An underbite in a young child should not automatically be assumed to be a simple tooth-position problem.

In some children, it can be associated with the way the upper and lower jaws are developing. This is why early assessment and careful growth monitoring are particularly important.

Why does early assessment matter?

Children’s facial structures are continually changing as they grow. A child who appears to have only a mild underbite at a young age may develop a more pronounced Class III relationship as growth progresses.

At Gentle Dental, children with signs of a developing Class III pattern are monitored particularly closely. One of the important measurements we follow is the overjet—the horizontal relationship between the upper and lower front teeth.

Regular records allow us to determine whether the relationship is remaining stable or changing as the child grows.

The role of the upper jaw

In some children, the upper jaw may be narrow or underdeveloped relative to the lower jaw. Because the upper and lower jaws need to develop together, a discrepancy between them can contribute to an unfavourable bite relationship.

Where appropriate, early treatment may aim to improve the development and relationship of the upper jaw while the child is still growing.

Treatment is individualised. Depending on the child’s growth pattern and clinical findings, appliances such as palatal expansion or reverse headgear may form part of the treatment plan. A lower lingual arch may also be used in selected cases.

Why does timing matter?

In a child with a significant developing Class III skeletal pattern, there may be a window during growth when treatment can influence the relationship between the upper and lower jaws.

If appropriate early intervention is delayed, the skeletal discrepancy may become more pronounced as growth continues. In severe cases, this can reduce the likelihood of achieving a full correction with orthodontic treatment alone and may increase the eventual need for orthognathic jaw surgery.

This does not mean that every child with an underbite requires immediate treatment, nor does early treatment guarantee that surgery will never be required. The purpose of early assessment is to identify which children may benefit from intervention while they are still growing.

Does every underbite need early treatment? No.

Some children require observation and regular growth records. Others have a developing skeletal discrepancy where delaying assessment or treatment could make management more difficult later.

The decision depends on the child’s individual growth pattern, jaw relationship, dental development and clinical findings.

At Gentle Dental, our approach to Phase 1 orthodontics is focused on identifying the problem, addressing it appropriately and then stopping treatment once the developmental objective has been achieved. For children who subsequently require Phase 2 orthodontic treatment after completing Phase 1, a 10% discount on Phase 2 treatment is provided.