Underbite: Causes, Symptoms, Treatment and Cost

Underbite is a kind of malocclusion, which refers to a misalignment of the teeth and/or jaws. Malocclusions can affect both adults and children. When the lower jaw protrudes more than the upper jaw, a condition known as an underbite occurs. This condition causes the lower front teeth to sit in front of the upper front teeth when the patient bites down.

When the teeth are brought together, those with an underbite will have an uneven bite, with the bottom teeth sticking out more than the upper teeth. This is the most noticeable sign of the condition.

Other symptoms include difficulty eating and speaking properly, jaw pain, TMJ (temporomandibular joint) disorder, and self-consciousness about one’s appearance due to an unattractive smile.

There are four main types of underbite:

• Class II Underbite: This is when the lower jaw is significantly longer than the upper jaw. The lower teeth may also overlap with the upper teeth.
• Class III Underbite: Also known as a reverse bite, this type occurs when there is an excess growth in the upper jaw compared to the lower jaw causing it to protrude outwardly.
• Transverse Underbite: This type involves misalignment due to asymmetry between both sides of the face which causes one side of your mouth to stick out more than other side making it look crooked and unbalanced.
• Open Bite: An open bite occurs when there is spacing between some front teeth usually caused by poor habits like tongue thrusting and nail biting that push your front teeth apart while leaving your back molars aligned correctly without any overlap with each other .

It can be caused by genetics, trauma, or abnormal growth of the jaws.

Poor oral habits such as thumb-sucking can also contribute to an underbite developing.

The most common symptoms of underbite are:

• Protruding lower teeth and jaw
• Difficulty closing the mouth properly
• Jaw muscle pain or discomfort
• TMJ (temporomandibular joint) pain
• Difficulty chewing food properly
• Unusual wear on the teeth
• Speech impediments due to misaligned jaw

To prevent Underbite, it is important to practise good oral hygiene, eat a nutritious diet, and visit the dentist regularly for check-ups and cleanings.

• Visual examination: A dentist or orthodontist will typically begin by visually examining the patient's face, jaw, and teeth. This can help to identify any obvious signs of an underbite, such as a protruding lower jaw or lower front teeth that are in front of the upper front teeth.
• X-rays: X-rays, including panoramic X-rays, can provide detailed images of the jaw and teeth, allowing the dentist or orthodontist to see the underlying bone structure and identify any discrepancies that may indicate an underbite.
• 3D images (CBCT): can be used to give more detailed and accurate images of the jaw and teeth, and can help to identify more complex cases of underbite.
• Cephalometric analysis: This technique involves taking a lateral head x-ray and using specific measurements to analyse the relationship of the jaw and teeth.
• Model analysis: Dentists will take a cast of the patient's teeth and jaw, which can then be analysed to identify any discrepancies and determine the extent of the underbite.
• Bite registration: This is an in-mouth measurement that is used to determine the position and relationship of the upper and lower jaws when the patient bites together.

It's important to note that some underbites are more complex than others and may require a combination of tests and a detailed examination to accurately diagnose and plan treatment.

Underbite can cause various complications such as difficulty with chewing, speaking, and even breathing; temporomandibular joint (TMJ) pain; facial pain; increased wear of the teeth; gingival recession; and tooth decay.

It can also lead to an unaesthetic appearance, which may negatively affect self-esteem.

• Chewing exercises: Chewing exercises can help correct an underbite by strengthening the jaw muscles and helping to reposition the jaw.
• Ayurvedic herbs: Ayurvedic herbs such as brahmi, ashwagandha, shankhapushpi and vacha can be taken internally to help strengthen the muscles of the face and jaws, helping to correct an underbite.
• Acupressure: Acupressure can help relax tight facial muscles that may be contributing to an underbite.
• Yoga poses: Certain yoga poses such as lion pose, fish pose and bridge pose can help improve your posture and strengthen your facial muscles, helping to correct an underbite over time.
• Massage: Massaging your jaw area in circular motions helps relax tense facial muscles which might be contributing to an underbite.

• Eating in Underbite can be simplified by focusing on fresh, local ingredients and simple, home-cooked dishes.
• There is a good selection of food that is suitable for vegans and vegetarians alike.
• Popular options include tacos, burritos, salads, sandwiches and burgers.
• Eating a healthy diet that includes plenty of fruits and vegetables is the best way to manage an underbite

It is generally recommended to avoid foods that are high in sugar, fat, and processed carbohydrates when dealing with an underbite.

Food consists of packaged snacks, drinks with excessive amounts of sugar, fried dishes, and refined grains like white bread and spaghetti.

Some common treatment options include:

• Orthodontic treatment: This is often the first line of treatment for an underbite. Braces or other orthodontic appliances can be used to reposition the teeth and jaws into their proper alignment.
• Jaw surgery: In more severe cases of underbite, surgery may be necessary to reposition the jaw bones. This can involve cutting and repositioning the jaw bones and stabilising them with hardware, such as screws or plates.
• Invisalign: As a more recent alternative to braces, Invisalign, is a removable and clear plastic aligner that can also be used to correct an underbite, as well as several orthodontic issues.
• Orthognathic Surgery : It is a surgical procedure that corrects certain conditions of the jaw and face that can’t be corrected with braces alone. This surgery can involve moving the upper jaw, lower jaw, or both, to improve the way the upper and lower teeth fit together.
• Maxillomandibular advancement (MMA): the procedure which involves surgically moving both upper and lower jaws forward; or a combination of both procedures. In some cases, braces may be used to help correct an underbite as well.

A person who is experiencing an underbite should consult with an orthodontist.

An orthodontist specialises in diagnosing and treating malocclusions, which is the misalignment of a person’s teeth and jaws, including underbites.

Depending on the severity of the underbite, an orthodontist may recommend braces or other treatments to help correct the problem.

• NSAIDS: NSAIDs, also known as non-steroidal anti-inflammatory medicines, are a class of pharmaceuticals that relieve pain as well as inflammation and swelling. In dentistry, they are frequently utilised as a treatment for disorders such as underbite. Ibuprofen is an example of a typical NSAID.
• Steroids : These medications work by reducing inflammation and swelling around the jaw joint, allowing it to move more freely. In addition, they also reduce muscle tension and pain associated with malocclusion. The most common type of steroid used in treating underbites is prednisone.
• Antibiotics: Antibiotics can be used to treat an underbite. Antibiotics are often prescribed to reduce inflammation and prevent infection in the affected area. Penicillin is a common antibiotic used in this condition.

Surgical treatment typically requires a longer recovery time, ranging from 3-6 months, while non-surgical treatment such as orthodontic braces or clear aligners usually take 12-18 months.

• The results of treatment for an underbite can be permanent, depending on the type of treatment used.
• Generally, surgery is recommended to correct an underbite, which can be a permanent solution.
• Non-surgical treatments such as orthodontics and braces may also provide long-term results.

• Follow your surgeon’s instructions regarding diet and exercise, including any restrictions or recommendations.
• Practise good oral hygiene by brushing twice a day, flossing daily, and using antibacterial mouthwash to prevent infection and aid in the healing process.
• Avoid hard or crunchy foods that can damage the affected area while it is healing, such as chips, nuts, hard candy, ice cubes, etc., until cleared by your doctor to consume them again safely.
• Wear any special appliances (headgear/ retainers) as instructed by your surgeon for optimal results from the treatment plan.

Generally, orthodontic treatment for an underbite may cost anywhere between Rs. 15,000 to Rs. 1,00,000 or more.

The cost will also depend on the type of braces used and the duration of treatment. In some cases, surgery may be recommended which could increase the overall cost by a few thousand rupees.

Common side effects of underbite treatments can include:

• Pain and swelling in the jaw area
• Bruising around the jaw
• Temporary numbness or tingling in the face, lips, or tongue
• Difficulty opening and closing the mouth
• Difficulty eating or talking
• Jaw stiffness

If you are suffering from any complications relating Underbite then you should consult a doctor nearby as they can complications like ' difficulty with chewing, speaking, and even breathing; temporomandibular joint (TMJ) pain; facial pain; increased wear of the teeth 'in which treatment course can range from a few months to years depending on the severity of the situation.