Your teeth can have a big effect on your overall health and well-being. Having a row of straight, white teeth can boost your self-esteem and confidence. But teeth don't always grow straight. It can take work and time to get straight teeth. In some cases, it might not just be your teeth that need straightening.
The way your jaw sits also plays a role in your mouth's appearance. Your jaw has an upper part and a lower one. An underbite is when the lower part of your jaw juts out farther than the upper part. It can be uncomfortable, causing problems with chewing, digestion, and sleeping.
What Is Underbite?
Normally, the top teeth sit slightly outside the bottom teeth. An underbite is a dental condition where your lower teeth extend farther than your upper teeth. Usually, it results from a misalignment of the jaw. This is known as a class III malocclusion.
Not all underbites are the same. There are different levels. A mild case may not be visible, while in severe cases, the jaw extends outward so far that it is noticeable to others.
Underbites are more than a cosmetic issue. They can cause problems with your teeth and jaw.
Underbite vs. overbite: What's the difference?
An underbite is when the bottom teeth sit in front of the top teeth. An overbite is the opposite. It's when the top front teeth extend too far over the bottom teeth. "While both are types of bite misalignments, underbites are often more noticeable and can involve more complex treatment," says Ryann Christensen, DDS, a board-certified orthodontist in Fresno, CA.
What Causes an Underbite?
There are a few different reasons why you might have an underbite.
Genetics. The shape and size of your teeth and the way they grow are largely passed down from your parents or other relatives. If someone else in your family has had an underbite, it's likely a genetic condition.
Injury. Trauma or injury to your jaw can cause it to break. Treatments can help it heal back to its original state, but they might not always work. If your jaw doesn't heal right, it can cause an underbite.
Childhood habits. Long-term behaviors such as sucking the thumb, using a pacifier, and bottle feeding can cause the jaw to change shape. These behaviors are fairly common for children. They don't often cause issues when done in moderation for a short period of time.
Tumor. The growth of a tumor can shift or misalign your jaw. This can lead to an underbite.
How an Underbite Can Affect Your Health
An underbite can affect your health in several ways. It not only changes your appearance but can also make it harder to eat, lower your self-esteem, and lead to sleep problems.
An underbite can cause wear and tear on your front teeth, which makes them more prone to chipping or breakage. You might have trouble chewing food when your jaw isn't aligned properly. If the underbite is severe, it may be hard to speak clearly.
If you're self-conscious about the condition, it can harm your self-confidence and social life.
Underbite can also cause the following conditions:
Temporomandibular joint disorder (TMD). An underbite can cause problems with your temporomandibular joint. This is the hinge that connects your skull to your jaw. When you have TMD, your jaw might feel like it's locked in one position. You might hear a popping sound as you try to move it, which can be painful.
Chronic bad breath (halitosis). An underbite makes it easier for bacteria to grow inside your mouth and cause an infection. Bacteria are a cause of bad breath.
Snoring and sleep apnea. Jaw misalignment may block your airways while you sleep, causing repeated pauses in breathing — a condition called sleep apnea. Snoring is a sign of sleep apnea. Having apnea can prevent you from sleeping well at night, which can leave you feeling tired during the day.
How to Fix an Underbite
Which treatment the orthodontist recommends depends on your age and how severe the underbite is. "For mild cases, we can utilize braces or clear aligners," says Christensen. Growing children who have a more severe underbite may need an expander and a device called a reverse pull headgear, along with braces. For older teens and adults, treatment might involve braces with elastics or clear aligners. In case of a severe underbite, you may need surgery to fix it.
Treatments are often most successful when they're done early, during childhood and preteen years. The jaw is somewhat moldable when it's still growing.
Braces.They can help straighten your teeth and realign your jaw. You'll see an orthodontist for a checkup and to fit you with braces. You may have to wear a retainer after the braces are removed to keep the new shape.
Elastics. This treatment goes along with braces. The orthodontist attaches elastic rubber bands to the braces. The elastics pull the upper jaw forward into the proper alignment to create balance.
Reverse-pull headgear. A reverse-pull headgear or facemask is a device that you wear on your face. It rests on your forehead and chin. Elastic bands attach to your upper jaw and the device. The idea is to pull your upper jaw forward to realign the upper and lower jaws.
This treatment requires commitment. The headgear typically needs to be worn for 16 hours per day for about a year. It's most successful for children aged 8 or younger. It can also work well for teenagers.
Expanders. An expander is a dental appliance that's used to treat a variety of problems with the teeth and jaw. "Expanders help [with an underbite] by increasing the overall size of the upper jaw," says Brett Lawton, DMD, MS, an orthodontist in Winter Park, FL. Widening the jaw creates more space for the upper teeth to move forward and fit together, which reduces the underbite.
Underbite surgery. Surgery to realign the upper and lower jaws is a treatment for a severe underbite. It can fix sleep apnea caused by an underbite, align your jaws properly, and relieve pain. Surgery is usually done only after the jaws have stopped growing, which usually happens at the end of the teen years.
Takeaways
An underbite means that the lower teeth jut further forward than the upper teeth. Genes, an injury, and childhood habits such as thumb sucking can cause this jaw misalignment. Having an underbite can make it harder to eat, speak clearly, and sleep if you don't treat it. Orthodontists can fix an underbite with braces, elastics, expanders, and in severe cases, surgery.
Underbite FAQs
Can Invisalign fix an underbite?
In some cases, especially when the underbite is mild, Invisalign clear aligners can help fix the problem. But often, other appliances or even jaw surgery may be required.
Do underbites get worse with age?
Some underbites stay the same. Others get worse with age if they're not treated in childhood. Once you reach adulthood, your jaw hardens, and the underbite shouldn't worsen.
What happens if I don't fix my underbite?
Without correction, an underbite can lead to problems such as jaw pain, difficulty chewing or speaking, and changes in the appearance of the face. The misalignment may also cause excess wear on the teeth, which can result in restorative work like crowns and bridges.
How much can underbite surgery cost?
Costs for corrective jaw surgery, called orthognathic surgery, vary depending on the orthodontist's experience, the type of procedure, and where you live. The price ranges from $10,000 to $20,000 per jaw. Health insurance will often cover the cost if the surgery is considered medically necessary.
