Orthodontists fix an underbite by moving the lower teeth back, the upper teeth forward, or guiding jaw growth, using braces, aligners, elastics or expanders. Children can often be treated early; some adults need surgery too.
An underbite is when the lower front teeth sit in front of the upper front teeth when you bite down. It can be mild and mostly about how the teeth are angled, or it can come from the lower jaw growing further forward than the upper jaw. Which of those you have decides the treatment, so this guide starts there, then walks through the options for children, teens and adults.
What causes an underbite?
Most underbites run in families, because jaw size and shape are largely inherited. Others are dental, meaning the jaws are fairly balanced but the front teeth are tipped the wrong way. Habits in early childhood, such as prolonged thumb sucking, pacifier use or a tongue that rests low and forward, can also play a part. A narrow upper jaw is a frequent contributor, and it often shows up alongside a crossbite on the back teeth.
Dental versus skeletal underbites
A dental underbite comes from tooth position and usually responds well to braces or aligners alone. A skeletal underbite comes from the jaws themselves. In a growing child, a skeletal underbite can often be improved by guiding growth. Once growth is complete, a significant skeletal underbite may need orthodontics combined with jaw surgery. At ARCH we use digital X-rays and, when helpful, CBCT 3D imaging to see which type you have; our technology page explains both.
Why is it worth treating an underbite?
Appearance is often what brings people in, but function matters just as much. An underbite can wear down the front teeth unevenly, make biting into food harder, strain the jaw joints, and affect speech for some patients. A bite that does not fit together well is also harder to keep clean. Our post on how to know if your bite is off covers the signs to watch for.
How do orthodontists fix an underbite in children?
Timing is the biggest advantage a child has. Along with the American Association of Orthodontists, ARCH recommends an orthodontic evaluation by age seven. That is early enough to spot an underbite or crossbite while the jaws are still growing.
Palate expanders
If the upper jaw is narrow, an expander can widen it while the growth plate in the palate is still open. That gives the upper teeth room to sit outside the lower teeth again. Our post on palate expanders and timing explains how that works.
Two-phase treatment
For many children, correcting an underbite is part of two-phase treatment: a first phase with an expander or other appliance to guide growth, a resting period while the rest of the adult teeth come in, and a second phase of braces or aligners to finish. Treating early can make the second phase simpler and, in some cases, reduce the chance that surgery is needed later.
How do orthodontists fix an underbite in teens and adults?
After growth slows, the tools change. For mild to moderate cases, the goal is to move the teeth so the upper front teeth sit ahead of the lower ones again.
Braces with elastics
Braces line up each arch, and elastics running from the lower front to the upper back teeth pull the bite into a better relationship. Wearing them as prescribed matters a great deal; our guide to rubber bands with braces explains why.
Clear aligners
Many dental underbites can be treated with Invisalign, often with attachments and elastics to control the bite. Your orthodontist will tell you honestly whether aligners can reach your goal.
Orthodontics with jaw surgery
When an adult’s underbite is mainly skeletal and significant, moving teeth alone may only disguise it. In those cases the usual path is braces before and after corrective jaw surgery, planned together with an oral and maxillofacial surgeon. It is a bigger commitment, and it is not the right answer for most people, but it is worth understanding if your orthodontist raises it.
| Option | Best suited to | How it helps |
|---|---|---|
| Palate expander | Growing children with a narrow upper jaw | Widens the upper jaw so teeth fit outside the lower ones |
| Two-phase treatment | Children seen early | Guides growth first, then aligns teeth later |
| Braces with elastics | Teens and adults with mild to moderate underbites | Moves teeth and shifts how the arches meet |
| Clear aligners | Mostly dental underbites | Moves teeth with removable trays, often with elastics |
| Orthodontics plus jaw surgery | Adults with significant skeletal underbites | Repositions the jaw, then refines the bite |
How long does underbite treatment take?
It varies with age and severity. A child’s first phase is usually shorter than full braces; a teen or adult course depends on how far the teeth and bite need to move. Surgical cases take longer because of the preparation and finishing phases. Your orthodontist will give you an estimate at your consultation, and after treatment retainers keep the correction stable.
What happens at an underbite consultation?
Your first visit at ARCH is a records and consultation appointment, and there is no charge for it. Our team takes digital X-rays and photos, and your orthodontist examines your teeth, jaws and bite. For underbites we pay close attention to how the jaws line up at rest and when you close, whether the upper jaw is narrow, and, for children, how much growth is still ahead.
You will then sit down with the orthodontist and a treatment coordinator to go over what we found, the treatment we recommend and any alternatives. If treatment should start now, we review insurance benefits and payment options, and in many cases we can start the same day. Plan for a bit more than an hour. Our patient resources page has the forms to fill out ahead of time.
Questions worth asking
- Is my underbite (or my child’s) mainly dental or skeletal?
- What happens if we wait, and is there a best time to start?
- Can braces or aligners correct it on their own, or is surgery a possibility?
- How will we keep the correction stable after treatment?
Frequently Asked Questions
Can an underbite correct itself?
Rarely. A true underbite tends to stay the same or become more pronounced as the lower jaw grows, which is why an early evaluation helps.
Is it too late to fix an underbite as an adult?
No. Many adult underbites can be improved with braces or aligners. Significant skeletal cases may need surgery for the best result.
Is an underbite the same as a crossbite?
They are related. An underbite involves the front teeth; a crossbite can affect any teeth, including the back ones. Many patients have both.
Does fixing an underbite change your face?
It can soften a prominent chin or improve lip balance, especially in growing children or surgical cases. Your orthodontist will talk through what to expect for your case.
Get your underbite evaluated at ARCH
Whether it is your child or you, the first step is a careful look at the teeth and jaws. ARCH has helped families from Boston to Cape Cod since 1974, and your first records and consultation visit is free. Book a free consultation to find out which option fits.