If you’ve ever had the occasion to speak with someone about how to correct an underbite, your conversation no doubt centered on the painful idea of having to “break” the jawbone, weeks on a liquid diet because of a jaw that was then wired shut, and the application of braces both before and aftersurgery. Understandably, such conversations tend to elicit a lot of wincing from any parent considering the same for their child. There are alternatives, however, IF you act early.

Why it’s Important to Act Early

When a child is young, the bones in their jaw are more malleable and welcoming to adjustment than at a later age. If treatment is delayed until later in life, the “tender” jawbones of a child become fused to such a degree that surgery presents itself as the only option. The options we’ll discuss below play upon this particular window of opportunity.

1. Expanders:  As is the case when a child has a crossbite, initial treatment for an underbite typically involves the use of an expander to adjust the spread of a child’s teeth so the bite matches evenly on all sides. Expanders resemble orthodontic retainers, and include a screw that is tightened nightly so as to “spread” a child’s bite to the prescribed measurements.
2. Braces: If a child is presented with a minor underbite restricted to tooth overcrowding, braces alone can sometimes alleviate the concern. Most often, however, braces are used in conjunction with, or as a precursor to a headgear appliance, which can apply a more direct, and significant,amount of “pull-pressure” to the lower jawbone.
3. Reverse-pull Face Mask (with or without a chincap): Sometimes used in combination with or after an expander, headgear can provide additional stimulation and directional guidance to a jaw not wanting to develop in the correct fashion. Headgear works by applying forward “pull pressure” to the jaw by resting atop the face, and connecting to either braces or an expander contained within the mouth.
4. Veneers: Very mild underbites can be cosmetically altered with veneers so the teeth give the appearance of no underbite. There is a good degree of artistry with this approach, and when done correctly, this creative placement of veneers on the upper jaw mimics a jaw in proper alignment.

Fixing an underbite doesn’t have to be fraught with expense and pain if dealt with in a timely fashion. Speak early and often with your dentist and orthodontist about the options available to your child.