If you or your child has been diagnosed with an underbite, you may be wondering what treatment options are available. An underbite affects the way your upper and lower teeth come together, and in more serious cases, it can lead to pain, speech issues, or difficulty chewing. Many people assume surgery is the only solution but is that always true?

One of the most common questions orthodontists hear is: Can Braces Fix an Underbite? The answer is often yes, especially when the underbite is mild to moderate and caused by dental alignment issues rather than skeletal structure. In many cases, braces and other orthodontic tools can correct the problem without the need for surgery.

Let’s break down what causes an underbite, how braces can help, and when surgery might still be necessary.

What Is an Underbite?

An underbite is a type of dental misalignment where the lower front teeth extend beyond the upper front teeth when the mouth is closed. Also known as a Class III malocclusion, this bite issue can be mild or severe.

Common signs of an underbite include:

• A visible gap between the upper and lower front teeth

• Difficulty biting or chewing food properly

• Jaw pain or clicking sounds

• Speech challenges like lisps

• Changes in facial balance or appearance

Depending on the cause and severity, different treatment paths may be recommended.

What Causes an Underbite?

Underbites can develop due to a variety of factors:

• Genetics: The most common cause. Jaw size and alignment often run in families

• Childhood habits: Thumb sucking, tongue thrusting, or extended pacifier use

• Tooth issues: Crowded, missing, or poorly positioned teeth

• Jaw growth problems: Uneven growth of the upper and lower jawbones

Identifying the cause is key to understanding whether braces alone will be enough.

When Braces Alone Can Fix an Underbite

Braces can be very effective for underbites that are primarily dental in nature. In these cases, the position of the teeth not the jawbones causes the misalignment. With consistent pressure over time, braces can shift teeth into a more natural position.

Braces can help by:

• Pulling back lower front teeth

• Moving upper teeth forward

• Correcting spacing or crowding

• Aligning the upper and lower arches

When started early, particularly during childhood or the teenage years, braces can even influence jaw development in a way that prevents surgery later on.

Non-Surgical Tools That May Support Braces

In addition to braces, orthodontists may use other non-surgical tools to treat underbites, including:

• Rubber bands (elastics): Help guide the bite into alignment

• Palatal expanders: Widen the upper jaw in growing children

• Functional appliances: Help direct jaw growth in young patients

• Clear aligners: Can work for mild underbites in adults or teens

• Retainers: Used after braces to keep the bite stable

These tools are especially helpful when the jawbones are still developing, and the goal is to guide natural growth in the right direction.

When Surgery May Be Required

Braces alone are not always enough. Surgery is usually needed when the underbite is skeletal rather than dental meaning the lower jaw is too large or the upper jaw is too small, creating a structural imbalance.

Signs surgery may be necessary include:

• Severe bite misalignment

• Jaw pain that affects daily life

• Breathing or speech problems related to jaw structure

• Lack of improvement with braces or orthodontic appliances

• Adult patients whose jawbones are fully developed

Orthognathic surgery involves repositioning the jawbones to correct the alignment. It is usually done in combination with braces before and after surgery to fine-tune the bite.

What Does the Treatment Process Look Like?

If braces are enough for your case, here’s what to expect:

1. Consultation and diagnosis: Your orthodontist evaluates your bite using scans or X-rays

2. Custom treatment plan: Braces are tailored to gradually move your teeth

3. Progress tracking: You’ll visit regularly for adjustments

4. Bite correction: Rubber bands or appliances may be added to help

5. Retention: After the braces come off, you’ll wear a retainer to keep your new bite in place

The full treatment can take anywhere from 18 to 30 months, depending on how complex your case is and how early treatment begins.

Benefits of Avoiding Surgery

Many patients prefer non-surgical options whenever possible. Choosing braces instead of surgery can offer:

• Lower risk: No hospital stay or general anesthesia required

• Faster recovery: No downtime or healing period from a surgical procedure

• Lower cost: Braces are typically more affordable than jaw surgery

• Flexible options: Braces and clear aligners can be customized for your lifestyle

• Reliable outcomes: Non-surgical treatment still offers excellent results in the right cases

That said, avoiding surgery is only advisable when it won’t compromise your long-term results or comfort.

How to Know What’s Right for You

The only way to know whether braces will be enough or if surgery may be needed is through a full orthodontic evaluation. This includes:

• A physical examination of your bite

• Digital imaging (like X-rays or 3D scans)

• A review of your dental history

• A discussion of your treatment goals

From there, your orthodontist can recommend the best course of action based on your unique case.

Final Thoughts

Surgery is not always necessary to fix an underbite. Braces and other non-surgical methods can often correct the problem, especially when started early or when the bite issue is related to tooth position rather than jaw size.

If you are dealing with an underbite or are concerned about needing surgery, the best first step is to schedule a consultation with a qualified orthodontist. You might be surprised to learn that a scalpel-free solution is possible and that a straighter, more functional smile is well within reach.