Having an underbite can make biting and chewing difficult, in addition to causing you to feel self-conscious about your smile.

Underbite Q & A

What causes an underbite?

An underbite is when the lower arch extends outward beyond the upper front teeth. In many cases, having an underbite is an inherited trait. But you can also develop an underbite due to:

  • Thumbsucking
  • Tongue thrusting
  • Pacifier use after the age of 3
  • Long-term bottle feeding after infant years

As an adult, you can develop an underbite due to facial injury (if you broke your jawbone) or if you have a tumor in your jawbone.

Why do I need treatment for an underbite?

The lower teeth are supposed to fit comfortably behind the upper teeth so that the molars rest on top of one another. Proper alignment is essential for effective chewing. If you have an underbite, you need treatment to lower your risk of:

  • Jaw pain
  • Tooth decay
  • Gum disease
  • Sleep apnea
  • Tooth fractures
  • Speech difficulties
  • Altered facial appearance
  • Cheek, lip, or tongue biting
  • Discomfort while chewing or biting

How is an underbite treated?

The doctor reviews in-house digital X-rays (if needed) and examines the patient to determine which type of underbite treatment will be most effective. Some of the most common underbite treatments are described below.


The doctor may suggest braces as a treatment for underbite. Braces align the misaligned teeth, correcting an underbite.

Tooth extraction

Tooth extraction can relieve crowding so the bite comes together more naturally.

Upper jaw expander

An upper jaw expander is a wire frame that’s custom designed to fit across the palate (roof of the mouth). You use a specialized key to widen the expander in tiny increments daily or several times throughout the week. This treatment gradually forces the upper arch to widen enough so the lower teeth no longer close on the outside of the upper arch.

Reverse-pull facemask

The reverse-pull facemask, similar to headgear for braces, wraps around the head. This underbite treatment involves attaching metal bands to the upper back teeth, so the device can gently pull the upper jaw into proper alignment.

Orthognathic (jaw) surgery

Orthognathic jaw surgery involves separating the jawbones and making modifications to correct jaw alignment. We collaborate with you and your oral surgeon on a treatment plan and offer preoperative care if surgery is needed.

After orthognathic surgery, the doctor ensures that you are healing properly and will

administer any additional orthodontic treatment the patient may need. No matter which type of treatment is right for you, at Georgetown Orthodontics, you can expect personalized adult or pediatric underbite correction, so you can achieve a healthy bite and smile.