What causes an underbite?

An underbite may develop due to a combination of factors. Genetic influences play a significant role, as jaw size and shape are largely inherited. Natural jaw growth patterns during childhood and adolescence may result in the lower jaw growing more prominently than the upper jaw. Childhood habits, tooth loss affecting bite balance, and gradual changes in tooth position over time may also contribute. In many cases, several factors are involved simultaneously.

Can an underbite cause dental problems?

Depending on the degree of misalignment, an underbite may contribute to uneven pressure on certain teeth, which can lead to gradual wear over time. The jaw muscles may also work harder during chewing, which may contribute to muscle tension or discomfort. However, not everyone with an underbite experiences problems. Professional dental assessment can help evaluate whether your bite alignment is contributing to any oral health concerns and determine whether management may be appropriate.

How is an underbite assessed?

A dental examination allows your dentist to evaluate bite alignment, jaw function, and tooth position. This may involve visual examination, assessment of how the teeth come together when biting, and evaluation of any signs of tooth wear or jaw discomfort. In some cases, dental imaging may be recommended to assess the underlying jaw structure. The findings inform whether monitoring, preventive measures, or active treatment may be appropriate.

Can an underbite be corrected in adults?

Management options for an underbite in adults depend on the cause and severity of the misalignment, as determined through professional clinical assessment. Options may include orthodontic approaches, restorative treatments to improve bite balance, or in some cases referral for specialist evaluation. The most appropriate approach depends on individual clinical findings, and your dentist can discuss the options that may be suitable for your situation.

Does an underbite always need treatment?

Not necessarily. Mild underbites that do not cause functional problems, discomfort, or significant tooth wear may simply be monitored during routine dental examinations. Treatment is generally considered when the misalignment contributes to symptoms such as difficulty chewing, jaw discomfort, speech changes, or progressive tooth wear. Your dentist can advise whether active treatment or ongoing monitoring may be more appropriate based on your individual circumstances.

Underbite: Causes and Management Options

An underbite occurs when the lower teeth extend in front of the upper teeth when the mouth is closed. Bite alignment differences may affect both appearance and oral function.

Some individuals may experience chewing difficulties or jaw discomfort, while others may notice little functional impact. Bite misalignment can influence how pressure is distributed across the teeth. Professional dental assessment can help evaluate bite position and overall oral health.

Professional Assessment

A thorough clinical examination can evaluate bite alignment, jaw function, and tooth wear to determine whether management may be appropriate.

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Assessment for underbite and bite alignment at Smile Dentist London

“They took the time to explain my bite alignment and outlined options clearly — I felt very well informed.”

Understanding the Condition

What Is an Underbite?

An underbite is a form of malocclusion where the lower teeth sit in front of the upper teeth when the mouth is closed. The degree of misalignment varies between individuals — some underbites are mild and cause few noticeable symptoms, while more pronounced cases may affect chewing mechanics and contribute to tooth wear over time.

Varying Degrees

The extent of an underbite can range from a very slight overlap to a more noticeable protrusion of the lower teeth. Mild cases may go unnoticed for years, while more significant misalignment may become apparent through changes in bite comfort, chewing efficiency, or the appearance of the smile. The degree of the underbite helps inform the most appropriate management approach.

Skeletal and Dental

An underbite may result from the position of the jaw (skeletal underbite), the alignment of the teeth (dental underbite), or a combination of both. Understanding the underlying cause is important in determining the most appropriate management. Professional assessment helps distinguish between these types and informs treatment planning.

Not Always Symptomatic

Not everyone with an underbite experiences discomfort or functional problems. Many people live comfortably with a mild underbite that requires no active treatment. However, if symptoms such as difficulty chewing, jaw discomfort, or uneven tooth wear develop, professional evaluation can help determine whether management may be beneficial.

A can help evaluate bite alignment and determine whether further assessment or management may be appropriate.

Contributing Factors

Common Causes of an Underbite

An underbite may develop due to a combination of genetic, developmental, and environmental factors. Understanding these contributing factors can support discussions with your dentist about the most appropriate management approach.

1Natural Jaw Growth and Development

The size and position of the upper and lower jaws are determined during growth and development. In some individuals, the lower jaw may grow more prominently than the upper jaw, or the upper jaw may be smaller relative to the lower jaw. These natural variations in jaw growth are one of the most common contributing factors to an underbite and are largely determined during childhood and adolescence.

2Genetic Factors

Jaw size, shape, and position are significantly influenced by genetics. If a parent or close family member has an underbite, there may be an increased likelihood of similar bite alignment patterns developing. Inherited skeletal proportions — including the relative size of the upper and lower jaws — play a key role in determining how the teeth come together when the mouth is closed.

3Childhood Habits

Certain habits during childhood — such as prolonged thumb sucking, extended use of a dummy, or tongue thrusting — may influence jaw development and tooth position over time. While these habits are common in early childhood, prolonged continuation may affect the growth pattern of the jaw and contribute to bite alignment changes including an underbite in some individuals.

4Tooth Loss Affecting Bite Balance

The loss of one or more teeth can affect how the remaining teeth are positioned and how the bite comes together. Over time, teeth may shift into gaps left by missing teeth, potentially altering the balance of the bite. In some cases, tooth loss may contribute to changes in bite alignment that result in the lower teeth sitting further forward relative to the upper teeth.

5Changes in Tooth Position Over Time

Teeth are not fixed permanently in position — they may gradually shift throughout life due to natural ageing, changes in gum and bone support, or the cumulative effects of biting and chewing forces. These gradual changes may alter bite alignment over many years, and in some individuals may contribute to the development or worsening of an underbite pattern.

Multiple factors may contribute to the development of an underbite simultaneously. A can help identify relevant contributing factors and inform appropriate management.

Recognising the Signs

When an Underbite May Need Professional Assessment

Many individuals with a mild underbite may not experience significant discomfort or functional concerns. However, professional evaluation may be appropriate if you notice any of the following signs, which may suggest that bite misalignment is affecting your oral health or comfort.

Chewing Discomfort or Inefficiency

If biting and chewing food becomes uncomfortable or feels less efficient than usual, this may indicate that the bite alignment is affecting how forces are distributed across the teeth. Difficulty breaking down food effectively or discomfort during meals may warrant professional evaluation.

Signs of Uneven Tooth Wear

When the bite is misaligned, certain teeth may bear more pressure than others during chewing. Over time, this may contribute to uneven wear patterns — such as flattening of tooth surfaces, thinning of enamel, or chipping. Your dentist can identify early signs of wear during routine examination.

Jaw Discomfort or Muscle Tension

The jaw muscles may work harder to compensate for bite misalignment, which may contribute to jaw ache, muscle tension, or fatigue — particularly after eating or during periods of stress. Persistent jaw discomfort may benefit from professional assessment to evaluate whether bite alignment is a contributing factor.

Speech or Bite Function Changes

In some cases, a more pronounced underbite may affect speech clarity or the way the teeth come together during normal function. If you notice changes in how you speak or if the bite feels increasingly unbalanced, professional evaluation may help determine whether the underbite is involved.

Oral Health Effects Linked to Underbite

Depending on the degree of misalignment, an underbite may contribute to a number of oral health considerations. Professional dental assessment may help evaluate whether bite balance is a contributing factor to any of these concerns.

Bite imbalance may place uneven pressure on certain teeth during chewing

Teeth in the contact zone may experience gradual wear over time

Jaw muscles may work harder to compensate for misalignment

Gum tissue around misaligned teeth may be more difficult to clean effectively

The risk of tooth chipping or fracture may be increased in areas of concentrated force

Speech clarity may occasionally be affected by more pronounced underbites

Assessment and advice for underbite concerns are available at our London clinic, where professional evaluation can help determine the most appropriate course of care.

Clinical Management

Preventive and Professional Care

Management of an underbite depends on the underlying cause, the degree of misalignment, and whether the condition is causing functional problems or contributing to tooth wear. Professional evaluation determines the most appropriate approach.

Regular dental examinations help monitor bite alignment and identify early signs of tooth wear or jaw strain. Your dentist can evaluate jaw function and tooth position and recommend the most appropriate management based on clinical findings. Treatment depends on clinical evaluation.

Management Approaches

Monitoring and Observation

For mild underbites that are not causing functional problems or significant wear, regular monitoring during routine dental examinations may be the most appropriate approach. Your dentist can track any changes in bite alignment or tooth condition over time and recommend intervention if needed.

Orthodontic Considerations

In cases where the underbite is contributing to functional problems or progressive wear, orthodontic assessment may be recommended. Orthodontic approaches aim to improve tooth alignment and bite balance. Your dentist can discuss whether orthodontic evaluation may be appropriate for your situation.

Restorative Treatment

Where tooth wear or damage has occurred as a result of bite misalignment, restorative options such as dental crowns, composite bonding, or other approaches may help restore tooth structure and improve bite balance. Treatment planning depends on the extent of wear and individual clinical findings.

Tooth Contouring and Adjustment

In some cases, minor adjustments to tooth shape or bite surfaces may help improve how the teeth come together. Tooth contouring involves carefully reshaping small areas of enamel to improve bite balance. This conservative approach may be appropriate when small adjustments could improve comfort and function.

Specialist Referral

For more complex cases — particularly those involving significant skeletal discrepancy — referral to a specialist such as an orthodontist or oral surgeon may be recommended. Your dentist can help coordinate referrals and ongoing care to ensure a comprehensive approach to management.

General Guidance

Temporary Measures Before Assessment

If you are concerned about your bite alignment, the following general precautions may be helpful while professional assessment is arranged. These measures do not replace professional dental care.

Avoid

Avoid attempting to adjust your bite or tooth position yourself.

Do not use unregulated devices or appliances without professional guidance.

Avoid ignoring persistent jaw pain, tooth wear, or changes in bite comfort.

Do not delay assessment if chewing becomes painful or significantly uncomfortable.

Avoid excessive force when biting if the bite feels misaligned or unbalanced.

These precautions are general guidance only and do not replace professional dental care. If you are concerned about bite alignment, please contact us to arrange an assessment.

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Frequently Asked Questions

Underbite Assessment

If you are concerned about your bite alignment, a professional dental assessment can help evaluate whether an underbite may be affecting your oral health and determine appropriate care options.

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Professional Underbite Assessment in London

Whether you are concerned about bite alignment, jaw discomfort, or tooth wear, our South Kensington team can evaluate your situation and discuss the most appropriate management options.

20 Old Brompton Road, South Kensington, London SW7 3DL

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Dr. Yasha Y Shirazi

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GDC: 195843

Meticulous preventative care meets high-quality cosmetic dentistry. Yasha offers complicated surgical extractions, complex treatments, and smile makeovers.

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Conservative dentistry specialist with postgraduate degrees from UCL Eastman. Believes in preserving as much natural tooth structure as possible.

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GDC: 229601

Friendly and enthusiastic dentist passionate about cosmetic and aesthetic restorative dentistry. Patient-centred care is at the heart of everything she does.

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