(561) 880-4334
Book Free Consult
An underbite occurs when the lower teeth sit in front of the upper teeth. We correct underbites with braces, jaw development appliances, and clear aligners for patients of all ages.
An underbite (clinically called prognathism or Class III malocclusion) is when the lower front teeth sit in front of the upper front teeth, creating a reversed bite. Underbites affect chewing efficiency, speech clarity, and facial appearance — the lower jaw may appear to protrude. The condition is treatable with braces, clear aligners, jaw development appliances, or in severe cases, surgical orthodontics. Early treatment in children is especially effective because the jaw is still growing.
An underbite — clinically known as prognathism or Class III malocclusion — occurs when the lower jaw extends forward of the upper jaw, causing the lower front teeth to sit in front of the upper front teeth when the mouth is closed.
Underbites are less common than overbites or crowding but tend to be more complex to treat because they often involve a skeletal component — meaning the problem is in the jaw bones themselves, not just the tooth positions. A skeletal underbite occurs when the lower jaw (mandible) is too large, the upper jaw (maxilla) is too small, or both. A dental underbite occurs when the lower teeth are angled forward even though the jaw sizes are relatively normal. Many patients present with a combination of skeletal and dental factors. Genetics is the strongest predictor — underbites run in families and are more prevalent in certain ethnic populations.
Untreated underbites create functional problems beyond appearance. The reversed bite makes it difficult to chew food properly, as the front teeth cannot shear through food normally. Speech can be affected, with lisping or difficulty pronouncing certain sounds. The misaligned bite places abnormal stress on the jaw joints, potentially causing TMJ pain, clicking, and headaches. Teeth wear unevenly, and the lower front teeth may develop gum recession from the abnormal forces. Treatment options include braces, clear aligners, jaw development appliances, early interceptive treatment for children, and surgical orthodontics for severe skeletal cases.
The lower jaw visibly extends forward beyond the upper jaw, creating a prominent chin and a concave facial profile when viewed from the side.
Biting into food feels awkward because the front teeth do not meet properly, making it hard to tear or shear through foods like sandwiches or apples.
An underbite can cause lisping, slurring, or difficulty pronouncing certain sounds — especially "s," "z," and "th" — due to improper tongue and tooth positioning.
The misaligned bite places abnormal stress on the jaw joints (TMJ), leading to chronic pain, clicking or popping sounds, and tension headaches.
The lower face may appear disproportionate, with the chin appearing too prominent relative to the midface, affecting overall facial balance and harmony.
The reversed bite causes teeth to contact in abnormal positions, leading to accelerated and uneven enamel wear, chipping, and potential gum recession.
Dr. Brandon Zipper creates a customized treatment plan based on the cause of your underbite (dental vs. skeletal), its severity, your age, and your treatment goals. Here is our typical approach.
We take 3D digital scans, panoramic X-rays, and a lateral cephalometric X-ray to measure the jaw relationship and determine whether the underbite is skeletal, dental, or a combination. Dr. Zipper explains all findings and outlines treatment options.
For mild to moderate underbites, braces or clear aligners with elastics can compensate for the jaw discrepancy through strategic tooth movement. For children ages 7–11, jaw development appliances and Phase 1 early treatment can encourage upper jaw growth and restrict lower jaw growth. Severe skeletal underbites in adults may require surgical orthodontics — braces combined with corrective jaw surgery.
Treatment duration varies from 12 to 30 months depending on severity and approach. Non-surgical cases use braces or aligners with elastics and other mechanics to shift the teeth into a corrected bite. Jaw appliances for children typically require 9 to 15 months of active wear. Regular progress check-ups every 4 to 8 weeks ensure treatment stays on track.
After active treatment, custom retainers maintain the corrected bite and tooth positions. Underbite cases require diligent retainer wear because the jaw has a tendency to return toward its original position, especially in patients who were treated during active growth.
Underbites can be treated at any age, but the approach and effectiveness vary based on the patient's growth stage and the severity of the jaw discrepancy.
The cost of underbite treatment at Zipper Orthodontics depends on the severity of the jaw discrepancy, whether jaw appliances or surgery are needed, and the estimated treatment duration.
Mild dental underbites treated with braces or clear aligners fall on the lower end of this range. Cases requiring jaw development appliances, two-phase treatment, or longer treatment times approach the upper end. If corrective jaw surgery is needed, the surgical component is typically covered separately by medical insurance. Most dental insurance plans with orthodontic benefits cover $1,000 to $2,500 of the orthodontic portion. We also offer flexible monthly payment plans and interest-free financing. Your exact cost is determined at your free consultation — no surprises.
An underbite is most commonly caused by genetics — inheriting an oversized lower jaw, an undersized upper jaw, or both from your parents. If one or both parents had an underbite, their children are significantly more likely to develop one. Less common causes include childhood habits like chronic mouth breathing and abnormal tongue posture that encourage forward lower jaw growth. Jaw injuries or certain medical conditions affecting bone growth can also contribute to an underbite.
Yes — an underbite can worsen over time, especially during childhood and the teen years when the lower jaw is still actively growing. The mandible often continues growing forward into the late teens and even early twenties. Without treatment, a mild underbite can become severe enough to require surgery. In adults, the underbite itself may stabilize, but the consequences — uneven tooth wear, jaw pain, gum recession, and TMJ issues — will continue to accumulate.
Adults with mild to moderate underbites can often be treated with braces or clear aligners combined with elastics to reposition the teeth into a corrected bite. Severe underbites caused by a significant jaw size discrepancy may require surgical orthodontics — braces combined with corrective jaw surgery performed by an oral surgeon. Dr. Brandon Zipper evaluates the skeletal and dental components of each case to recommend the least invasive effective option.
Yes — early treatment is especially effective for underbites. Phase 1 treatment between ages 7 and 11 uses jaw development appliances like a reverse-pull headgear or upper jaw expander to stimulate upper jaw growth and guide lower jaw development. Treating during this growth window can dramatically reduce the severity of the underbite and may eliminate the need for jaw surgery later. The AAO recommends all children be evaluated by age 7.
No — jaw surgery is not always required. Many mild to moderate underbites can be corrected with braces or aligners alone, using elastics and orthodontic mechanics to compensate for the jaw discrepancy through tooth movement. Surgery is typically reserved for severe skeletal underbites where the lower jaw is significantly larger than the upper jaw. Dr. Zipper always explores non-surgical approaches first and only recommends surgery when it provides a clearly superior outcome.
Yes, most dental insurance plans with orthodontic benefits cover a portion of underbite treatment — typically $1,000 to $2,500 toward the orthodontic cost. If corrective jaw surgery is needed, medical insurance may also cover a portion of the surgical procedure. Coverage varies by plan, and Zipper Orthodontics accepts most major providers. Our team verifies your benefits before treatment begins. We also offer flexible monthly payment plans and interest-free financing.
Dr. Brandon Zipper, DMD, MS — board-certified orthodontist and AAO member — treats underbites for patients of all ages in Boca Raton, Boynton Beach, and throughout South Florida.
