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Causes and Treatments for Underbite

If left untreated, an underbite can cause major problems. This bite problem can affect everything from self-esteem to sleep quality.

An underbite happens when the bottom teeth and lower jaw extend out beyond the upper teeth when the mouth is closed. Sometimes an underbite is called by its scientific name; prognathism.

In moderate to severe cases of underbite, the face can take on a bulldog-like look due to the bottom jaw bone protruding forward.

This is one of “the most severe” conditions that can occur in the jaw, teeth, and face. The protruding jaw is not just a cosmetic concern, but a potential threat to the patient’s dental health. It can cause many serious issues if left untreated.

If you have an underbite, it is crucial to seek treatment, because an underbite can cause many unpleasant complications.

What causes underbite?

Several factors, including genetic makeup, environmental factors, or other illnesses can cause an underbite. Some of the factors that cause an underbite include:

· Genetic factors, like the famous Hapsburg jaw (many members of the German-Austrian royal family in the 17th and 18th centuries had a distinctive underbite).

· The upper jaw is aligned too far backwards, or the lower jaw is aligned too far forwards

· The upper teeth are tipped backward, the lower teeth are slanted forward, or the teeth are overcrowded

· Thumb sucking, pacifier overuse, mouth breathing, or tongue thrusting, which can shift the      teeth

· A broken jawbone that has healed improperly

· Cleft lip or palate

· Inherited conditions, like Treacher Collins syndrome or nevoid basal cell carcinoma

Complications and Symptoms of Underbite.

An underbite is typically not a difficult condition to spot. Both its conditions and symptoms are usually clear and easy for a dentist to spot, even in younger children.

The symptoms of an underbite depend, in part, on how severe the misalignment is between the top and bottom teeth.

Perhaps the most commonly noticed is a visible protrusion of the lower jaw beyond the upper front teeth. Noticing overcrowding in the teeth and an aching jaw is also very common.

There are many difficulties that can come with an underbite, many ranging beyond the mouth. Here are some of the most common effects:

  • Speech difficulties
  • Pain in the jaw or mouth
  • Frequent headaches
  • TMJ/TMD
  • Ear discomfort or dysfunction
  • Stomach issues
  • Sleep apnea
  • Bruxism
  • Hypertension

Treating an Underbite

You have several treatment options if you or your loved one suffers from an underbite.

Your insurance will want to know if this is cosmetic dentistry or a necessary procedure for your oral health, which may determine how much of the treatment cost the insurance will cover.

Pricing for dental work also depends on your location and the dentist you choose.

The severity of your underbite can also affect what sort of treatment you need—more severe cases may require more invasive methods.

If you or your child has a “pseudo” class III underbite, meaning lower teeth are ahead of the upper but jaw sizes are appropriate, braces/Invisalign and extractions may be an option. However, if an underbite is caused by skeletal issues, surgery may be the only choice.

1.     Braces/Invisalign

You will need a treatment plan to realign your jaw and align your teeth, once an underbite is detected. In milder cases, your underbite may be correctable with orthodontic treatment alone.

Invisalign (or other clear retainers), when it’s an option, creates fewer calcifications and uses safe ingredients that are free of BPAs and carcinogens.

This option however may not work for children. Invisalign has been successfully used  on class III underbites, but it may require tooth extractions. Metal braces are generally the go-to method for kids.

Before or instead of braces, your orthodontist may recommend specialized headgear. A reverse-pull headgear uses metal bands attached to the upper back teeth and wraps around the head to pull the jaw into place.

Another potential orthodontic treatment is an upper jaw expander, which involves fixing a plastic and wire device to the roof of the mouth, expanded by turning a key daily. Over the course of roughly a year, the palate expands to correct the bite.

2. Tooth Extraction

Overcrowding in the teeth can create an underbite, particularly in the upper or lower front teeth.

In the case of overcrowding, tooth extraction may be necessary to relieve the pressure this causes and aid the jaw in relaxing into its natural position.

3. Tooth Reshaping

Tooth reshaping is a cosmetic dentistry option, in cases where the teeth do not fit in the mouth properly.

In this treatment, the bottom teeth may be shaved down and reshaped slightly, and veneers fitted to the upper teeth. This can realign how the jaw fits together and is appropriate for some mild cases of an underbite.

The benefit of tooth reshaping is that it’s relatively painless, since it only alters tooth enamel, and lowers the incidence of tooth decay.

4. Surgery

For severe underbite or older patients, jaw surgery (also referred to as orthognathic surgery) may be necessary. This typically is recommended in conjunction with orthodontic treatment.

Jaw surgery can realign the position of your upper and lower jaw, and create proper bite patterns in extreme cases of prognathism.

The typical recovery time for a surgery can range between ten and 12 weeks.

5. “Facelift” Dentistry

“Facelift” dentistry aims to correct bite problems using their specialized JawTrac and VENLAY technology—designed to prevent the need for braces and jaw surgery.

This dentistry, available only to adult patients, claims the ability to correct underbites in as little as three weeks by harnessing electronic jaw tracking readings. These are based on the projected natural position of the jaw without having been shifted by a malocclusion. 

Differences Between Underbite and Overbite

In proper alignment, when the mouth is closed, the top front teeth extend very slightly over the lower teeth and jaw.

Extreme cases of this are called an overbite, where the top front teeth extend an extreme amount over the lower teeth. An underbite creates the opposite effect when the mouth closes, pushing the lower jaw and teeth to the front.

Both an underbite and an overbite can make patients self-conscious, causing issues with breathing, chewing, and speaking.

However, the difference is simple: an overbite looks like the upper jaw and teeth are too far forward, and an underbite presents as a protruding lower jaw and teeth.

Underbite Statistics

Estimates for underbite prevalence claim they occur in 5-10% of the population.

One global study took a closer look at the incidence in different nations. The U.S. has a 5% incidence, while China has a whopping 15% of the population with an underbite—perhaps due to genetics.

Burhenne, Mark. “What is an underbite? Causes, Treatments”. Ask the Dentist, 11 Dec 2019

https://askthedentist.com/underbite/

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