If your upper and lower teeth don’t fit together properly, you likely have a misaligned bite, or as we say in orthodontic speak, malocclusion. As an El Dorado Hills orthodontist, two common types of malocclusion I see are overbites and underbites.
While they might sound like opposite versions of the same issue, they affect your teeth, jaw, and overall oral health in very different ways, and they don’t always require the same treatment.
In this post, I’ll break down the key differences between an underbite vs. overbite, how I diagnose each one, and the options for correcting them.
What’s the Difference Between an Underbite and an Overbite?
When comparing an underbite vs. overbite, the main difference is in whether the upper or lower teeth and jaw are affected. Both issues are often due to a discrepancy in jaw size. Below, I describe the hallmarks of the two types of malocclusion.
What Is an Overbite?
An excessive overbite, also called a deep bite, is when the upper front teeth cover too much of the lower front teeth when you bite down.
A small overbite is actually normal. But when the overlap is excessive (typically more than about 3mm), it can lead to issues with function and wear.
Ideally, the top teeth should only cover ⅓ to ½ of the bottom teeth when the jaws are together.
Why Treating Overbites Matters
If left untreated, an overbite or deep bite can cause:
- Premature enamel wear, chipping and/or cracking
- Gum irritation or recession
- Jaw pain or TMJ issues
- Difficulty chewing
- Increased risk of injury to the front teeth
- Soft tissue damage if the lower teeth bite into the roof of the mouth
What Is an Underbite?
An underbite is when the lower teeth sit in front of the upper teeth.
Unlike some overbites, underbites are most often skeletal, meaning they’re related to the size or position of the jaws rather than just the teeth.
Why Treating Underbites Matters
An underbite can lead to:
- Difficulty chewing food
- Speech challenges
- Breathing issues
- Jaw strain and discomfort
- Uneven tooth wear
- Stress on the gums and supporting bone
How Orthodontists Diagnose an Overbite or Underbite
While sometimes an overbite or underbite is extremely obvious, it can’t always be identified by looking at your smile in the mirror.
At Jeffrey Kwong Orthodontics, I perform an exam and take digital x-rays and scans of your dentofacial anatomy to evaluate:
- How your teeth come together when you bite
- Jaw position and growth patterns
- Tooth alignment and spacing
This is important because both overbites and underbites can be dental (caused by tooth position) or skeletal (caused by jaw structure). And that difference determines how we treat them.
Can Braces Fix an Overbite?
One of the most common questions I hear is: Can braces fix an overbite?
The answer is, yes, in most cases, braces can fix an overbite.
Braces for Overbite Correction
Braces work by exerting steady, gentle pressure that gradually shifts the teeth into better alignment.
When using braces for an overbite, I may also incorporate rubber bands (elastics), which provide the connective force necessary to align the bite.
If you’ve ever looked at before-and-after braces overbite photos, you’ve probably seen how dramatically treatment can improve the bite and smile.
Can InSmile™ Behind-the-Teeth Braces Fix an Overbite?
If you’re looking for a more discreet way to fix your bite, InSmile™ hidden braces are another excellent option for correcting an overbite.
InSmile braces are placed on the back (tongue side) of your teeth, so they’re completely hidden from view.
Like traditional braces, InSmile uses a system of brackets and wires to move teeth into their ideal positions. The difference is in the technology and customization behind the scenes.
The braces rely on Smartwire® technology that delivers gentle, controlled forces based on your individualized treatment plan. The teeth take a more direct path to their final positions with fewer adjustments needed.
In some cases, I’ll also incorporate rubber bands to help align the bite more precisely.
Will InSmile or Conventional Braces Fix an Overbite in Every Case?
While braces and InSmile are highly effective, the exact approach depends on the cause and severity of the overbite.
For a mild to moderate overbite, braces alone are often enough to get the job done.
In growing patients, depending on the complexity, we may recommend early intervention to guide jaw development and prevent or reduce the overbite.
In adults, severe cases might require additional techniques or, rarely, corrective jaw surgery paired with orthodontic treatment.
Can Clear Teeth Aligners Fix an Overbite?
Yes, clear aligners like Spark™ Aligners are an excellent option for many patients with an overbite.
Teeth Aligners for Overbite Correction
When using clear teeth aligners for overbite correction, again, we may need to pair the aligners with rubber bands to align the bite in addition to straightening the teeth. We often use attachments; these tooth-coloured buttons are bonded to your teeth to help to facilitate more complex tooth movements.
And as I always tell patients, it’s not the aligners that deliver results; the lab plays a role in making the plastic. It’s the treatment plan and communication from the doctor behind them, which is why seeking care from a certified specialist in orthodontics is key.
For a more in-depth look at clear aligners for overbite treatment, read: “Can Clear Aligners Fix an Overbite?”
Or to learn why seeing an orthodontic specialist is so important, check out: “How Come My Back Teeth Don’t Touch After At-Home Clear Aligner Treatment?”
How Are Underbites Treated?
Treating an underbite can be a bit more complex, especially when it involves the jaws.
Braces, Clear Aligners, or InSmile™ for Mild to Moderate Underbites
If the underbite is primarily caused by tooth position, I may use clear aligners, InSmile behind-the-teeth braces, or traditional braces in combination with rubber bands to bring the teeth and jaw into proper alignment.
Early Treatment for Kids
An underbite is one of the types of malocclusion that can significantly benefit from early intervention. If we catch an underbite early while a child is still growing, we can use certain orthodontic appliances to guide jaw growth and minimize the bite problem.
This can help kids avoid the need for extractions or jaw surgery down the road. It may also make later treatment with braces, InSmile, or clear aligners faster and easier.
Underbite growers tend to grow for longer and tend to grow more, but there are new ways to help treat underbites without solely relying on jaw surgery. Depending on your level of comfort, we can customize and tailor the treatment towards your needs.
Treatment for Adults
For adults with a severe skeletal underbite, surgical orthodontics could be the best way to get stable results. With this approach, I work closely with your oral surgeon to create a comprehensive treatment plan.
You wear braces or clear aligners for a specified period of time. Then, we remove your appliance so your oral surgeon can perform corrective jaw surgery. After a healing period, you wear braces or aligners again to fine-tune your smile.
When Should You See an Orthodontist?
If you’re unsure whether you have an overbite or underbite, or if your bite feels off, it’s worth getting an expert opinion.
Signs to look for include:
- Teeth that don’t line up properly
- Difficulty chewing
- Jaw discomfort or clicking
- Uneven wear on teeth
- Speech issues
The American Association of Orthodontists recommends children have their first orthodontic evaluation by age 7, but it’s never too late for adults to seek treatment. No referral is necessary; just reach out to us.
Underbite vs. Overbite: The Bottom Line
When it comes to underbite vs. overbite, both conditions affect your appearance, the function of your teeth and jaw, and your long-term oral and overall health.
The good news? With modern orthodontic treatment, including traditional braces, InBrace hidden braces, and clear aligners, most cases can be corrected safely and effectively.
Get Expert Bite Correction in El Dorado Hills, CA
If you’re dealing with an overbite or underbite, the first step is an accurate diagnosis.
At Jeffrey Kwong Orthodontics, my team and I create personalized treatment plans using advanced technology and proven techniques to deliver healthy, lasting results.
Schedule your complimentary consultation today and find out which treatment option is right for you.
