An underbite means the lower front teeth sit in front of the upper front teeth when you bite down. Many underbites can be corrected with braces or aligners alone, especially when caught early. Severe underbites caused by jaw growth in adults may need surgery.
Which group you fall into depends on one question more than any other: is the problem in the teeth, or in the jaws? This guide walks through how an orthodontist tells the difference, what treatment looks like at each age, and when jaw surgery genuinely comes into the conversation.
What Is an Underbite, Exactly?
In a normal bite the upper teeth close slightly in front of the lower teeth, a bit like a lid sitting over a box. With an underbite, that relationship is reversed at the front of the mouth. Our page on common orthodontic problems describes it simply: the lower front teeth protrude beyond the upper teeth.
How it differs from a crossbite
A crossbite is a similar reversal, but it can affect a single tooth or the back teeth on one side. An underbite usually describes the front teeth and often the whole lower jaw. The two can show up together, and our post on crossbites and their consequences covers the side-to-side version in more detail.
Why it is worth correcting
Beyond appearance, a reversed front bite can wear the front teeth unevenly, make biting into food awkward, and put strain on the jaw joints over time. Some people also notice it affects how certain sounds come out when they speak.
Is It a Tooth Problem or a Jaw Problem?
This is the first thing Dr. Masri works out, because it decides almost everything else about the treatment plan.
Dental underbites
Here the jaws are a reasonable size and position, but the front teeth are tipped the wrong way: upper incisors leaning back, lower incisors leaning forward, or both. Because the problem lives in the teeth, moving the teeth can fix it.
Skeletal underbites
Here the lower jaw has grown longer than the upper jaw, the upper jaw is underdeveloped, or both. The teeth may be perfectly straight within jaws that do not match. Moving teeth can disguise a mild skeletal difference, but it cannot change the size of a bone in an adult.
How we tell them apart
Records do the work. Digital images and X-rays show the angle of each tooth within the bone and how the jaws relate to each other and to the rest of the face. Family history matters too, because jaw size tends to run in families. We also check whether the lower jaw slides forward to let the front teeth meet, which can make a dental problem look skeletal.
How Are Underbites Treated Without Surgery?
Braces
Braces can tip upper front teeth forward and lower front teeth back until they overlap correctly. Rubber bands running between the upper and lower braces add the directional force that does much of the heavy lifting in underbite correction, which is why wearing them as instructed matters so much.
Clear aligners
Milder dental underbites can often be treated with clear aligners, sometimes paired with elastics as well. Whether aligners are a good fit depends on how far the teeth need to move and how consistently the trays will be worn.
Temporary anchorage devices
For bigger corrections, temporary anchorage devices (TADs) change what is possible. These tiny anchors give the orthodontist a fixed point to pull against, so teeth can be moved further and more precisely than braces alone allow. As our TAD page explains, they can often eliminate the need for jaw surgery, and Dr. Masri places them himself.
Underbite Treatment Options at a Glance
| Approach | Best suited to | What it changes | Typical role |
|---|---|---|---|
| Early treatment and expansion | Growing children | Guides jaw growth and widens a narrow upper jaw | Prevents or reduces the problem before growth ends |
| Braces with elastics | Teens and adults with dental underbites | Tooth angles and position | The main correction for most dental cases |
| Clear aligners | Milder dental underbites | Tooth angles and position | A discreet option when the movement is modest |
| Braces with TADs | Larger corrections, including some skeletal cases | Allows bigger, controlled tooth movement | Often an alternative to jaw surgery |
| Braces plus jaw surgery | Adults with severe skeletal underbites | The position of the jaw bones | Reserved for cases teeth alone cannot fix |
Why Does Age Matter So Much for Underbites?
Children: growth is on your side
The American Association of Orthodontists recommends a first orthodontic evaluation by age 7, and underbites are one of the clearest reasons why. While a child is still growing, an orthodontist can influence how the jaws develop instead of only moving teeth. A narrow upper jaw, for example, can be widened with a palatal expander, which can help the upper teeth sit in front of the lower ones again. Our page on early orthodontic treatment explains how that first phase works.
Teens: the window is narrowing
Teenagers still have some growth left, so there is often room to combine tooth movement with a little help from growth. A teen with an underbite should be followed closely, because a lower jaw can keep growing after the upper jaw has slowed down.
Adults: the bones are set
Once growth is complete, treatment can only move teeth within the jaws as they are. That still covers a lot of adult underbites. When it does not, surgery becomes part of the discussion.
When Is Jaw Surgery Necessary for an Underbite?
Our surgical orthodontics page explains that surgery is considered for non-growing adults whose bite cannot be corrected by moving teeth, and for people with significant facial or aesthetic concerns tied to jaw position.
Growth has to be finished first
Jaw growth is usually complete by about 16 for girls and 18 for boys, and surgery waits until it is. Pre-surgical tooth movement can start one to two years before those ages, so planning often begins in the teen years.
How braces and surgery work together
Braces come first to line the teeth up within each jaw, usually over 6 to 18 months. During this stage it can seem as if the bite is getting worse, because the teeth are being positioned to fit the jaws after they are moved, not before. The surgery itself is done in a hospital by an oral surgeon. Braces then stay on for a period afterward to fine-tune how the teeth meet.
Surgery is the exception, not the default
Most people who come in worried about an underbite do not end up needing surgery. Between early treatment in children and TADs in older patients, the cases that truly require it are the minority.
What Happens at an Underbite Consultation?
A look at the whole face, not just the teeth
Dr. Masri looks at how the teeth meet, how the jaws line up, and whether the lower jaw shifts forward to bite. Digital images and X-rays fill in what cannot be seen from the outside.
A clear answer about the type of underbite
You should leave knowing whether the problem is dental, skeletal or a mix, and what that means for your options. For a child, that may simply be a plan to watch growth and check back.
Real results to compare against
If you want to see what corrected bites look like, our before and after gallery shows cases treated in our Livonia office.
Frequently Asked Questions About Underbites
Can an underbite get worse over time?
It can, particularly during growth spurts when the lower jaw is still growing. In adults the jaws are stable, but uneven wear on the front teeth can continue as long as the bite stays reversed.
Can Invisalign fix an underbite?
Clear aligners can correct many mild dental underbites. Larger or skeletal underbites usually need braces, often with elastics or TADs, and sometimes surgery.
Will my child grow out of an underbite?
An underbite rarely corrects itself. If anything, jaw growth tends to make a skeletal underbite more noticeable, which is why an early evaluation is worth doing.
How long does underbite treatment take?
It depends on the cause and the approach. A mild dental underbite is a shorter course of treatment than a case that involves TADs or surgery. Dr. Masri will give you a timeline once your records are reviewed.
Schedule an Underbite Evaluation in Livonia
Dr. Nawaf Masri is a board-certified orthodontist who has treated patients across Southeast Michigan for more than 26 years. If you or your child has an underbite, the first step is finding out what kind it is. Request a complimentary consultation or call us at (734) 261-8860.