TL;DR: Underbites and overbites are two common jaw alignment issues. Mild cases can often be treated with orthodontics, but moderate to severe bite misalignments, especially those affecting jaw structure or facial aesthetics may require corrective jaw surgery (orthognathic surgery). Underbites typically involve a forward lower jaw, while overbites involve a protruding upper jaw. Surgery is usually recommended when function (chewing, speech, breathing) or facial harmony is compromised. If you’re facing persistent jaw issues, a specialist evaluation is essential to determine whether surgical intervention is necessary.
What Is the Difference Between an Underbite and an Overbite?
An underbite occurs when the lower jaw extends forward, causing the bottom teeth to overlap the top teeth. In contrast, an overbite is when the upper jaw protrudes too far forward, causing excessive overlap of the upper teeth over the lower teeth.
| Feature | Underbite | Overbite |
| Jaw Position | Lower jaw extends forward | Upper jaw extends forward |
| Common Cause | Mandibular prognathism | Maxillary protrusion |
| Facial Profile | Prominent chin | Receding chin |
| Correction | Braces, surgery | Braces, surgery |
Understanding the distinction between the two is crucial for determining the right treatment plan.
Causes of Jaw Misalignment: Genetics, Habits, and More
Jaw alignment issues like underbites and overbites can stem from:
- Genetic factors (most common)
- Prolonged thumb sucking or pacifier use in childhood
- Jawbone development imbalances
- Injury or trauma to the face
- Poor dental habits or early loss of baby teeth
Identifying the root cause helps determine whether non-surgical orthodontics or surgical correction is needed.
Functional and Aesthetic Problems Caused by Underbites and Overbites
Both underbites and overbites can affect much more than just your appearance. Here are some common issues:
🦷 Functional Problems:
- Difficulty chewing and biting
- Speech difficulties (e.g., lisp or mispronunciations)
- Jaw pain or TMJ disorders
- Uneven tooth wear, increasing risk of cavities
- Breathing issues, especially during sleep
💡 Aesthetic Concerns:
- Facial asymmetry
- Prominent or recessed chin
- Low self-esteem due to facial imbalance
- Noticeable bite irregularities when smiling
When Does an Underbite Require Jaw Surgery?
Jaw surgery for an underbite is typically recommended when:
- The lower jaw protrudes significantly and causes functional problems
- Orthodontic treatment alone cannot correct the alignment
- The patient has stopped growing (usually age 17+)
- Facial aesthetics are heavily affected
- TMJ pain or bite instability is present
Corrective jaw surgery (orthognathic surgery) repositions the jawbone, often combined with orthodontics for full alignment.
When Is Jaw Surgery Recommended for an Overbite?
An overbite may require surgery when:
- The upper jaw (maxilla) extends excessively over the lower jaw
- The overbite is classified as severe (deep bite)
- Braces and retainers fail to achieve proper bite function
- The patient experiences gum recession, tooth wear, or speech issues
- Facial harmony is disrupted due to maxillary protrusion
Orthognathic surgery realigns the jaw for improved bite, facial structure, and long-term oral health.
Non-Surgical Treatment Options for Bite Correction
Not all underbites or overbites require surgery. Mild to moderate cases can often be managed through:
- Braces or Invisalign: Gradually shift teeth and minor jaw discrepancies.
- Elastics (Rubber Bands): Used with braces to correct jaw positioning.
- Orthodontic appliances: Such as palate expanders or Herbst appliances in children.
- Behavioral therapy: For bite issues caused by habits like tongue thrusting.
However, if the problem is skeletal rather than dental, these methods may not be enough.
What to Expect from Jaw Surgery: Procedure, Recovery, and Results
Corrective jaw surgery typically includes the following steps:
- Initial Evaluation: Orthodontist and oral surgeon assess the severity.
- Pre-Surgical Orthodontics: Braces prepare teeth for proper alignment.
- Surgery Day: Jaw bones are cut and repositioned under general anesthesia.
- Recovery Phase: Includes 1-2 weeks of downtime, soft diet, and follow-ups.
- Post-Surgical Orthodontics: Final adjustments are made over several months.
Patients usually see significant improvement in bite function, facial balance, and confidence.
How to Choose the Right Clinic for Jaw Surgery
Selecting a qualified clinic is crucial to the success of your treatment. Here’s what to look for:
- Board-certified oral and maxillofacial surgeons
- Multidisciplinary team including orthodontists and radiologists
- Proven experience with orthognathic surgery cases
- Advanced imaging (e.g., 3D CT scans) for accurate planning
- Transparent consultation process and before-after gallery
- Positive patient testimonials and follow-up care protocols
Look for clinics that offer comprehensive support from diagnosis to post-surgical care – especially for complex cases like severe underbites or overbites.
