As you read today’s post I would like you to do some physical movement for me. Of course you say? Well excellent! WIth your mouth closed and jaw relaxed slowly move your chin and jaw forward so that your bottom teeth extend further forward than your top teeth. Feel free to step away from your PC or mobile device to check yourself out in a mirror while you do this to see what it looks like (see photo below). Now hold this position until the end of the next paragraph.
The position you currently find your bite in, with the lower jaw and teeth protruding beyond the upper teeth and overlapping them is known as an underbite or a ‘Class 3 Bite’ in dental jargon. Unlike its more common cousin the overbite (upper teeth extending beyond and overlapping the lower teeth and jaw) underbites affect only 5-10% of the overall population. To contrast, up to an incredible 70% of children develop some degree of an overbite. Many such cases are barely noticeable and often require little to no treatment. This is not the case for underbites. When left neglected over time, underbites can lead to painful jaw issues including TMJ Disorder as well as other complications with tooth, cheek and gum health.
Feel free to now put your face back into a comfortable position. Feel better? Chances are the held underbite position left the sides of your face feeling a little tense and possibly sore. Now imagine if you had to walk around like that all day? Understanding underbites, their causes and more importantly their treatment will go a long way in ensuring that you, a loved one or even a friend does not have to live with them unnecessarily.
What Causes an Underbite?
Unfortunately for many, underbites are usually hereditary and therefore an issue that one is born with. People of Asian heritage are more likely than others to have underbite related issues as they age. Other causes include:
poor eating and chewing habits
mouth breathing as a result of constant congestion or habit
an abnormal jaw bone
In many of the cases above, it can be the individual’s tongue resting against the lower jaw and lower front teeth that causes the jaw to move forward over time.
What Happens if my Underbite goes Untreated?
Unlike an overbite which can go untreated over the course of a lifetime, the unnatural underbite position can cause a bevy of issues as people age without intervention. Possible complications resulting from an untreated underbite include:
jaw pain as well as major jaw issues including TMJ
increased wear and tear on your tooth enamel due to an unnatural bite and chewing movement
increased chance of tooth decay
abnormal tooth alignment
heightened risk of developing gum (periodontal) disease
Issues chewing, speaking clearly and swallowing
change to one’s facial structure, appearance and jaw position
low self esteem resulting from an altered physical appearance
Treating an Underbite
As with most things in life, fortune favours those who are early. As a parent detecting a child’s potential underbite at an early age is paramount to ensuring the shortest and most comfortable means of treatment possible. It is a dentist’s ideal scenario that treatment begin before the age of 8 and at least before the age of 13. This is the time when a child’s jaw is still growing and forming, allowing for treatment that works naturally with this expansion. If you are unsure whether your child has an underbite or not, consult with your dentist and express your concerns. This could save you and your child a lot of hassle, pain and money down the line.
Common treatments for children with underbites include:
1. An upper jaw expander – a turnkey assisted plastic and wire device used in the mouth to expand the upper jaw overnight for a year. This is usually replaced by a retainer.
2. A reverse-pull face mask – a facial apparatus that wraps around the head and attaches metal bands to the upper rear teeth to pull the upper jaw into place. This s often used when an expander fails.
3. A chin cap – used to control the growth of the lower jaw and chin
4. Braces – a classic
For adults suffering from an underbite, the news is not as optimistic. Unfortunately, an adult jaw is a fully formed one meaning that any bite correction is likely to require dental surgery. In many milder cases extracting teeth or using braces can go a long way in adjusting the jaw and teeth to create a more natural jaw position. Braces are often used along with surgery (before and after) to complete an adjustment over time.
Depending on the severity of the case, the surgical correction includes pushing the lower jaw back, pulling the upper jaw forward or adjusting both accordingly on a case by case basis.
Whether you or a loved one has an underbite, it is imperative that full treatment of the issue be a priority. The tooth, mouth and jaw related problems that can arise from an untreated underbite are not worth living with and although the treatment can take time, the end result is comfortable, natural, healthy and inspires confidence.