Underbite Correction

Fixing an underbite condition can be expensive, difficult and challenging. Underbites are when the lower jaw abnormally protrudes past the upper jaw, and in some cases the lower front teeth may actually overlap the upper front teeth.   Underbites are most often caused by genetics, thumb sucking, poor chewing habits, and even tumors in the jaw bone.  Patients may experience pain when chewing, speech impediments, and a limited range of jaw motion, headaches, and even TMJ.

Underbite Treatments

Until recently the only treatment options for patients needing underbite correction was surgery, teeth extraction or a combination of braces and surgery, but an alternative less invasive procedure does exist called in-office bite construction.  In-office bite construction does not involve braces or surgery.  Less invasive forms of treatment for underbites mean an end to long hospitalization, invasive surgery and the high costs in terms of hospitalization and recovery time.    Of course, this form of treatment is not for every patient and it will depend upon a patient’s underbite condition. If the underbite itself is severe, and the underlying cause is skeletal (resulting from an adverse formation of the jaw) rather than dental (improper placement of the teeth), then jaw surgery may be a consideration.  Generally, a patient may have to undergo a combination of treatments to correct the underbite, such as extraction, followed by surgery then an orthodontic treatment like braces.

Alternative methods to underbite correction are less expensive and can mean less time taken off from work or school.  With surgical and orthodontic treatments taking nearly one year or more to correct the condition, frequent visits to an oral surgeon, orthodontist plus post surgery recovery can be expected.

A cosmetic dentist may be a viable alternative to under bite correction if surgery seems too risky for you, and if your underbite is caused by underlying dental problems.  Under bite correction through restorative dentistry, dental veneers, and removable oral appliances is available.  Crowns, veneers, and bonding are all in-office procedures for mild under bite conditions that have fewer complications.

To decide for yourself the approach which best suits you.   Meet with both a dentist that specializes in under bite conditions and cosmetic dental procedures and an orthodontist.  In the final analysis, it’s your decision to make and you should take every opportunity to make it one that you can live with.

Although this patient had striking eyes and a youthful personality, her appearance was less than it could be. She had a pronounced underbite that she didn’t like and she wanted to get it fixed.  The doctors she had seen recommended jaw surgery, followed by an estimated two years of braces. That’s dismal news for a young adult.

This patient decided she wanted a non-invasive solution for her underbite. She did not want to undergo surgery or its potential complications. The hospital stay and painful recovery period were not something she wanted to face, and the stint with orthodontics sounded unpleasant at best. That’s when she decided to make an appointment to consult with Dr. Sam Muslin, DDS, in Santa Monica, Calif.

Underbite Correction Without Surgery

Dr. Muslin examined the patient’s dental situation and determined that not only was her underbite hampering her chewing, but her bottom teeth were standing too tall in her lower jaw. The lower arch was in a forward position with her bottom teeth overly erupted. Her lower arch jutted forward beyond her narrow upper arch, causing her bottom teeth and lip to protrude. When she spoke, this patient’s lower teeth dominated her expression and obscured most of her upper teeth.

Before underbite correction, a horizontal gap between the upper and lower arches is pronounced even though the patient is biting her back teeth together. Her bottom teeth overpower the size and shape of her upper teeth and sit in front of the upper arch instead of behind it.

A Narrow Upper Arch

When the size of the upper and lower jaws is out of sync, a person’s profile is impacted – as is face shape. This patient’s appearance was out of balance because her upper arch was much narrower than her lower arch – the opposite of what is desired. Her upper teeth were positioned inside the curve of her bottom teeth, causing an overly pouty lower lip and a pronounced chin, as well as a moon-shaped face.

When eating, this patient had to compensate for her malocclusion. To make her upper and back molars meet while chewing, she had to slide her lower jaw forward. This made chewing food problematic and made her underbite even more pronounced than it actually was. Her expression sometimes showed the hint of a grimace rather than reflecting a natural smile or relaxed look.

Dr. Muslin took into account this patient’s bite mechanics, as well as her cosmetic concerns, and came up a proposed course of treatment. Because she wanted to avoid the difficulties associated with oral surgery and braces, Dr. Muslin felt that the techniques used in Face Lift Dentistry® would be a dental solution best fitted for her situation.

Dr. Muslin proposed developing a comfortable bite by building up her back teeth to make them meet easily and to eliminate the slide that hampered her jaw. Normal effective chewing was one of his chief treatment goals. He proposed a three-dimensional approach that took into account her face length and width, her nose, forehead and jaw size, the shape of her teeth and the overall impact on her profile and oral health.

Balancing functionality and aesthetics is what takes Dr. Muslin’s practice from blueprint dentistry to artistry. These elements came together to give this patient a tremendous outcome.

Dr. Muslin rebuilt her upper teeth and several of her lower teeth in the back of her mouth, using Face Lift Dentistry® principles, the technique that he has had trademarked. The comfort level in her jaw improved almost immediately, and any obvious underbite was virtually eliminated – all without going under the knife, staying in the hospital, having her jaw wired shut or drinking a liquid diet for weeks on end.

 A winsome smile is the outcome of this non-invasive underbite correction. On the right, beautiful hand-crafted porcelain crowns on the upper arch complement the patient’s natural bottom teeth in color, proportion and position.

 Translucent and True Hue

What makes this dental transformation sensational is the level of workmanship and the premium materials used. Dr. Muslin rebuilt the surface of the back teeth with top-grade composite to allow for better movement in the jaw. Then, translucent porcelain was handcrafted to refurbish the position of the upper teeth.

Using the right shade of material is paramount when staging a smile makeover. If the wrong color is selected or the material is not translucent, the result will be unnatural even if the underbite were addressed adequately. Dr. Muslin, however, customized this step to assure a natural and becoming outcome, matching the color of the upper porcelain to mimic the exact shade and light reflection of the enamel on the lower teeth – which were reshaped slightly, but otherwise untouched.

Case Study Outcome

This patient was ecstatic with the outcome of her Face Lift Dentistry® procedure. Her bite had been corrected, and the prominence of her chin and lower lip had been refined. Her face has taken on a more feminine oval shape, and her smile now matches her gorgeous eyes. No surgery. No braces. No regrets!

Among the various types of malocclusion, the least common is underbite. This Class III malocclusion is sometimes referred to as negative overjet, where the mandible is either very large or the maxillary bone is too short.   Underbites affect a small population of people between 5 and 10 percent.  This dental condition causes the lower jaw to jut up and out, overlapping the upper teeth.  In most cases, the lower teeth are positioned in front of the upper teeth, causing the lower jaw to be more pronounced.   Depending upon the severity of the underbite it can be barely noticeable or like with other cases, extreme.  Consider Billy Bob Thornton’s character Karl in the 1996 movie Slingblade.

A number of factors can cause an underbite including poor chewing habits or abnormalities of the jaw.  Genetics, childhood thumb sucking and tongue thrusting are also causes.   When discussing this condition, orthodontists will explain how crucial it is to correct it in its early stages.   Young patients, under the age of eight, can have their jaws reshaped much more easily since their bones are still growing.   As we age, our bones become permanently positioned and the only way to correct an underbite as an adult is surgery, which can be costly and require extensive treatment.

If left untreated, it can cause a greater risk of poor bite, tempero-mandibular joint disorder (TMJ) or the uneven wear and tear of tooth enamel.  Because of the positioning of the jaw, flossing and brushing can be difficult putting patients at risk for gingivitis or gum disease resulting in tooth decay.  Over time, a protruding lower jaw can drastically change the appearance and structure of the entire face, including one’s smile, deeply affecting self esteem and in some cases speech patterns.

Correcting Underbites

Without addressing the underlying cause of the lower jaw protrusion, attempts at fully correcting the condition may prove futile.  But if addressed early on, especially in children, bite correction of this condition offers several options.   Children can be fitted with a chin cap or chin strap.  This dental device straps around the back of the head and secures the chin preventing the lower jaw from growing at the same rate as the upper jaw.   Another option for children is inserting expanders into the mouth.  This dental device widens the upper jaw with a metal bar.  By attaching the bar between the bicuspid and the first molar of the mouth, a key is then used to turn the expander causing an extension.  Worn for a few hours every day for several months, it expands the jaw and improves bite alignment.

Another option orthodontist use to correct underbite is a reverse-pull mask.  Similar to a catcher’s mask, it is also worn a few hours a day.  Sometimes an orthodontist may require a patient to wear the chin strap and the mask simultaneously.   Orthodontic braces are also another option for children.

Bite correction of this condition in adults often means orthognathic surgery and is usually performed in conjunction with orthodontic therapy.  Basically an orthodontist teams up with an oral surgeon, and together, develop a specific treatment plan.  Generally, it’s the in-depth changes which involve the surgical aspects of the treatment, and the more detailed structural changes that are resolved with orthodontic braces.

One dentist in Los Angeles has a non-surgical correction treatment for underbites. Considering the discomfort of orthognathic surgery followed by a few years of braces, you may want to consider his option and rather feel the pain in your wallet.

Cost of Underbite Correction

The actual cost of correcting an underbite can be best determined by a number of factors, including the severity of the condition, the type of treatment plan and its duration, and the type of dental insurance coverage.  The breakdown of costs includes the surgery, anesthesia and the orthodontic treatment plan.  Generally, the overall costs can run anywhere from $20,000 to $30,000.

When is the best time for Underbite Correction?

According to orthodontic specialists, the sooner you address causes behind the condition the better.  Orthodontists prefer to begin as early as 8 years of age. The longer treatment or surgery is put off the worse the condition can become, because as we age it becomes more of a skeletal issue rather than a dental condition.  Once our bones complete the growth process jaw surgery remains the only option available.