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What is an underbite?

The technical classification for an underbite is called as a class III malocclusion. The condition refers to a situation where the teeth of the mandible (lower jaw) are covering the teeth of the maxilla (upper jaw).

In a normal situation, the teeth of the upper jaw should be overlapping the teeth of the lower jaw. There are two reasons for an underbite developing and they affect the kind of treatment that is advised as well.

The first reason for the development of an underbite is a skeletal deficiency between the upper and lower jaw. In such a case the maxilla either develops less than what is considered normal or the mandible grows a little more.

The second reason for the development of the underbite is for the occlusion of the teeth present to push the jaw forward. Occlusion refers to the manner in which the upper teeth contact the lower teeth, whereas in normal conditions the upper teeth will overlap the lower teeth (and more specific interactions that the dentist will look for.

Treatment of underbite

As mentioned earlier, the treatment of the underbite will depend on the reason behind its development. If the cause is judged to be skeletal then no treatment will be advised to a growing child. This is because a growth spurt could see a reduction or even complete elimination of the discrepancy that exists.

Some extra oral orthodontic appliances (chin strap, headgear etc) which have been shown to promote the growth of a jaw can be utilized if the child is old enough to accept them.

In such a case, once the growth is complete, orthognathic surgery has to be undertaken to correct the deformity followed by some amount of orthodontic treatment to get the teeth back into their correct occlusion.

If, however, the treatment is believed to be caused due to interferences in the occlusion then there are two possible ways to go about it. The conventional view is to wait for all the permanent teeth to erupt and then correct the occlusion with braces starting at the age of 11-13.

A more aggressive approach is to start treatment when the child is still young, even as 3. The idea here is that by correcting the abnormality early, you are giving the child the best chance to develop a normal speech pattern, good chewing habits, make it easier to maintain oral hygiene and to minimize and growth pattern changes that might occur due to the presence of an underbite.

There are several advantages of the latter method and a lot of case reports have been published where the results have been very encouraging. The problem is sometimes getting children so young to co-operate with the treatment.

There is also a wealth of information regarding the success that dentists have had treating underbite the conventional way so it would be unfair to completely rule that out as well.

Conclusion

An underbite is a relatively common malocclusion and it has multiple modes of accepted treatment methods. The important thing to understand is that treatment is necessary and to meet an orthodontist to figure out what is the best time to start.  

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