The Underbite

By Jean LeBron

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.

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