Q
My two-year-old has a slight underbite that seems to result from her lower jaw coming farther forward than her upper jaw (rather than due to lower teeth protruding outwards). Is this something that might self-correct over time? What is the earliest age when we’ll know it’s time to seek treatment if the underbite hasn’t changed? Also, can this be fixed without surgery? Thank you. – Lisa
A
It’s good that you’re paying attention at age two. A mild lower jaw prominence is not uncommon in toddlers because the mandible can sometimes appear to grow ahead of the maxilla during early development. In many children this difference diminishes as both jaws continue to grow, so some cases do improve on their own.
However, when the lower front teeth come to rest consistently in front of the upper front teeth, there is a greater risk the upper jaw will not develop fully while the lower jaw continues to grow forward. That pattern can make the underbite more persistent and harder to correct later on.
I recommend seeing an orthodontist for an early evaluation. An orthodontist can assess growth patterns and advise whether watching and waiting is reasonable or whether early intervention is appropriate. In many cases, non-surgical approaches can redirect growth and correct the jaw relationship. There are removable appliances that work well with cooperative young children and fixed appliances designed for those who are less cooperative. These options can improve the upper-to-lower jaw balance and may prevent the need for jaw surgery in the future.
Early assessment and, when indicated, timely treatment are the best ways to reduce the chance of a more extensive problem later. Your orthodontist can discuss the most suitable devices and the likely timing of treatment based on your child’s development.
Mark Burhenne DDS
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