Understanding Underbites: Causes, Effects, and Treatment Options
At Life Orthodontics, we often see patients with underbites seeking guidance on how to correct this malocclusion. An underbite occurs when the lower teeth sit in front of the upper teeth, creating a misaligned bite. Other terms that may be used to describe an underbite include an anterior crossbite or a Class III malocclusion. This blog post will cover everything you need to know about underbites, including causes, risks, and treatment options.
What Causes an Underbite?
While there are several potential causes of an underbite, genetics is the primary factor. Most patients with underbites have parents and/or grandparents who also had an underbite. Understanding a patient’s family history is essential in planning the best treatment approach, as it often influences the chosen path. If you know there is a history of underbites in your family, then it’s important to have your child evaluated for early interceptive orthodontic treatment (Phase I treatment) at around age 7 or 8.
What Happens If an Underbite Goes Untreated?
Leaving an underbite untreated can lead to several long-term issues. Studies have shown that underbites result in weaker chewing muscles, making it harder to chew food effectively. In addition, many patients with untreated underbites experience temporomandibular joint (TMJ) pain, which can lead to headaches, muscle pain, and jaw locking. Additionally, untreated underbites can cause increased wear on teeth, speech problems, and a noticeable facial imbalance which can affect a patient’s self-confidence.
Early Intervention: Phase I Treatment for Underbites
Treatment for underbites often begins with early intervention during a child’s developmental years, typically starting around age 7 or 8. Phase I treatment for underbites will typically use methods such as reverse-pull head gear or elastics to resolve the underbite. Studies have shown that addressing the underbite before age 10 results in stable correction in about two-thirds of cases, reducing the chance of needing orthognathic surgery later. However, in about one-third of cases that undergo Phase I treatment, particularly those with a strong family history of underbites, the condition may return if the lower jaw outgrows the underbite correction achieved during Phase I treatment.
If early interceptive orthodontic treatment is not performed on a patient with an underbite, the patient is twice as likely to require orthognathic surgery to resolve the underbite. This underscores the importance of early evaluation and treatment to improve long-term outcomes.
Treatment Pathways for Underbites: Phase II Treatment
If an underbite wasn’t corrected during Phase I, or the patient outgrows the phase I correction, there are two primary treatment pathways to consider during Phase II:
Path 1: Orthognathic Surgery for Severe Underbites
In cases of significant underbite, orthognathic surgery (jaw surgery) is often necessary. This surgery is performed in combination with orthodontic treatment, typically occurring midway through a 2-3 year orthodontic treatment plan. This procedure involves repositioning the jaws – either bringing the upper jaw forward, the lower jaw back, or a combination of both – to correct the underbite.
Orthodontic treatment for patients likely needing orthognathic surgery should begin after growth is near or fully complete. Performing surgery before growth is complete can result in the lower jaw continuing to grow afterward, causing the underbite to return. In such cases, a second orthognathic surgery may be needed. To prevent this, we closely monitor a patient’s growth and begin treatment when it is appropriate.
Path 2: Non-Surgical Orthodontic Treatment for Milder Underbites
For patients with a less severe underbite and minimal family history of jaw growth issues, non-surgical orthodontic treatment can be an option. However, families must understand that if the lower jaw grows more than expected, orthognathic surgery may still be required. Treatment may include reverse-pull headgear, elastics, temporary anchorage devices (TADs), or strategic extractions to achieve a positive overbite.
In these cases, we manage expectations with families, making it clear that while we aim to achieve a positive overbite, there is no guarantee the underbite won’t return in growing patients.
Conclusion
At Life Orthodontics, our orthodontists are experienced intreating underbites using both surgical and non-surgical methods. Whether your child needs early intervention or you’re an adult considering surgery for amore severe underbite, our team has the expertise to guide you through every step of the process. Serving patients from Tustin, Irvine, Santa Ana, Costa Mesa, Orange, Anaheim, and beyond, we take pride in our humble pursuit of excellence and our commitment to providing the best service and experience possible.
Schedule a free consultation with Life Orthodontics today to explore the best treatment options for you or your child. Your smile is our priority, and we’re here to help you achieve the healthy, confident smile you deserve.
