Underbite is the term used to refer to a common jaw relationship condition, observed in many people. Also known as Class III malocclusion or prognathism, this condition involves the abnormal protrusion of the lower jaw, causing the lower jaw to protrude forward in front of the upper jaw. Thus, on closing the jaw, the lower teeth overlaps the upper teeth, thereby giving the chin and lower jaw teeth a far more prominent appearance on the face.
About 5-10% of the world's population is seen to suffer from this jaw condition. Underbite condition is mostly hereditary, however, it can also be caused by habits like excessive thumb sucking, breathing from the mouth, tongue thrusting, prolonged use of feeding bottles and pacifiers or even poor chewing habits. Underbite correction is carried out in different ways depending on the patient's age and severity of the condition.
Importance of Underbite Correction
At times the underbite condition can be minor and hardly noticeable. However, in some people the condition is quite visible and prominent. People are conscious of their appearance and often such people are found to struggle with low self-esteem. However, it is not only for cosmetic purposes that underbite correction procedure needs to be carried out, but also because if not corrected, the person can develop temporomandibular joint disorder, poor bite, speech interference, jaw pain and even have their teeth worn off easily.
Since underbite tends to worsen with time, it is important to begin treatment as soon as the condition is noticeable. Underbite correction in children needs to be carried out as soon as possible. This is because the jawbones of children (below age of 8) are easier to shape and the condition can be corrected without surgery. In teenagers and adults, the correction will be more difficult and challenging. The type of treatment will vary depending on the severity of the underbite and the age of the individual.
Underbite Correction in Children
Corrective measures can be started as early as the age of 5. For kids below the age of eight, surgery is not required. Since the jawbone is malleable and tender, it can be reshaped to correct the underbite in a far more easier manner. Correction is done using an upper jaw expander, which is nothing but a plastic and wire mold that fixes on the roof of the mouth and comes with a turnkey. It is left there for a few months. During the first few months, parents are given the task of opening the expander to a small degree with a key. The expansion will take place for a few months, till the required jaw width is attained. After attaining the jaw width, the expander is left as it is in the mouth for another few months, after which it is replaced by a retainer. The retainer will keep the upper jaw in place (in its new position) until it hardens there.
For kids between the age of 8 and 9, instead of an expander, a reverse-pull face mask is used. The child is asked to wear the mask everyday after school till the next day before leaving for school. This mask rests against the child's forehead and chin. It has metal bands that fix on the back molars of the upper jaw and rubber bands that fix them to the mouth. The mask exerts gradual pressure on the upper jaw via the rubber bands and fosters bone growth. The outcome of this treatment is that eventually the upper jaw gets pulled out over the lower jaw.
The child may have to wear this mask for a few months till the correction is attained. The orthodontist may also ask the child to wear the mask for longer periods during the day, depending on the severity of the underbite. Children with severe underbite condition will be asked to wear a chin cap, along with a reverse-pull face mask, to curtail the growth of the lower chin. This cap wraps the area from the chin to the forehead, thereby preventing the movement of the lower jaw. This curbs lower jaw and chin growth and facilitates underbite correction. Braces and retainers may also be required for the next few years, so as to keep the jaw in place.
Underbite Correction in Adults
In teenagers and adults the mode of treatment is different and will depend on whether the condition is dental or sketal. This means the orthodontist will check if the underbite is caused due to placement of teeth on the jawbone or it's a problem of an extended jaw itself. If the cause is dental, then braces and other orthodontic treatment measures are used to solve the problem. However, if the problem is a skeletal issue, surgery is mandatory for correction. The patient is asked to wear braces for a period of 9 to 11 months before surgery and 6 to 9 months post surgery. The surgery involves forcefully pushing back the lower jaw, by sectioning the lower jawbone and removing a piece from it to push the lower jawbone, chin and teeth back. The surgeon may also section and advance the upper jawbone to pull it forward. Both the procedures may also be used simultaneously to treat the condition.
Underbite correction cost will vary depending on the kind of facility where you carry out your treatment, the surgeon's charges, the severity of one's condition, etc. It will also depend on the place one resides in as some places are more expensive than others. However, since insurance does not cover orthodontic treatment in most cases, the treatment can prove very expensive. It's best to get underbite corrected as soon as possible, as many teenagers find wearing braces embarrassing during their school and college years.