How to fix an underbite if you have missing front teeth?

Doctor's Answers (2)

An underbite or crossbite, which means having your lower teeth positioned in front of your upper teeth is a problem that can post great aesthetic concern and motivates patient to see an orthodontist to fix the issue. Depending on the severity of the condition, it may also cause biting and speech issues in some patients. This problem can be caused by either a dental (teeth) issue or jaw size issue.

For patients with teeth growing in the wrong position due to teeth crowding or teeth erupting in the wrong position, this problem can be fixed by just braces or aligners. Extraction may be necessary in such cases.

However, in patients whose underbite is the result of an underlying jaw size discrepancy (long lower jaw), this problem may require orthodontic treatment (braces or aligners) in conjunction with jaw surgery to correct in severe cases.

In some patients, they may have present an underbite in conjunction with missing front teeth. The treatment plan will depend on the number of the missing front teeth as well as its location

During the consultation regarding underbite, the orthodontist will assess:

  • Patient's profile (side view and lip position)
  • Teeth health condition
  • Number of the missing amount of space requirement
  • Teeth position and angulation
  • Gum thickness.
  • X-rays will be taken to assess jaw relationship

Depending on the condition, some possible treatment options for upper missing teeth to correct underbite:

  1. Orthodontic treatment with the aim to replace missing upper teeth to coordinate the number of teeth in both jaws
  2. Orthodontic treatment with extraction of lower teeth to coordinate the number of teeth in both jaws 

For patients with an underbite and lower missing teeth, possible treatment options may include:

  1. Orthodontic treatment with additional extraction (if possible)
  2. Orthodontic treatment in combination with jaw surgery

As every patient is different, do consult an orthodontist for a thorough assessment so that you understand your problem, as well as the pros and cons of the different treatment options suitable for your condition to make an informed choice.

An underbite is a common term used to describe the lower front teeth being further forwards and in front of the upper front teeth. Though the front teeth give us a measure of how much correction is necessary, there are other reference points that your dentist/orthodontist can use to help correct your bite. 
The most important consideration is your facial profile, how your jaw position looks like and what are the treatment goals for correcting the bite. I will use the landmarks of the jawbones to determine what are the movements required to achieve a better facial profile and plan the treatment accordingly.
If the goal is not to change the facial profile and only correct the teeth position, I will use the bite of your other teeth as a reference to determine how much movement is necessary.
Teeth fit each other like a jigsaw puzzle, hence the back teeth bite gives me a clue on how to position the front teeth. I can also use the canine position as a reference for where the ideal bite should be. Your dentist can also do a diagnostic mock-up (i.e a set up of the final outcome with the missing teeth replaced in its ideal location) plan the treatment based on this setup. 
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All content posted is for general informational purposes only and is not a substitute for professional medical advice. This Q&A is not a patient consultation and any information provided herein is not intended to replace consultation with a qualified medical professional. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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