entire treatment process.

Underbite vs. Overbite: Understanding the Difference

How They Differ

While both are bite misalignments, underbites and overbites represent opposite conditions:

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Feature	Underbite	Overbite
Position	Lower teeth extend beyond upper teeth	Upper teeth significantly overlap lower teeth
Jaw Relation	Lower jaw positioned ahead of upper jaw	Upper jaw extends beyond lower jaw
Visual Appearance	More prominent chin and lower profile	Recessed chin, potential “buck teeth” appearance
Common Causes	Genetics, childhood habits, injuries	Genetics, thumb sucking, prolonged pacifier use

Understanding these differences helps explain why treatment approaches vary between these conditions, even though both involve bite correction.

Treatment Approach Variations

The fundamental difference in jaw relationships means underbites and overbites often require different treatment strategies:

• Underbite Correction: Often focuses on bringing the upper jaw forward or restricting lower jaw growth/position.
• Overbite Correction: Typically aims to bring the lower jaw forward or restrict excessive upper jaw development.

Both conditions benefit from early intervention, but the specific appliances and techniques differ based on the direction of correction needed. At Belmar Orthodontics, we specialize in treating both conditions with customized approaches for each patient.

Why Choose Belmar Orthodontics for Underbite Treatment

At Belmar Orthodontics, our approach to underbite treatment combines clinical excellence with personalized care:

• Board-Certified Expertise: Dr. Timothy Hardy and Dr. Cierra Randall bring specialized training and experience in treating complex bite issues.
• Comprehensive Options: From traditional braces to cutting-edge options like Invisalign, we offer solutions for every preference and lifestyle.
• State-of-the-Art Technology: Our digital treatment planning and 3D imaging ensure precise diagnosis and treatment planning.

We believe in empowering our patients through education and involving them in treatment decisions, creating a collaborative approach that leads to better outcomes and greater satisfaction.

Frequently Asked Questions About Underbites

At what age should underbite treatment begin?

While the ideal age varies depending on the case, early evaluation is crucial. The American Association of Orthodontists recommends children have their first orthodontic check-up by age seven. For underbites specifically, early intervention between ages seven and ten can take advantage of growth modification, potentially preventing the need for surgery later. However, it’s never too late to seek treatment—many adults successfully correct underbites through orthodontics, sometimes combined with surgical approaches when necessary. At Belmar Orthodontics, we evaluate each case individually to determine the optimal timing for intervention.

How long does underbite correction typically take?

Treatment duration varies significantly based on several factors: the severity of the underbite, whether it’s dental or skeletal in nature, the patient’s age, and the treatment method selected. Generally, orthodontic treatment for underbites ranges from 12 to 36 months. Early interventions using growth modification appliances in children might require 12-18 months, while comprehensive treatment with braces or aligners typically takes 18-24 months. Cases requiring surgical intervention may extend to 24-36 months total, including pre-surgical orthodontics, surgery, and post-surgical refinement. During your consultation at Belmar Orthodontics, we’ll provide a personalized timeline based on your specific situation.

Will my insurance cover underbite treatment?

Insurance coverage for underbite treatment varies widely depending on your specific plan. Many dental insurance plans provide partial coverage for orthodontic treatment, typically ranging from 25% to 50% of the total cost, often with a lifetime maximum benefit. When the underbite causes functional problems (difficulty chewing, speaking, or breathing), medical insurance might provide coverage, particularly for surgical interventions. At Belmar Orthodontics, we accept all PPO dental insurance plans and Medicaid. Our team works directly with your insurance providers to maximize your benefits and can also help determine if you qualify for medical insurance coverage for your treatment.

Is underbite correction painful?

Modern orthodontic treatment has become significantly more comfortable than in previous decades. While some discomfort is normal, particularly in the days following adjustments or when beginning with new appliances, this discomfort is typically mild and temporary. Most patients describe it as pressure rather than pain, and it can be easily managed with over-the-counter pain relievers. Surgical correction involves a recovery period with more significant discomfort, but this is carefully managed with appropriate pain medication and detailed recovery instructions. At Belmar Orthodontics, patient comfort is a priority, and we provide thorough instructions and support to minimize discomfort throughout treatment.

What happens if I don’t treat my underbite?

Untreated underbites often worsen over time, leading to a cascade of potential problems. The functional issues—difficulty chewing, speaking clearly, and jaw pain—typically intensify with age. Uneven tooth wear accelerates, potentially leading to enamel loss, sensitivity, and even tooth fracture or loss. The strain on jaw joints can develop into temporomandibular joint disorders (TMD), causing chronic pain, headaches, and limited jaw function. Additionally, some patients experience progressive changes in facial appearance as the misalignment becomes more pronounced. While mild underbites might cause minimal problems for some people, most moderate to severe cases benefit significantly from correction to prevent these long-term complications.

Take the First Step Toward a Healthier Smile Today

Don’t let an underbite affect your oral health, function, or confidence. At Belmar Orthodontics, we’re committed to providing personalized underbite treatment using the latest orthodontic techniques in a comfortable, supportive environment.

Our experienced team, led by Dr. Timothy Hardy and Dr. Cierra Randall, specializes in correcting underbites for patients of all ages throughout Lakewood and surrounding communities. Whether you’re considering treatment for yourself or your child, we’ll create a customized plan that fits your unique needs and lifestyle.

Ready to transform your smile? Schedule your complimentary consultation today and discover how we can help you achieve optimal dental health and a confident smile.

📍 Visit Us: 311 S Teller St, Lakewood, CO 80226 📞 Call: (720) 330-2673 📩 Or Request an Appointment Online Today