Underbite Braces: Treatment Options for Underbite Correction

It’s been bothering you for your whole life. While others around you have well-aligned jaws and teeth, you’ve been dealing with an underbite, also known as a Class III malocclusion. In these types of malocclusion, the lower teeth stick out in front of your upper teeth.

You don’t want to continue looking and feeling like a bulldog. It can cause jaw pain, and you have trouble chewing and biting down on food. You may have heard about specific underbite braces to help correct the problem, and want to learn more. So what are underbite braces, and what can they do?

Key Takeaways

  • Underbites is when the lower jaw is pushed forward, in front of the upper jaw. This may be treated with braces for mild cases or jaw surgery for severe underbite.
  • Braces can shift your front teeth forward over your bottom teeth, giving the appearance of a correction.
  • Treatment methods with braces have progressed from often unsightly, metal-only dental appliances to clear or lingual braces and even removable aligners.
  • Aligners, such as Invisalign treatment, can prevent other dental issues such as cavities by making teeth easier to clean.
  • Average treatment time with aligners may be shorter, and mail-order options are available.

How Do You Fix Underbite?

First, let’s look at the difference between overbite vs underbite. Overbites involve the upper jaw sitting excessively forward, so your top teeth may almost entirely cover where the lower teeth sit. In cases of underbite, the lower jaw sits forward more than the upper jaw, giving you a “bulldog” look.

The question of how to fix underbite depends on your age and the severity of your condition. Children have the option of growth modification, where internal “horseshoe” dental appliances or a reverse-pull face mask are used to reposition the jaw, and coax it into a normal growth pattern [1].

Adults with permanent teeth, however, can only choose between braces, orthognathic surgery, or both. The need for jaw surgery depends on the severity of your bone abnormality. Some people are “borderline” cases, where the angles of their teeth and jaw sit around the cutoff point for underbite surgery. You may be reading this because you are a borderline case yourself, and want to choose your treatment.

While jaw surgery can have some corrective benefits to bone abnormalities in severe underbites, braces only straighten teeth to disguise them, and so they are also known as camouflage. For example, your treatment with braces may involve flaring out your upper incisors (the two upper front teeth) and retracting your lower incisors. This gives the appearance of a more normal jawline [2].

Summary:

Depending on the severity of your underbite, treatment options as an adult involve either braces to straighten the front teeth, underbite surgery to correct the underlying bone abnormalities, or both.

Braces for Underbite

Although you may have come to know braces as giving you a “metal mouth”, there are now several types of braces on the market today:

underbite braces

  • Traditional metal braces.
  • Clear braces.
  • Lingual braces.
  • Clear aligners.
  • Six Month Smiles.

Traditional Metal Braces

Traditional braces are the “original” corrective treatment for crooked teeth, overbite, or underbite correction. Previously, there were no other treatment options for moving teeth into their proper position, and you likely had friends in school who wore them.

As you could see, they involve brackets stuck to the front of the teeth or bands, along with arch wires or flexible wires to hold them all together. Rubber bands or metal ties may be used to put more pressure on your teeth, so they migrate to the correct position.

Even though you may also remember some classmates arriving at school with colored brackets, for adults this option isn’t really compensation for the altered appearance that these type of braces bring.

Clear Braces

Clear braces were first made from plastic, and originated in the 1970s as an alternative to metal braces. Initially, they had issues with staining and deformity, as they were much weaker than regular braces. Clear braces have since improved, with additional types of plastic, ceramic, and metal slots now used in their production.

Today, ceramic braces with a metal slot are one of the best types of clear braces. These are still far less noticeable than metal-only braces, and their increased efficacy can make a world of difference in avoiding underbite jaw surgery if you are a “borderline” case [3].

Lingual Braces

Lingual braces are another option if you are concerned about the appearance of your smile, but don’t want to compromise on the performance of your treatment. Meaning “tongue” braces, lingual braces sit on the inner sides of your teeth, so remain invisible to others. They are the most effective of the non-traditional braces.

On the other hand, lingual braces can cause more discomfort and take longer to be bonded to your teeth. Their time-consuming application contributes to them being more expensive too [4].

Clear Aligners

Clear aligners not only look invisible but also allow for underbite correction without the risk of other oral health problems, such as cavities. They are molded to your tooth shape and where your top teeth and bottom teeth are meant to be positioned, allowing for gradual correction of bite misalignment.

The efficacy of clear aligners depends on whether the forces applied are relevant to your misalignment. Invisalign treatment, for example, uses “smart” force attachment where position and shape are monitored. Aligners can be used alongside tooth extraction where necessary, too [5].

underbite braces The effectiveness of clear aligners compared to fixed braces in treating misaligned teeth
It was found that clear aligners had a greater impact than fixed braces in the treatment of misalignment

Another option is Byte Aligners, which aims to deliver cost-effective treatment to you at home. The convenience of telehealth is combined with the short amount of time you need to wear the aligner each day, and the shorter treatment duration of two to four months. To learn more about clear aligners, read this Byte Aligners review to see an example of what they can do for you.

Six Month Smiles

Six Month Smiles are a brand of braces with clear brackets and white wires, so they are difficult to see from a distance. They claim to straighten your teeth in an average of six months, although treatment times of four to nine months are possible.

To learn more, read the complete Six Month Smiles review here.

Do Underbite Braces Have Rubber Bands?

Some traditional metal and clear braces make use of rubber bands, but aligners do not. They assist in putting pressure on your teeth to pull them in the correct position.

Braces Fixing Underbite Pictures

What does it look like to wear braces to fix an underbite?

Upper Teeth
Underbite braces
Image source: Smith Orthodontics
Lower Teeth

Underbite braces

Upper and Lower Teeth
Image source: Koch Orthodontics

Summary:

Gone are the days of having to settle for a metal mouth. Clear and lingual braces are now available as a treatment plan, as well as different types of aligner.

Underbite Braces Treatment

underbite braces

Ultimately, your treatment plan can only be provided by an orthodontist or qualified dentist. However, if you would prefer using an aligner, you have the FDA to back you up. Their use is supported for milder cases of teeth misalignment, but whether metal braces, clearer alternatives, lingual braces, or aligners are best for you depends on your individual needs.

If you have a very mild case of underbite or are at the stage where you need a retainer, Byte Aligners may be for you. Treatment first involves an in-home impression kit, which is then sent off to a dental professional so they can mold your first aligner and design a plan for you. Your progress is then monitored remotely. It is, overall, the most convenient option.

Process

Whether you’re traveling to each orthodontic appointment or using telehealth services, the process is similar. All aligners and braces fix crooked teeth by exerting pressure. Every few weeks, they are tightened or remolded closer to the optimal position by your orthodontist.

If you choose an aligner, you must follow your orthodontist’s instructions on how long to wear them, which is usually 22 hours a day. This allows for brushing your teeth or eating more comfortably. The FDA urges caution on any treatment that claims to work in less than two years, as permanent damage to teeth or bones can result from rapid realignment.

Afterward, you may still need to use a retainer at night. This ensures the jaw bone will readjust to the new position of your teeth, so they don’t go back to their original place.

Treatment Time

Depending on the severity of your condition, you may need to wear braces or an aligner for anywhere from just under one year to three years. This was the range of duration seen in a review comparing braces to aligners [6].

A study on braces for mild underbite found an average treatment time of 33 months for standard straight-wire braces. For braces designed to correct underbite, this was shortened to 26 months. The two were equally effective, but the delay in finishing treatment may push some towards jaw surgery [7].

Summary:

From braces to the Byte Aligner, the treatment process is similar. You can expect to wear a series of several aligners, steering your teeth towards the correct placement, over up to two years of adjustment.

Alternatives to Braces

You may be searching for an effective braces alternative because of the potential for long-term health concerns such as tooth decay. Aligners have an advantage in this situation, as they can be removed from the mouth when you brush your teeth. Fixed types of orthodontic treatment are associated with an increased risk of plaque and inflammation, so it may be best to find an alternative [8].

Clear Aligners for Underbite

Clear aligners may only be suitable for mild underbite, or moderate levels of severity at best. A review comparing aligners to braces found that, while aligners generally led to a shorter treatment time, they were less effective with severe underbites.

Half of the clinical trials analyzed specified that they were studies of class I malocclusions, with the others being unspecified. However, in cases of underbite, we may be able to assume similar results to traditional metal braces, as they are effective in underbite treatment [6].

Whether you want to treat a mild underbite at home, or are seeking a convenient treatment with a retainer, Aligner Co may be right for you. With an at-home impression kit, make a mold of your teeth that will be used to make a custom set of aligners, which may only take four to six months to be effective. Read the full Aligner Co review here to learn more.

Summary:

Clear aligners are a convenient method of treatment, but they may only be suitable for mild cases of underbite.

Underbite Braces Cost

The cost of braces varies by type. Metal-only braces, for example, cost an average of $5,000, but can range up to $10,000 for severe cases. As for clear or ceramic braces, you can expect to pay an average of $4,500, or up to over $8,000 without insurance. Invisalign treatment may cost between $3,000 to $8,000.

Your most expensive option is lingual braces. These can set you back up to $13,000 thanks to their need for customization, difficulty to install, and the lack of orthodontists available to treat you with them.

On the other hand, Byte Aligners cost $1,895 for the all-day option, and $2,295 for the night-only set. Aligner Co is even cheaper, at $1,145, with special offers periodically available.

Summary:

When it comes to cost, aligners win, but this may be partly because of their indication for mild malocclusions only.

Underbite Fixed With Braces

Can braces fix underbites? Let’s look at some visual comparisons, to see the degree of normalcy you can expect.

Underbite Braces Before and After

Image source: Smile Solutions

FAQ

What are the most important things to know about using braces for underbite?

Can Braces Fix an Underbite?

How Long Does It Take for Braces to Fix Underbite?

At What Age Do You Correct an Underbite?

Do Underbite Braces Hurt?

Conclusion

If you worry that you missed out on treating your underbite or want to avoid jaw surgery, don’t worry. Mild to moderate cases can be treated with braces or aligners, and there is even the option of aligners designed remotely from an impression kit. As home treatment is cost-effective and each person is different, the choice is ultimately yours, with advice from your orthodontist if accessible.

References:

  1. Lim, Li-In et al. “Treatment outcomes of various force applications in growing patients with skeletal Class III malocclusion.” The Angle orthodontist vol. 91,4 (2021): 449-458. doi:10.2319/090320-768.1
  2. Eslami, Sara et al. “Treatment decision in adult patients with class III malocclusion: surgery versus orthodontics.” Progress in orthodontics vol. 19,1 28. 2 Aug. 2018, doi:10.1186/s40510-018-0218-0
  3. Russell, J S. “Aesthetic orthodontic brackets.” Journal of orthodontics vol. 32,2 (2005): 146-63. doi:10.1179/146531205225021024
  4. Huh, Heidi H et al. “Practice of lingual orthodontics and practitioners’ opinion and experience with lingual braces in the United States.” Journal of clinical and experimental dentistry vol. 13,8 e789-e794. 1 Aug. 2021, doi:10.4317/jced.58328
  5. Tamer, İpek et al. “Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review.” Turkish journal of orthodontics vol. 32,4 241-246. 1 Dec. 2019, doi:10.5152/TurkJOrthod.2019.18083
  6. Ke, Yunyan et al. “A comparison of treatment effectiveness between clear aligner and fixed appliance therapies.” BMC oral health vol. 19,1 24. 23 Jan. 2019, doi:10.1186/s12903-018-0695-z
  7. Aragón, Mônica L C et al. “Efficiency of compensatory orthodontic treatment of mild Class III malocclusion with two different bracket systems.” Dental press journal of orthodontics vol. 22,6 (2017): 49-55. doi:10.1590/2177-6709.22.6.049-055.oar
  8. Boke, Fatma et al. “Relationship between orthodontic treatment and gingival health: A retrospective study.” European journal of dentistry vol. 8,3 (2014): 373-380. doi:10.4103/1305-7456.137651
Underbite Braces: Treatment Options for Underbite Correction

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