Do You Have an Underbite? Here’s What You Should Know

An underbite — where the lower jaw protrudes forward so that the bottom teeth sit in front of the upper teeth — is more than a cosmetic concern. Left untreated, an underbite can cause chronic jaw pain, difficulty chewing, uneven tooth wear, speech problems, and long-term stress on your temporomandibular joint (TMJ). If you’ve been living with an underbite in St. George, UT, the good news is that modern oral and facial surgery offers highly effective, lasting solutions.

At Red Rock Oral and Facial Surgery in St. George, UT, our board-certified oral and maxillofacial surgeon Dr. Jared Mack specializes in diagnosing and treating underbites at every level of severity — from mild cases that respond to orthodontics alone, to significant jaw discrepancies that require corrective jaw surgery (orthognathic surgery). Patients come to us from throughout Southern Utah, including Washington, Hurricane, Ivins, Santa Clara, and Cedar City.

What Causes an Underbite?

Underbites result from a mismatch between the upper jaw (maxilla) and the lower jaw (mandible). Common contributing factors include:

• Genetics: A hereditary tendency toward a prominent lower jaw or a recessed upper jaw is the most common cause.
• Childhood habits: Prolonged thumb-sucking, pacifier use past age three, or tongue thrusting can influence jaw development.
• Injury or trauma: A facial injury during growth years can alter how the jaw develops.
• Tumors or cysts: Rare growths affecting the jawbone can push the lower jaw forward.

Because the jaw continues developing through the late teens, the best time to evaluate an underbite is during adolescence — though adults can and do achieve excellent results with treatment as well.

Why Treating an Underbite Matters

Some patients in St. George, UT seek treatment primarily for aesthetic reasons — they want a balanced, confident smile. But the functional consequences of an untreated underbite are equally important:

• Accelerated wear on front teeth that can lead to tooth loss over time
• Chronic jaw pain and tension headaches linked to TMJ dysfunction
• Difficulty biting and chewing certain foods
• Sleep-disordered breathing and snoring in some cases
• Speech difficulties, particularly with certain consonant sounds

Addressing the underlying skeletal issue — rather than masking it — produces results that protect your oral health for decades.

Underbite Treatment Options in St. George, UT

The right treatment depends on the cause and severity of your underbite, your age, and whether the problem is primarily dental (teeth position) or skeletal (jaw bone structure). Dr. Mack will perform a thorough evaluation — including 3D cone-beam CT imaging available right here in St. George — before recommending a path forward.

1. Orthodontic Treatment Alone (Mild Cases)

For patients whose underbite stems primarily from the position of the teeth rather than a true skeletal discrepancy, braces or clear aligners may be sufficient. Your orthodontist will move the upper and lower teeth into a more aligned bite relationship. This approach works best for children and teenagers whose jaws are still growing.

2. Orthognathic Surgery (Corrective Jaw Surgery)

When the underbite is skeletal in origin — meaning the lower jawbone itself is too far forward, or the upper jaw is set too far back — orthodontic treatment alone cannot fully correct the problem. In these cases, corrective jaw surgery (orthognathic surgery) produces the most stable, functional, and aesthetic result.

At Red Rock Oral and Facial Surgery in St. George, UT, Dr. Mack performs orthognathic surgery to reposition one or both jaws into proper alignment. The most common procedures for underbite correction include:

• Mandibular setback (BSSO): The lower jaw (mandible) is surgically moved backward to align with the upper jaw using a bilateral sagittal split osteotomy.
• Maxillary advancement (Le Fort I osteotomy): The upper jaw is surgically moved forward when it is the recessed jaw contributing to the underbite.
• Bimaxillary surgery: Both jaws are repositioned simultaneously for more complex cases requiring comprehensive realignment.

Surgery is performed under general anesthesia, typically on an outpatient basis. Most patients return to light activity within one to two weeks and resume normal function within six to eight weeks.

3. Combined Orthodontic and Surgical Treatment

The most common treatment plan for adult underbite correction combines orthodontics with surgery. Pre-surgical orthodontics (typically 12–18 months) aligns the teeth within each jaw individually before surgery. After the jaws are repositioned, a shorter course of post-surgical orthodontics fine-tunes the bite. The result is a stable, well-aligned bite and a more balanced facial profile.

What to Expect: The Underbite Treatment Timeline

Understanding the full journey helps patients in St. George, UT — and surrounding communities in Washington, Hurricane, Ivins, Santa Clara, and Cedar City — plan ahead with confidence:

1. Consultation and imaging: Dr. Mack evaluates your bite, facial structure, and overall oral health using 3D imaging and dental models. A detailed treatment plan is created.
2. Pre-surgical orthodontics: Your orthodontist places braces or aligners to position teeth correctly prior to surgery (typically 12–18 months).
3. Corrective jaw surgery: The procedure is performed at our St. George, UT surgical suite under general anesthesia. Most patients go home the same day.
4. Recovery: Soft diet for several weeks, minimal activity restrictions, and scheduled follow-up visits with Dr. Mack.
5. Post-surgical orthodontics: Fine-tuning the bite after healing (typically 6–12 months).
6. Retention: Retainers maintain your new bite long-term.

Is Underbite Surgery Covered by Insurance?

Because underbite correction addresses functional impairment — not just aesthetics — corrective jaw surgery is frequently covered, at least in part, by medical insurance when a documented functional need exists. Our team at Red Rock Oral and Facial Surgery in St. George, UT works with patients to document medical necessity and navigate insurance pre-authorization. We encourage you to contact our office to discuss your specific coverage before committing to a treatment plan.

Why Choose Red Rock Oral and Facial Surgery for Underbite Treatment?

Dr. Mack is a board-certified oral and maxillofacial surgeon with advanced training in corrective jaw surgery. Our practice in St. George, UT offers in-house 3D cone-beam CT imaging so patients receive precise surgical planning without being referred elsewhere. We serve the full Southern Utah region — from Washington and Hurricane to Ivins, Santa Clara, and Cedar City — with a patient-centered approach that prioritizes both your functional health and your confidence in your appearance.

If you’ve been researching oral surgery in St. George, UT and wondering whether your underbite can be corrected, the answer is almost certainly yes. To learn more about how we approach jaw surgery and bite correction, visit our guide to choosing the best oral surgeon in St. George, UT. Patients curious about related facial and smile transformations may also find our overview of cosmetic dentistry and oral surgery in St. George, UT helpful.

Note: The information in this article is intended for educational purposes only and does not constitute medical advice. Every patient’s anatomy and bite discrepancy is unique. Please consult with a qualified oral and maxillofacial surgeon to determine the most appropriate treatment for your specific situation.

Frequently Asked Questions About Underbite Treatment in St. George, UT

Can an underbite be fixed without surgery?

Mild, dentally-based underbites — especially in children and teenagers whose jaws are still growing — can sometimes be corrected with orthodontics alone or in combination with orthodontic appliances like a reverse-pull face mask. However, moderate to severe underbites in adults that involve a true skeletal discrepancy typically require corrective jaw surgery for a stable, lasting result. An in-person evaluation with Dr. Mack at our St. George, UT practice will clarify which option is appropriate for you.

How long is recovery after corrective jaw surgery for an underbite?

Most patients return to light activity and work within one to two weeks of orthognathic surgery. A soft diet is typically required for six to eight weeks while the jaw heals. Full bone healing takes approximately three to four months, though most patients feel comfortable and functional well before that point. Dr. Mack provides detailed post-operative instructions specific to your procedure at Red Rock Oral and Facial Surgery.

Is underbite correction surgery painful?

Corrective jaw surgery is performed under general anesthesia, so there is no discomfort during the procedure. Post-operative discomfort is manageable with prescribed medications. Most patients describe the recovery as more uncomfortable than truly painful — swelling and jaw stiffness are the primary challenges. Our team in St. George, UT monitors patients closely throughout recovery and adjusts pain management as needed.

At what age can underbite surgery be performed?

Orthognathic surgery is generally performed after the jaw has finished growing — typically around age 16–18 for females and 17–21 for males. Operating before growth is complete risks relapse as the jaw continues to develop. For younger patients still growing, orthodontic appliances may be used to guide jaw development in the meantime.

Does Red Rock Oral and Facial Surgery in St. George accept insurance for jaw surgery?

Yes. When underbite correction involves documented functional impairment — such as difficulty chewing, TMJ dysfunction, or sleep-disordered breathing — corrective jaw surgery is typically covered by medical insurance, not just dental insurance. Our St. George, UT team assists patients with medical necessity documentation and insurance pre-authorization. Contact our office for guidance on your specific plan.