Underbite Correction Surgery
 If your lower jaw sits ahead of your upper teeth, Oral & Facial Surgery provides underbite correction surgery for patients in Pullman, WA and Lewiston, ID, with board-certified oral and maxillofacial surgeons.
An underbite is more than a cosmetic concern. When the jaws do not line up, it can affect how you chew, how you speak, and how evenly your teeth wear over the years.
For a mild underbite, braces or aligners alone sometimes do the job. For a more pronounced one, where the jaws themselves are out of proportion, moving the teeth is not enough, and the position of the jaw has to change. That is what underbite correction surgery does, and it is almost always handled as a team effort with your orthodontist.
This procedure is one part of the broader jaw surgery, or orthognathic surgery, our surgeons perform. The same training that lets them reposition a fractured jaw also lets them plan and carry out the precise, deliberate movements that correct a bite.
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What Is an Underbite?
 An underbite is when the lower jaw and lower teeth sit in front of the upper teeth instead of behind them. It is essentially the mirror image of an overbite, where the upper teeth project too far over the lower. A slight underbite may be mostly cosmetic, but a more pronounced one can make it hard to bite, chew, and speak clearly, and it can put uneven strain on the teeth and jaw joints over time.
The cause is what determines the fix. When an underbite comes mostly from the teeth being tilted, braces or aligners on their own can sometimes correct it. When it comes from the jaws being out of proportion, which is the more common reason for a noticeable underbite, moving the teeth is not enough; the jaw position itself has to change, and that is the role of underbite correction surgery.
This is a team effort. We perform the surgical part, the repositioning of the jaw, while your orthodontist handles the braces or aligners that line up the teeth before and after surgery. We do not provide the orthodontic phase ourselves; instead, we coordinate closely with your orthodontist so the two halves of treatment fit together.
Your Jaw Surgery Team in Pullman and Lewiston
Underbite correction is one of the more involved procedures in oral and maxillofacial surgery, and it belongs with surgeons who perform corrective jaw surgery regularly. At Oral & Facial Surgery, that work goes to Dr. Stephen W. Holm and Dr. Sherdon W. Cordova, two board-certified oral and maxillofacial surgeons whose training includes orthognathic, or corrective jaw, surgery.
Dr. Holm completed his residency at Carle Foundation Hospital, served as chief resident, and is a Diplomate of the American Board of Oral and Maxillofacial Surgery. More on Dr. Holm’s background. Dr. Cordova trained in the same program and served as an oral and maxillofacial surgeon in the United States Air Force; his bio has the details.
Just as important for this kind of surgery is how the surgeon works with others. Because correcting an underbite depends on close timing with your orthodontist, our surgeons plan each case alongside the orthodontic team, so the braces, the surgery, and the final alignment all line up.
How Underbite Correction Surgery Works
 Correcting an underbite is a staged process that usually unfolds over many months, because the teeth and the jaw are addressed in sequence. Here is what the path generally looks like.
Consultation and 3D Planning
We start with a thorough evaluation and a cone beam CT (CBCT) scan, which gives us a three-dimensional model of your jaws and teeth. We use that model to plan exactly how far and in which direction the jaw needs to move, and to coordinate the plan with your orthodontist.
Orthodontics Before Surgery
In most cases, braces or aligners come first. Your orthodontist moves the teeth into the position they need to be in for the new jaw alignment, which can take several months to a year. This phase is handled by your orthodontist, not our office, and we stay in contact throughout.
The Surgery
When the teeth are ready, we reposition the jaw. For an underbite, that often means setting the lower jaw back, advancing the upper jaw, or a combination of both. We secure the bone in its new position with small titanium plates and screws. We perform the surgery under general anesthesia, and our surgeons are trained in everything from local anesthesia to hospital-based anesthesia.
Recovery and Finishing Orthodontics
Most patients spend the first week or two on a soft or liquid diet while the jaw begins to heal, with swelling easing over several weeks. Once the bone is solid, your orthodontist finishes detailing the bite. From the start of braces to the final result, the full process commonly takes one to two years, and we walk you through the timeline at your consultation.
Benefits of Correcting an Underbite
Correcting an underbite changes more than how a smile looks, though the change in facial balance is often the first thing people notice. The bigger payoff is function.
When the jaws line up correctly, biting and chewing become easier and more efficient, and speech often improves. Aligning the bite also spreads the force of chewing evenly across the teeth, which reduces the abnormal wear and the strain on the jaw joints that a severe underbite can cause over the years.
There is a confidence side too. For someone who has lived with a pronounced underbite, the change in profile and bite can be significant. We are careful not to oversell it, though: using your own 3D imaging, we show you what is realistic for your case before you commit.
Why Choose Our Surgeons for Jaw Surgery
Corrective jaw surgery is not something every oral surgeon does often. Our surgeons perform orthognathic procedures as an established part of their practice, with more than forty years of combined surgical experience between them.
Two things set this kind of care apart. First, planning: we map every case in 3D before anything is moved, so the surgical plan is precise and predictable. Second, coordination: because underbite correction only works when the surgery and the orthodontics are in sync, we plan directly with your orthodontist rather than working in isolation.
We serve patients across the Lewiston/Clarkston and Moscow/Pullman regions from our two offices, and we stay involved from the first 3D scan through your recovery.
Underbite Surgery Cost and Insurance
Cost is a real consideration with jaw surgery, and we will be upfront about it. What underbite correction costs depends on the complexity of your case, whether one jaw or both are repositioned, the anesthesia involved, and the length of the orthodontic treatment your orthodontist provides separately.
Because underbite correction is often medically necessary, not purely cosmetic, when it affects chewing, breathing, or speech, many medical and some dental plans cover part of it. Coverage varies, so our team helps you understand your benefits and documents the medical need. You can review our insurance and financing options in more detail.
For a personalized estimate, call our Lewiston, ID office at 208-743-1640 or our Pullman, WA office at 509-330-5020. Keep in mind that your orthodontist bills for the orthodontic portion separately.
Schedule an Underbite Consultation
If an underbite affects how you eat, speak, or feel about your smile, a consultation is the place to start. Call our Lewiston, ID office at 208-743-1640 or our Pullman, WA office at 509-330-5020. You can also request an appointment online. We are at 444 Thain Rd, Lewiston, ID 83501 and 1256 Bishop Blvd Suite I, Pullman, WA 99163. For questions before you come in, you can contact us.
Frequently Asked Questions
What is the difference between an underbite and an overbite?
An underbite is when the lower teeth and jaw sit in front of the upper teeth; an overbite is the reverse, with the upper teeth overlapping too far over the lower. Both can be corrected with a combination of orthodontics and, when the jaws themselves are involved, surgery, but the direction of the correction is opposite. The cause, whether dental or skeletal, matters more than the label when planning treatment.
Do I really need surgery, or can braces fix my underbite?
The deciding factor is whether the underbite is skeletal or dental, and a cone beam CT scan settles that at your consultation. A purely dental underbite can often be handled by an orthodontist with no surgery at all. A skeletal one, where the jawbones are out of proportion, is the case that needs surgery, because no amount of tooth movement can reposition bone. We will tell you honestly which category you are in rather than steering you toward an operation you may not need.
Do you provide the braces, or do I need an orthodontist?
If you do not already have an orthodontist, that is not a problem; we work with several across the Pullman and Lewiston area and can point you to one. The braces or aligners happen in their office while the surgery happens in ours, and we keep the timing of the two in step. In practice, you end up with two providers working as a single team on one plan.
Is underbite correction surgery painful?
We perform the surgery under general anesthesia, so you feel nothing during it. Afterward, most patients describe soreness and swelling rather than sharp pain, manageable with prescribed medication for the first several days. The swelling is usually the most noticeable part of recovery, and it eases over a few weeks.
Can correcting my underbite help with jaw pain?
Sometimes, yes. A significant underbite can place uneven load on the jaw joints and muscles, and correcting the alignment can relieve some of that strain. That said, jaw pain has many causes, so we do not promise that surgery will resolve it. If jaw pain is your main concern, a TMJ evaluation is the better starting point for finding out what is driving it.
How long does the whole underbite correction process take?
Plan on one to two years from start to finish in most cases, because the orthodontic phase before and after surgery is what takes the time, not the surgery itself. The braces-before-surgery stage often runs six to eighteen months, the surgery is a single procedure, and the finishing orthodontic work adds several more months. Your orthodontist and our surgeons map the timeline together at the start.
Am I too old for underbite surgery?
Adults of many ages have underbite correction successfully; the main requirement is that the jaws have finished growing, which is usually by the late teens. There is no strict upper age limit, though your overall health matters more than age. We review your health history at the consultation to confirm that surgery is a safe option for you.
Why choose Oral and Facial Surgery for underbite correction in Pullman or Lewiston?
Underbite correction is corrective jaw surgery, and it should be done by surgeons who perform it regularly. At Oral & Facial Surgery, Dr. Holm and Dr. Cordova are board-certified oral and maxillofacial surgeons with orthognathic training and more than forty years of combined experience, serving both Pullman, WA and Lewiston, ID. They plan each case in 3D and coordinate directly with your orthodontist, so every stage of treatment fits together. |
