If you’ve been told you have an underbite — or if you’ve noticed your lower jaw sits in front of your upper jaw when you close your mouth — you already know it’s more than a cosmetic concern. Chewing discomfort, jaw pain, speech difficulties, and premature tooth wear are all real consequences of an uncorrected underbite. The good news: patients throughout St. George, UT and the surrounding communities of Washington, Hurricane, Ivins, Santa Clara, and Cedar City have access to the full spectrum of underbite treatment options right here in Southern Utah.

This guide walks you through exactly what happens from the moment an underbite is identified to the day you leave our office with a corrected, functional bite — and everything in between.

What Causes an Underbite?

An underbite — clinically called a Class III malocclusion — occurs when the lower jaw (mandible) protrudes further forward than the upper jaw (maxilla). The causes generally fall into two categories:

• Skeletal: The underlying jaw bones themselves are disproportionate in size or position. This is the most common cause in adults and typically requires jaw surgery for a lasting correction.
• Dental: Individual teeth are tilted or angled in a way that creates the appearance of an underbite, even though the jaw position itself is relatively normal. Braces or clear aligners can often resolve dental underbites.

Distinguishing between a skeletal and dental underbite is the single most important step in your treatment plan — and it’s one that requires a comprehensive clinical and radiographic evaluation, not a simple visual assessment.

Step 1: Comprehensive Diagnosis

At Red Rock Oral and Facial Surgery in St. George, UT, underbite evaluation begins with advanced 3D cone-beam computed tomography (CBCT) imaging. This technology gives our surgeons a precise three-dimensional view of your jaw anatomy, tooth roots, and facial skeleton — the same diagnostic precision used at major academic medical centers, available right here in Southern Utah.

During your consultation, we’ll assess:

• The degree of jaw discrepancy (measured in millimeters)
• Whether the problem is skeletal, dental, or a combination of both
• The health and alignment of your existing teeth
• Your airway and TMJ joint health
• Your facial profile and aesthetic goals

This thorough evaluation is what separates an accurate treatment plan from one that addresses the symptom but not the cause.

Step 2: Understanding Your Treatment Options

Once the diagnosis is complete, you’ll typically be presented with one of three treatment pathways — or a combination of them.

Option A: Orthodontic Treatment Alone (Dental Underbites)

For patients whose underbite is primarily dental in origin — meaning the jaw bones are in acceptable position but the teeth are creating the bite discrepancy — braces or clear aligners may be sufficient. Your orthodontist will move teeth into proper alignment, which resolves the bite problem without surgery. This pathway is most effective for younger patients and those with mild discrepancies.

Option B: Orthodontics + Orthognathic (Jaw) Surgery

For moderate to severe skeletal underbites, the gold-standard treatment is a coordinated approach between your orthodontist and your oral surgeon. The process typically looks like this:

1. Pre-surgical orthodontics (12–18 months): Braces are placed to align the teeth within each jaw individually — which may temporarily make the bite look worse before it gets better. This prepares the teeth to fit correctly once the jaws are repositioned.
2. Orthognathic surgery: The oral surgeon repositions the upper jaw (Le Fort I osteotomy), lower jaw (bilateral sagittal split osteotomy), or both to achieve the correct skeletal relationship. Learn more in our detailed overview of orthognathic surgery for underbite correction in St. George, UT.
3. Post-surgical orthodontics (6–12 months): Fine-tuning the bite after the jaws have healed in their new position.

This combined approach produces results that orthodontics alone simply cannot achieve for skeletal discrepancies — both in function and in the way your face looks and feels.

Option C: Monitoring (Growing Patients)

In children and adolescents, some jaw discrepancies are best monitored through growth rather than treated immediately. In certain cases, growth modification appliances can guide jaw development. An early evaluation — typically around age 7-10 — helps determine the best timing for intervention.

Step 3: The Surgical Process Explained

If you and your care team determine that jaw surgery is the right path, knowing what to expect removes a great deal of anxiety. Underbite treatment in St. George involving orthognathic surgery is performed under general anesthesia at a certified surgical facility. Incisions are made inside the mouth — no visible external scarring — and specialized plates and screws hold the repositioned jaw in place while you heal.

Recovery timeline at a glance:

• First week: Rest, liquid diet, significant swelling. Most patients manage well at home.
• Weeks 2–4: Swelling begins to subside; soft foods introduced. Many patients return to desk work.
• 6 weeks: Bones have healed sufficiently to resume a soft-to-normal diet and most daily activities.
• 3–6 months: Final results emerge as residual swelling resolves completely and the bite settles.

The results of properly planned and executed jaw surgery are permanent — the jaw bones stay in their new position for life.

What About Jaw Pain and TMJ Symptoms?

Many patients with underbites also experience jaw joint discomfort, headaches, or clicking — signs of temporomandibular joint (TMJ) stress. An underbite forces the jaw to work in an abnormal mechanical position every time you chew or speak, which places uneven load on the TMJ over time. Correcting the skeletal discrepancy often resolves or significantly reduces these symptoms.

If jaw pain is a primary concern alongside your bite, we also offer Botox for jaw pain in St. George, UT as a non-surgical adjunct therapy to relieve muscle tension while longer-term correction is underway.

Why St. George Patients Choose Red Rock Oral and Facial Surgery

Red Rock Oral and Facial Surgery is Southern Utah’s dedicated oral and maxillofacial surgery practice, serving patients from St. George, Washington, Hurricane, Ivins, Santa Clara, Cedar City, and across the region. Our board-eligible surgeons have completed years of hospital-based surgical residency training beyond dental school — the same training pathway as oral surgeons at major university hospitals.

We work closely with your orthodontist throughout the treatment process, coordinating records, surgical timing, and follow-up care so your experience is seamless. If you haven’t yet connected with an orthodontist and need a referral for someone experienced with orthognathic cases, our team is happy to help.

When you’re ready to explore your options, we encourage a consultation. Most insurance plans — including many PPO dental plans and some medical plans — provide coverage for orthognathic surgery when it is determined to be medically necessary. Our team will help you navigate the pre-authorization process.

Not sure whether jaw surgery is right for you? Learn more about how to choose the right oral surgeon in St. George, UT for a procedure this significant.

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

How do I know if my underbite requires surgery?

A skeletal underbite — where the jaw bones themselves are misaligned — generally requires surgery for a lasting correction. A dental underbite, where only the teeth are malaligned, can often be treated with orthodontics alone. A consultation at Red Rock Oral and Facial Surgery, including 3D imaging, is the most reliable way to determine which category applies to you.

Is underbite surgery covered by insurance?

Orthognathic surgery for underbite correction is often covered by medical insurance (not just dental insurance) when it is documented as medically necessary — for example, when the bite problem causes chewing dysfunction, airway compromise, or TMJ pathology. Our team assists with insurance pre-authorization documentation as part of your treatment planning process.

How long does the full underbite treatment process take?

The complete treatment from start to finish — pre-surgical orthodontics, jaw surgery, and post-surgical orthodontics — typically takes 2 to 3 years. The surgery itself is a single procedure; the majority of the time is spent in braces before and after the operation.

Will correcting my underbite change how my face looks?

Yes — and for the vast majority of patients, the change is significant and positive. Moving the jaws into proper proportion improves facial balance, strengthens the chin profile, and often takes years off a patient’s apparent age. Changes are planned using digital simulation during your consultation so you can visualize the expected outcome beforehand.

Can adults get underbite treatment, or is it only for kids?

Adults are excellent candidates for underbite correction. In fact, orthognathic surgery is performed exclusively on adults (or adolescents who have completed jaw growth), because surgery cannot be performed while the jaw is still actively developing. There is no upper age limit — the determining factors are overall health and bone quality, not age.

Disclaimer: This article is for informational purposes only and does not constitute medical or dental advice. Every patient’s anatomy and treatment needs are unique. Please schedule a consultation with a board-eligible oral and maxillofacial surgeon to receive a personalized evaluation and treatment recommendations.

Schedule Your Underbite Consultation in St. George, UT

Whether you’re just beginning to explore your options or you’ve already been told you need jaw surgery, the team at Red Rock Oral and Facial Surgery is here to guide you through every step. We see patients from St. George, Washington, Hurricane, Ivins, Santa Clara, Cedar City, and throughout Southern Utah.

Call us today or request a consultation online — and take the first step toward a bite that works the way it was designed to.