Having a great set of teeth can make anyone look attractive and help a person to smile freely without worrying about how they look. A healthy mouth allows a person to indulge in as much food or drink as they can and to hold conversation without worrying of pain or discomfort. However, everyone must have had problems with the mouth such as pain in the gums or teeth that often need medicine. In this article, we will be learning about underbite.

An underbite is an orthodontic issue that occurs when the lower teeth sit further than the upper teeth. It is also known as a Class III malocclusion or reverse-bite. In general, malocclusion is the clinical term for misaligned teeth, a developmental condition where there is deflection from the normal relation or alignment of the teeth to other teeth in the same arch and/or to teeth in the opposing arch. Underbite affects just 5 to 10% of the population which is in contrast with the more common protrusive bite which is often referred as an ‘overbite’.

Underbite severity ranges from mild to severe. Most cases are considered mild as it is unnoticeable. In severe cases, the jaw protrudes outwards so that it becomes noticeable to others as the teeth do not meet at all. The protrusion is often a result of prognathism. It is true that most people could live with mild underbite but those with severe cases of underbite may face serious problems such as speech, biting and chewing difficulties. This is much more than just pain and discomfort of the mouth as it interferes with a person’s ability to have a good life. Some underbite can damage tooth enamel and increase the chances for breakages and chips of the front teeth. It also increases the chance for tooth decay from wear of tooth enamel and increases risk for mouth infections. Some even experience chronic jaw or joint pain (temporomandibular) pain that results in headaches and earaches. Nighttime breathing difficulties, sleep apnoea and snoring from underbite can disturb a good night sleep.

There are many causes of underbite. Most common cause is genetics or inheritance. Overcrowded teeth or misaligned jaws are likely to be inherited from other family members. Underbite issue also occur with cleft lips and palates in babies. Childhood behaviour of thumb sucking and tongue thrusting often cause such condition. Bottle feeding for a long period of time and pacifiers may contribute to the issue. Serious facial injuries can cause lasting damage to the jaw which predispose to underbite. In uncommon case, tumours of the mouth or jawbone can cause underbite as it affect the growth or alignment of the jaw.

Due to the fact that underbite can cause many problems, getting rid of it can be a great relief for patients. While overbite may be natural, underbite is not considered natural. Underbite of any size can cause several problems especially when treatments are put on hold for a long time. When left untreated, it will be more difficult to treat the underbite. The best way to get rid of underbite is to get it fixed at an early age when the bones are malleable and coerced into alignment.

Most underbites can be treated with orthodontic methods. Again, treatments are most successful when it is performed during childhood. Adults can be successfully treated with underbite but treatment often involves surgery at this point. Treatment will depend on severity of the underbite. Below are correction methods or combination of methods use to treat underbite:

• Braces- most common way to align the bite, often wear for 2 to 3 years and followed by retainer after braces come off.
• Reverse-pull face mask or facemask therapy- this resembles headgear designed for children before their bones fuse, this mask pulls the upper jaw back into correct position using meta bands fastened to the upper back teeth.
• Upper jaw expander or elastic- wire-frame device across the palate that will be worn for a year before replacing with retainer to promote proper bone growth.
• Tooth extraction- extra teeth are pulled as a one-off procedure or done with other methods.
• Surgery- recommended in adults with severe cases, can be either orthognathic jaw surgery or Le Fort III osteotomy.

It can be concluded that underbite is the condition where the lower teeth overlap the upper teeth. Underbite can be mild to severe. There are many problems that can affect a person’s daily life when they have underbite such as eating difficulties, speaking problems and breathing issues. Underbite should be fixed right away as early as possible. Due to the fact that most cases of underbite are inherited, underbite will not disappear as underbite becomes larger with the lower jaw and chin appearing more protrusive as adult teeth come through. Treatment is most successful in children with minimal intervention. Surgery is the last resort to fix underbite.

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