A bite problem affects the way your upper and lower teeth come together. Overbite, underbite, and crossbite are common types of bite problems, but each affects your teeth and jaw differently.
In this guide, I’ll explain the differences between overbite, underbite, and crossbite, what can cause them, and when treatment may be needed. I’ll also explain how I evaluate bite problems and determine the right treatment for each patient.
What Are the Most Common Types of Bite Problems?
A bite describes how the upper and lower teeth come together. When the teeth or jaws do not align properly, the condition is called a malocclusion, or misaligned bite.
| Bite Problem | What It Means |
| Overbite | The upper front teeth overlap the lower teeth too much. |
| Underbite | The lower teeth sit in front of the upper teeth. |
| Crossbite | One or more upper teeth sit inside the lower teeth. |
| Open bite | Some teeth do not touch when the back teeth are closed. |
The severity of a bite problem can vary. Treatment may be considered when the bite affects chewing, speaking, tooth wear, jaw function, or overall dental health.
What Is an Overbite and When Does It Need Treatment?
What Does an Overbite Look Like?
An overbite is present, to some degree, in almost everyone; a small amount of overlap between the upper and lower front teeth is normal. It becomes a concern when that overlap is excessive, sometimes called a deep overbite, where the upper teeth cover most or all of the lower front teeth.
What Causes an Overbite?
A few factors typically contribute to overbite:
| Tooth position | Teeth that erupted or shifted out of ideal alignment |
| Jaw development | How the upper and lower jaw grew in relation to each other |
| Genetics | Bite patterns often run in families |
| Deep overbite specifically | which can involve both dental and skeletal factors |
When Can an Overbite Become a Problem?
| An overbite typically warrants a closer look when it involves: |
| Excessive overlap of the upper and lower front teeth |
| Tooth wear on the lower front teeth or upper palate-facing surfaces |
| Gum irritation where the lower teeth contact the roof of the mouth or gum tissue |
| Difficulty with certain functions, like biting or speaking clearly |
| Appearance concerns, when relevant to the patient |
How Is an Overbite Treated?
Overbite treatment depends on the diagnosis. In milder cases, monitoring may be appropriate. In more significant cases, overbite correction may involve braces, clear aligners, or other orthodontic appliances designed to bring the front teeth into a more balanced relationship.
What Is an Underbite and When Does It Need Treatment?
What Does an Underbite Look Like?
An underbite is the reverse of a typical bite: the lower front teeth sit in front of the upper front teeth instead of behind them. This is sometimes referred to as a Class III malocclusion.
What Causes an Underbite?
| Underbite causes can be dental, skeletal, or a combination of both: | |
| Jaw growth | The lower jaw may grow more than the upper jaw |
| Genetics | Underbites frequently have a hereditary component |
| Tooth position | How the teeth erupted and settled |
| Skeletal vs. dental causes | Some underbites stem from bone structure, others from tooth position alone, and distinguishing between them matters for treatment planning |
Can an Underbite Affect Chewing or Jaw Function?
Yes, in many cases. An underbite can affect:
● Chewing efficiency, since the front teeth may not meet properly
● Overall bite function
● Facial balance and profile
● The jaw relationship, particularly in more skeletal cases
How Is an Underbite Treated?
Underbite treatment varies based on:
- Age of the patient
- Severity of the underbite
- Whether the cause is primarily dental or skeletal
- Growth status, especially in children and teens
In milder or purely dental cases, underbite correction is often possible with braces or aligners alone. In more severe skeletal cases, a different treatment approach may be needed, and surgical consideration may be part of the conversation once growth is complete.
What Is a Crossbite and Why Does It Matter?
What Is an Anterior Crossbite?
An anterior crossbite involves the front teeth, where one or more upper front teeth sit behind the lower front teeth instead of in front of them.
What Is a Posterior Crossbite?
A posterior crossbite involves the back teeth, where the upper back teeth sit inside the lower back teeth rather than overlapping them normally. This is often related to a narrower upper jaw.
What Causes a Crossbite?
Crossbite causes include:
- Tooth position or crowding
- Jaw width, particularly a narrow upper jaw
- Growth and development patterns
- Genetics
- Certain childhood habits, such as prolonged thumb sucking
Why Should a Crossbite Be Treated?
A crossbite is worth evaluating because it can lead to:
- Uneven tooth wear over time
- Jaw shifting when biting down
- Functional problems with chewing
- Asymmetric facial or jaw development, particularly if left untreated during childhood growth
According to the American Association of Orthodontists, early evaluation of developing bites in children can help identify issues such as crossbite while the jaw is still growing, making treatment more straightforward.
How Is a Crossbite Corrected?
Crossbite treatment depends on the patient’s age and the specific type of crossbite. Options may include expanders, braces, or clear aligners, and timing can matter — particularly for posterior crossbites in growing children.
Which Is Worse: Overbite, Underbite, or Crossbite?
There isn’t one bite problem that is automatically worse than the others. The severity and effect on the teeth, jaws, and function matter more than the name of the condition.
An overbite tends to need attention when the overlap is deep enough to cause wear, gum irritation, or contact between the lower teeth and the roof of the mouth.
An underbite typically needs treatment when it affects chewing, causes uneven jaw development, or reflects a skeletal discrepancy between the upper and lower jaw.
A crossbite often warrants treatment when it causes the jaw to shift on closing, leads to uneven wear, or affects only a few teeth versus a broader pattern tied to jaw width.
| Condition | Mild Cases | More Significant Cases |
| Overbite | May simply need monitoring | May cause wear or tissue irritation |
| Underbite | May have limited functional impact | May involve significant jaw/tooth relationship |
| Crossbite | May affect only a few teeth | May cause shifting, uneven wear, or developmental concerns |
In my experience, patients are often relieved to hear that having an overbite, underbite, or crossbite doesn’t automatically mean extensive treatment is coming. When I evaluate a bite, I’m looking at the whole picture of how the teeth meet, how the jaws relate, and whether there are signs of wear or strain rather than reacting to the name of the condition alone.
How Do I Know If My Bite Needs Treatment?
Here are some signs that suggest a bite misalignment may be worth having evaluated:
- My teeth do not meet evenly.
- I have difficulty chewing.
- My teeth are wearing unevenly.
- My jaw shifts when I bite.
- I frequently bite my cheek.
- My teeth contact my gums or palate.
- My front teeth appear significantly too far forward or backward.
- My bite feels uncomfortable or unusual.
- I notice facial or jaw asymmetry.
- My child’s bite appears to be developing unevenly.
If several of these sound familiar, it’s a reasonable next step to have the bite looked at, even if nothing feels urgent. Not every misaligned bite needs immediate correction, but it’s worth understanding what’s going on.
What Causes Bite Problems?
| Cause | How It Can Affect the Bite |
| Genetics and Jaw Growth | Many bite patterns are inherited. The way the upper and lower jaw grow relative to each other has a strong genetic component, which is why bite problems often run in families. |
| Tooth Position and Eruption | Teeth that come in crowded, rotated, or out of sequence can affect how the upper and lower arches meet, even when jaw growth is otherwise typical. |
| Childhood Habits | Certain habits during early development can influence bite alignment, including thumb sucking, prolonged pacifier use, and other repetitive oral habits. |
| Crowding and Other Alignment Problems | Crowding, missing teeth, or extra teeth can all change how the upper and lower teeth fit together. Often, more than one of these factors is involved at once, which is part of why a full evaluation matters more than looking at a single symptom in isolation. |
Can Braces or Clear Aligners Fix Bite Problems?
Bite correction depends on the diagnosis, but several orthodontic approaches can help, depending on what’s causing the bite problem and how significant it is:
- Traditional Braces
- Clear Braces
- Self-Ligating Braces
- Clear Aligners
- Elastics, to help guide the bite into a better relationship
- Orthodontic Appliances, including expanders when appropriate
- In certain severe skeletal cases, surgical treatment may be a consideration
For patients comparing braces with clear aligners, the right choice depends on the type and complexity of the bite being corrected.
Does Age Affect Treatment for Bite Problems?
| Age | Treatment Considerations |
| Children | Early evaluation can be valuable because the jaws are still growing. Developing crossbites or significant overbites may benefit from timely treatment. |
| Teens | Remaining growth can influence bite correction and treatment timing. Teen Orthodontics often addresses bite and alignment together. |
| Adults | Bite correction is still possible, but treatment planning depends on the teeth, jaws, and existing dental conditions. Adult Orthodontics requires individualized planning since growth is complete. |
What Happens During a Bite Evaluation?
| Evaluation Step | What I Check |
| How Your Teeth Meet | How the upper and lower teeth come together. |
| Tooth and Jaw Relationship | How the jaws relate to each other and affect treatment planning. |
| Wear or Functional Problems | Signs of uneven wear, jaw shifting, or difficulty chewing. |
| Age and Growth | Remaining growth potential in children and teens. |
| Treatment or Monitoring | Whether treatment, monitoring, or future re-evaluation makes sense. |
Frequently Asked Questions
Which is worse, an overbite or an underbite?
Neither is automatically worse; severity, function, and effects on the teeth and jaws matter more.
Is a crossbite worse than an overbite?
Not necessarily; the need for treatment depends on the severity and how the bite affects the teeth, jaws, and function.
Which bite problems need treatment?
Bite problems may need treatment when they cause tooth wear, gum irritation, chewing difficulty, jaw shifting, or uneven development.
Can a bite problem get worse with age?
Yes, some untreated bite problems can contribute to increasing tooth wear, gum recession, or jaw strain over time.
Can braces fix an overbite, underbite, or crossbite?
Yes, braces can correct many overbite, underbite, and crossbite cases, although severe skeletal problems may require additional treatment.
Can clear aligners fix bite problems?
Yes, clear aligners can correct many mild to moderate bite problems depending on the type and severity of the misalignment.
What happens if a crossbite is left untreated?
An untreated crossbite can contribute to uneven tooth wear, jaw shifting, and asymmetric jaw development in children.
Can an underbite be corrected without surgery?
Yes, many dental underbites can be corrected with braces or aligners, while severe skeletal underbites may require surgery.
At what age should a bite problem be treated?
Treatment timing depends on the type and severity of the bite, with some problems benefiting from early evaluation during childhood.
How do I know if my bite is abnormal?
Uneven tooth contact, chewing difficulty, jaw shifting, visible misalignment, or facial asymmetry may indicate an abnormal bite.
Final Thoughts
No single bite problem is automatically the worst. Treatment depends on the severity, function, and relationship between your teeth and jaws. Whether you’re a child, teen, or adult, an orthodontic evaluation can help determine whether treatment or monitoring is right for you.
At Ziehmer Orthodontics, I focus on understanding your bite and creating an individualized treatment plan based on your specific needs.
