Concerned about an underbite? Book an orthodontic assessment.
Underbite: Symptoms, Causes and When to Consider Orthodontic Assessment
South Kensington, London
An underbite is a type of malocclusion in which the lower front teeth sit in front of the upper front teeth when biting together. Sometimes referred to as a reverse bite, this pattern can affect a few teeth or the entire dental arch. Underbite teeth patterns vary in severity — from a subtle edge-to-edge relationship to a more pronounced forward positioning of the lower jaw. At our South Kensington dental practice, our team provides structured bite evaluations to assess the type and severity of an underbite and to discuss underbite treatment options tailored to each patient’s needs.
Underbite Assessment
Structured bite evaluation and orthodontic consultation
- Visual bite examination
- Tooth overlap measurement
- Jaw position evaluation
- Tooth wear assessment
- Orthodontic options discussion
What Is an Underbite?
An underbite occurs when the lower front teeth sit in front of the upper front teeth when biting together. In a typical bite relationship, the upper teeth slightly overlap the lower teeth both vertically and horizontally. A reverse bite reverses this pattern, with the lower dental arch positioned forward of the upper arch.
The condition may involve only a few front teeth, or it may affect the entire dental arch depending on the underlying cause. Underbite severity varies considerably — from a subtle edge-to-edge relationship where the front teeth barely touch to a more pronounced pattern where the lower jaw sits well forward of the upper jaw.
Only a clinical examination can reliably determine whether an underbite is dental in origin (relating primarily to tooth position), skeletal (relating to jaw size and proportion), or a combination of both. This distinction is important because it influences which underbite correction approaches may be most suitable. Explore other bite alignment concerns we assess or read on to understand the causes, symptoms, and how to fix an underbite.
What Causes an Underbite?
An underbite may develop as a result of a combination of genetic, developmental, and dental factors. In many cases, more than one contributor is involved.
Genetic Jaw Growth Patterns
The size and proportional relationship between the upper and lower jaws are largely determined by genetics. A relatively larger lower jaw or a smaller upper jaw can result in the lower front teeth sitting forward of the upper teeth, creating a malocclusion underbite pattern.
Differences in Upper and Lower Jaw Size
When the lower jaw (mandible) grows proportionally larger than the upper jaw (maxilla), or when the upper jaw is underdeveloped relative to the lower, the resulting size discrepancy can produce an underbite. This skeletal imbalance is one of the most common underlying factors.
Childhood Developmental Factors
Certain habits or conditions during childhood development — such as prolonged dummy use, mouth breathing, or tongue posture patterns — may influence the growth and positioning of the jaws and teeth. These factors can contribute to a reverse bite that persists into adulthood.
Tooth Positioning Irregularities
In some cases, the jaw relationship may be relatively normal but the individual teeth are positioned in a way that creates an underbite. The lower front teeth may be angled forward (proclined) or the upper front teeth may be tilted backward (retroclined), producing a dental rather than skeletal underbite.
Tooth Loss or Shifting Over Time
Loss of upper teeth or gradual shifting of the dental arches over time can alter the bite relationship. In some individuals, these changes may result in the lower teeth moving into a more forward position relative to the upper teeth.
Common Symptoms Associated with an Underbite
Not all underbites cause symptoms. The concerns experienced depend on the severity of the reverse bite and how the teeth and jaws function together.
Difficulty Biting or Chewing
- Uneven contact between the upper and lower teeth when eating
- Increased pressure concentrated on certain teeth, as the bite does not distribute forces evenly
Speech Changes
- Altered pronunciation of certain sounds, particularly those requiring contact between the upper and lower front teeth
- A subtle change in speech clarity that may be more noticeable to others
Tooth Wear
- Excessive wear on the biting edges of the front teeth due to the reversed contact pattern
- Chipping or flattening of the teeth that bear the greatest load
Jaw Discomfort
- Muscle fatigue in the jaw, particularly after meals or prolonged chewing
- Strain or discomfort as the jaw works to compensate for the altered bite relationship
How Dentists Assess an Underbite
When you attend our practice with concerns about underbite teeth, our dental team carries out a structured evaluation. The assessment determines whether monitoring or underbite correction is appropriate.
Visual examination of bite relationship — observing how the upper and lower teeth come together when the mouth is closed
Measurement of tooth overlap — quantifying the extent to which the lower teeth sit forward of the upper teeth
Evaluation of jaw position — assessing the anteroposterior relationship between the upper and lower jaws
Assessment of tooth wear — checking for signs of accelerated wear associated with the reversed bite pattern
Radiographs or digital scans where clinically indicated — to assess skeletal proportions, root positions, and jaw anatomy
The findings guide a personalised discussion about whether treatment is recommended and which approach may be most suitable.
Concerned About a Reverse Bite?
If you are concerned about a reverse bite or notice difficulty when chewing, an orthodontic assessment can help evaluate the alignment of your teeth and jaws. Book a consultation at our South Kensington clinic for a structured bite evaluation.
Underbite Correction Options
The most appropriate approach to underbite correction depends on the type, severity, and underlying cause identified during assessment.
Orthodontic Treatment
Orthodontic treatment using fixed braces or clear aligners can gradually reposition the teeth to improve the bite relationship. This approach is most effective for dental underbites where the tooth positions are the primary concern. Treatment may involve retraction of the lower front teeth, advancement of the upper front teeth, or coordination of both arches.
Combined Orthodontic and Surgical Approach
In more severe skeletal underbite cases, where the jaw size discrepancy is significant, multidisciplinary planning between orthodontics and oral surgery may be discussed. This combined approach addresses both the tooth positions and the underlying jaw relationship to achieve a stable result.
Monitoring
If the underbite is mild, stable, and not causing functional concerns or progressive symptoms, monitoring may be appropriate. Regular review allows any changes to be identified early, and treatment can be discussed if the situation evolves.
Our orthodontics team can discuss alignment-based approaches in detail, including clear aligners where the underbite pattern and clinical presentation are suitable. In cases where significant tooth wear has occurred, our restorative dentistry services may also be discussed as part of a comprehensive management plan.
Can an Underbite Affect Jaw Health?
A significant malocclusion underbite may place uneven strain on the jaw muscles. When the teeth do not meet in their expected relationship, the muscles of mastication may work harder to achieve functional contact during chewing, which can contribute to fatigue, tension, or discomfort.
In some patients, an underbite may be associated with symptoms of temporomandibular disorder (TMD), including jaw clicking, stiffness, or limited opening. The relationship between underbite and TMD varies between individuals — not all patients with an underbite experience joint symptoms, and the presence of TMD-related concerns is assessed on a case-by-case basis.
A structured assessment helps determine whether joint involvement is present. Our TMJ assessment and treatment service can provide further evaluation if jaw joint symptoms are present alongside an underbite.
When Should You Consider an Orthodontic Consultation?
Consider arranging an assessment if you experience any of the following:
The lower teeth sit noticeably in front of the upper teeth
Chewing feels uncomfortable or inefficient
Tooth wear is increasing, particularly on the front teeth
Jaw discomfort or muscle fatigue develops
You are considering alignment treatment to improve bite function
Frequently Asked Questions
About underbite assessment and treatment options
Book an Underbite Assessment in South Kensington
An underbite can vary in severity, and not all cases require treatment. However, if symptoms or alignment concerns are present, an orthodontic assessment can help determine appropriate options.
Our dental team in South Kensington provides structured bite evaluations and orthodontic consultations tailored to individual needs. Book your appointment to have your bite assessed and discuss suitable next steps.
Open Monday–Sunday • 2 mins from South Kensington tube
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At South Kensington Medical & Dental, we are fully registered with the Care Quality Commission (CQC) and our clinicians are registered with the relevant UK regulatory bodies, including the GDC and GMC. Our dentists, dental nurses and medical professionals deliver care that meets the highest clinical, safety and ethical standards, because our patients deserve nothing less.
