Oct 25, 2022 | Clear Braces

Underbite: A Comprehensive Guide to Causes and Treatments

Peri Elgrot

Top 10 Clear Aligners Expert

Our smiles are the first thing others notice. A beautiful smile projects positivity and signifies delight allowing the other person to smile in return. That is why it’s important to be confident in our smiles. However, this can be difficult when our smiles are affected by conditions such as an underbite.

An underbite happens when the lower jaw juts forward the upper jaw. The clinical term for this condition is prognathism or Class 3 malocclusion. As this happens, the lower jaw and teeth protrude beyond the upper jaw and teeth. Malocclusions simply mean that the teeth are not properly aligned. Malocclusions vary in levels that range from minor misalignment that can go unnoticed to severe cases where the lower teeth extend far beyond.

More than being an aesthetic and cosmetic issue, an underbite can cause problems to our health depending on the level of complications. For those with milds cases, they can often manage with their underbite. However, those with severe cases can find themselves experiencing health problems that significantly affect everyday life.

In severe cases, it can be hard to bite and chew food. Additionally, speaking becomes a toll on top of the pain brought by the misalignment of the jaw. This makes it all the more important to understand what an underbite is, its causes and complications, as well as strategies for correcting it.

If your smile isn’t genuinely what you want it to be, this guide is here to help you fix that.


Proper alignment means that the upper teeth fit slightly over the lower teeth. Furthermore, the points of the molar must fit properly to the grooves of the other molar. Misaligned teeth and underbites may cause you to bite your cheeks, lips, and tongue involuntarily.

Several factors can contribute to or aggravate an underbite. Some of these causes may include:

● Genetics
● Childhood behaviors
● Injuries
● Tumors


Underbites are most often hereditary and run in the family. This means that you probably got yours from your folks. You can think of it as an unwanted heirloom. It’s also very likely that you’ll develop an underbite if there’s at least one person in your family who has it.

Because genetics determine someone’s jaw and teeth shape and size, you can be born with teeth too close to each other, shaped abnormally, or don’t fit properly. Furthermore, certain defects that appear at birth such as a cleft palate or lip can result in an underbite.

Childhood behavior

The habits we had as children can increase the risk of developing an underbite. Such childhood habits may include thumb sucking and tongue thrusting. A study from 2012 also found that there is an association between the use of pacifiers and prolonged use of a bottle beyond the age of 3 with developing an underbite.


Underbites can also come as a result of tumors in the mouth or the jawbones. These tumors can cause the jaws to protrude and for an underbite to be developed.


Another factor that contributes to and aggravates an underbite is severe injuries to the face. An injury can cause permanent harm to the jaw bone. Although you can repair broken jaw bones, it is not always guaranteed that your jaws can fit together properly again after being surgically realigned. In cases like these, an underbite can occur.

Other causes

Aside from genetics, childhood habits, injuries, and tumors, there are other causes for an underbite. These include extra or missing teeth and impacted or abnormally shaped teeth. Ill or loose-fitted braces, retainers, crowns, and dental fillings and appliances also contribute to an underbite.


The severity of complications varies depending on the degree of the underbite. The complications can affect both your mental and physical health.

Jaw issues such as chronic jaw pain or Temporomandibular Joint Disorder (TMJ) are a common complication of an underbite. Temporomandibular Joint Disorder can make you feel that your jaw is stuck or locked and would result in popping sensations as well as varying levels of pain in the jaw. This joint disorder can also cause chronic hearing problems, dizziness, toothaches, earaches, headaches.

Other complications that come with an underbite may include chewing and biting difficulties, tooth decay, halitosis, sleep apnea, and breathing and speech issues.

An underbite may affect your mental health as well given how it contributes to your confidence or lack thereof.


Given that we all want perfectly aligned teeth, a majority of us aren’t born with them. Cases of slight misalignment usually won’t require any medical treatment. But for cases of an underbite and especially the severe ones, going through treatment and correcting it can provide big benefits.

These benefits include having your teeth easier to clean, decreasing your risk for tooth decay and gum disease. Additionally, you will experience less strain on your facial muscles, jaws, and teeth. This will also help you reduce the risk of breaking a tooth. Furthermore, the painful symptoms of temporomandibular disorders that are so common with an underbite will also be reduced.

There are various treatments to correct an underbite. The treatment will vary based on the aged of the patient as well as the cause of the underbite. The common treatments for an underbite are as follows.

At-home treatment

Regular brushing and flossing of your teeth on top of dental checkups and cleaning are all important to keeping your teeth healthy. As such, they are considered treatments for making teeth healthy and keeping them that way. SmileDirectClub aligners also hold the ability to treat an underbite but only if it is concerning single pairs of your upper or lower teeth. Moreover, your treatment plan is designed and monitored by one of their 250 and more certified dentists and orthodontists, thus ensuring the perfect results from the treatment.

However, those with an underbite and other dental issues will need to take extra care with their teeth so as to prevent further decay.

With this, you need to brush your teeth twice a day at the very least and for two minutes each time. Also, you should use toothpaste that contains fluoride. In brushing your teeth, you need to pay close attention along your gum line as well as on the inside, outside, and back of your mouth. After brushing your teeth, you also need to floss. You should also schedule a visit to your dentist once every six months.

Sometimes all of these can be a hassle, but these are the bare minimum. Not meeting the bare minimum can prove to be a bigger hassle in the long run.

Medical treatment

The only way to be able to correct an underbite and align your teeth properly is through medical treatment. In cases where medical treatment can’t achieve the best result, at the very least you can lessen the appearance of the underbite.

With mild cases of an underbite, dentists would use wire or plastic braces or other dental appliances. These dental appliances will move the teeth into their correct place. Another strategy is to remove one or more teeth on the lower jaw to help lessen the appearance of an underbite. This is done when overcrowding of the teeth is a factor for the underbite. Dentists also use grinding devices to shave down or smoothen teeth that stick out or are too large.

Dentists may recommend surgical treatment to correct severe cases of an underbite.

Treatment for children

It’s best to address an underbite at the earliest time. When a child’s underbite is mild or less severe, it’s best to wait until age 7 at the least to seek corrective treatment. This is because 7 is the age when permanent teeth begin to develop.

When a child suffers from severe underbite, early surgery may help. Defects that appear at birth such as cleft lip can cause a severe underbite. Surgical treatment of course has its share of risks. Therefore, it should only be used when the child’s underbite is affecting their ability to eat, breathe, speak, and their quality of life.

Consult with your child’s dentist and doctor to determine the best course of treatment.


Most underbites can be corrected successfully by certified oral surgeons. There are several common types of surgery done to correct cases of an underbite. These include reshaping the jaw to lengthen the upper jaw or shorten the lower jaw. There are cases where wires, plates, and screws are utilized to maintain the correct shape of the jawbone.

Surgery does come with several risks. These risks include those associated with general anesthesia as well as infection, scarring, and bleeding problems.

The process for surgery involves X-rays, exams, general anesthesia, bone cutting and reshaping, and jaw repositioning. After surgery, wires, plates, screws, and rubber bands are used to hold the jaw in place. It usually takes one to three weeks to recover from the surgery. To keep the teeth in place, braces and other dental appliances are often recommended after the surgery.


Prices for jaw surgery to correct an underbite varies depending on the provider. There are cases where dental and skeletal defects or abnormalities cause health problems. In these cases, some health and dental insurance plans cover jaw surgery.

If you are covered by health insurance you may be paying as little as $100 for a surgery copay. Although you might pay $5,000 or more for surgery if your insurance plan has a price cap for jaw surgery.

There are also cases where insurance companies do not cover jaw surgery if it’s been determined that surgery isn’t required to keep the insured person healthy.

If you aren’t covered by insurance, jaw surgery for correcting an underbite would typically cost between $20,000 and $40,000. If surgery is needed for only one jaw, the cost would usually be lower.


An underbite can affect more than just your self-esteem and can even damage your quality of life. It is very possible to treat and fully correct an underbite. There’s no reason for you to live with an underbite and suffer the consequences of the condition. As such, you need to consult with your dentist to learn more about and determine the best treatment option for you. Also make sure that you check if you are eligible or not for SmileDirectClub’s underbite treatment plan. SmileDirectClub offers great underbite solutions for single pair of lower and upper jaw teeth.