How to Fix Underbite Without Surgery

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How to Fix Underbite Without Surgery – Orthodontic Treatments Explained

Usually, camouflage means to mask an item so as to hide it from something or somebody. In the field of orthodontics, however, camouflage refers to the use of orthodontic appliances like braces to move teeth in a certain way so as to cover an underlying jaw or skeletal discrepancy. Numerous people have jaw discrepancies of varying degrees. As an example, some people have a situation where their upper or lower jaw is larger than its counterpart. Hence, camouflage is an exceedingly popular practice in orthodontics and is known to produce exceptional results without inclusion of surgery.

Camouflage is of different kinds, including the orthodontic camouflage that is further grouped into class II camouflage, class III camouflage, camouflage of skeletal open bite, and camouflage of asymmetry. Another type of camouflage is the surgical one that is sub-divided into a chin surgery, nasal surgery and single jaw surgery in a patient with double jaw problems. Since all of these kinds of camouflages are too extensive to describe here, we will only focus on discussing the class III camouflage.


It is usually done so as to correct a class III malocclusion.  This malocclusion can be caused by the mandibular prognathism, maxillary retrusion or both, unlike several class II skeletal discrepancies that are largely triggered by a mandibular deficiency. A class III malocclusion varies based on what incisor relationship is found. It can be anything, including a reduced overjet incisor relationship or an obvious reversed overjet incisor relationship. The level of severity of any relationship clearly depicts the seriousness of the underlying skeletal discrepancy. In certain cases, however, orthodontists find considerable dento-alveolar compensation that disguises the discrepancy in question.

And when maxilla is deficient in three spatial planes, which is largely the case, serious teeth crowding and posterior crossbites can occur. When an anterior displacement masks an underlying class I base relationship, dental specialists refer to it as Pseudo-class III situation. In class III malocclusions, skeletal asymmetries that happen along with mandibular prognathism are common as well as cases where patients are found to have a full range of vertical growth patterns. While class III malocclusions are not reported often in the U.S and other western nations, it is still a problem that orthodontists encounter and are unable to determine whether a camouflage treatment is better than an orthodontic surgery. All in all, patients who have repaired a cleft lip and palate have higher odds of developing a class III malocclusion.


Early correction techniques are needed if you have any of these problems:

  • Average or increased overbite
  • Average or reduced lower face height
  • Retroclined upper incisors
  • Proclined lower incisors
  • Anterior mandibular displacement


The bottom-line is that planning treatment in class III malocclusion is really difficult. It is also affected by the kind of skeletal discrepancy one has, size of the reverse overjet, degree of crowding of teeth and whether there is dento-alveolar compensation of any extent. But there are only three ways through which class III malocclusion is solved. These are: growth modification, orthodontic camouflage and surgery.


If you are suffering from a mild class III skeletal discrepancy, and dento-alveolar compensation exists, there are definite treatments that can be done in the permanent dentition.  In this case, an orthodontist uses fixed appliances with class III inter-arch elastic traction.  To camouflage an incisor relationship and stop a mixed dentition issue, orthodontists use removable appliances and sectional fixed appliances. Moreover, if needed when trying to camouflage the lower arch, extractions are performed to create space for the retraction of the lower labial segment.

Further, orthodontists can perform mid-arch extractions in upper and lower arches if needed; but in the case of an adult, they may do a single lower incisor extraction. While determining the presence of an overjet and an overbite is usually the first thing, a professional dentist must as well establish the pattern and level of further growth in future. When a doctor discovers that a patient has extremely severe skeletal class III relationship with compensated incisors, he or she may recommend an orthognatic surgery treatment. Prior to providing this sort of treatment, though, an orthodontist will take the time to establish if your case is appropriate.  In case you are found to have a substantial antero-posterior or vertical skeletal component to your bad bite, your orthodontist might combine camouflage with surgery to achieve perfect restoration.

Surgery should be the last resort, as always, but if it must be done, then it should be deferred until the mandibular growth is complete. If it is done when the mandibular growth is going on, the end result could be skeletal relapse. Therefore, the best practice is to observe and monitor the mandibular growth of a child during teenage so as to consider a surgical plan when it is safe to do so. Camouflage is hardly possible if the mandibular incisors are too retroclined and the maxillary incisors are too proclined.

Potential future growth in people with class III malocclusion is very possible, such that the mandibular development continues even after teenage years. This is detrimental and could lead to a reverse overjet reestablishment during treatment or afterwards. That’s why orthodontic treatment for camouflaging skeletal discrepancy should be done in either late teenage or early twenties. In severe cases of Class III malocclusions, orthodontists run the risk of being unable to attain a class I incisor relationship. But as long as you are being treated by a knowledgeable and experienced dental physician, and you are committed to the treatment, camouflage risks are likely to be few to none.

When camouflaging class III malocclusions, this dental expert will use all their knowledge and skills to achieve successful corrections. This includes the use of either fixed or removable orthodontic appliances to correct a particular type of a class III malocclusion. Whether it is you or your child who has class III malocclusion problems, camouflaging could be the best kind of treatment. In case it isn’t, surgery might be the ultimate choice. Ignoring underbite can lead to rapid teeth wear, speech problems, and chewing difficulties.


Prado, Daniela Galvão De Almeida, et al. “Speech Articulatory Characteristics of Individuals With Dentofacial Deformity.” Journal of Craniofacial Surgery, vol. 26, no. 6, 2015, pp. 1835–1839.

Cooper, Barry C., and Israel Kleinberg. “Examination of a Large Patient Population for the Presence of Symptoms and Signs of Temporomandibular Disorders.” Cranio®, vol. 25, no. 2, 2007, pp. 114–126.

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