Underbite Treatment on Mercer Island
When your bottom teeth close in front of your top teeth, that's an underbite — and it affects a lot more than how your smile looks. Chewing feels off. Your jaw aches. Teeth wear unevenly. And if you've been researching this online, you've probably seen the word "surgery" enough times to make you nervous.
So let's clear that up right away: many underbites don't require surgery. Especially in kids whose jaws are still growing, or in teens and adults where the issue is dental (tooth position) rather than skeletal (jaw position).
At Islander Orthodontics on Mercer Island, board-certified orthodontist Dr. Alissa Borda treats underbites in children, teens, and adults using braces, clear aligners, and early intervention approaches. Every case starts with a free exam — an honest look at what's causing the underbite, what it'll take to correct it, and exactly what it'll cost. No obligation.
Quick Answers About Underbite Treatment
- What is it? Your lower teeth sit in front of your upper teeth when you bite down
- Does it need surgery? Not always — many underbites are correctable with braces or clear aligners alone
- Best age to start? Kids should be evaluated by age 7 (jaw is still growing). Teens and adults can start anytime
- Treatment timeline: 12–30 months depending on severity and approach
- Cost: $3,000–$7,000 for most cases. Free exam includes your complete cost breakdown
- Insurance: All orthodontic insurance accepted, plus in-house financing and a pay-in-full discount
What Is an Underbite?
An underbite (orthodontists call it a Class III malocclusion) happens when your lower teeth and jaw extend forward past your upper teeth. Instead of your top teeth sitting slightly in front when you bite down, the opposite happens — your lower jaw leads.
Some underbites are subtle. Others are noticeable enough that you can see the jaw protrusion from the side. Either way, underbites tend to get worse over time if left untreated — especially in growing kids.
There's an important distinction that shapes everything about treatment: dental underbites (the teeth are misaligned but the jaws are proportional) are treated very differently from skeletal underbites (the jaw itself is the problem). Getting this right from the start is what separates effective treatment from wasted time and money.
Why Underbites Develop
Underbites typically come down to one of three things:
Genetics
Genetics play the biggest role. If a parent or grandparent had an underbite, there's a real chance it gets passed down. Jaw size and shape are inherited, and sometimes the lower jaw simply grows larger or further forward than the upper jaw.
Childhood Habits
Childhood habits like prolonged thumb sucking, tongue thrusting, or extended pacifier use can push the lower teeth and jaw forward over time. These habits don't always cause underbites, but they can contribute — especially if a child is already genetically predisposed.
Jaw Development Imbalances
Jaw development imbalances happen when the upper jaw doesn't grow enough or the lower jaw grows too much. This is exactly why early orthodontic evaluation matters with underbites — catching a growth imbalance while your child is still developing gives the best shot at guiding jaw growth before the bones stop changing.
How to Tell If You or Your Child Has an Underbite
Some underbites are obvious from across the room. Others aren't immediately visible but still cause real problems. Here's what to watch for:
In Children
- •Lower teeth visibly sit in front of upper teeth
- •Difficulty biting into food (especially sandwiches or apples)
- •A protruding lower jaw
- •Speech issues like lisping
- •Habitual mouth breathing
In Teens and Adults
- •Jaw pain or TMJ discomfort
- •Clicking or popping when opening and closing the mouth
- •Difficulty chewing
- •Uneven tooth wear on the front teeth
- •A flattened or protruding appearance to the lower face
- •Feeling self-conscious about your profile
The American Association of Orthodontists recommends kids have their first orthodontic evaluation by age 7 — and underbites are one of the main reasons why. At that age, Dr. Borda can spot developing jaw imbalances before they become bigger problems down the road.
What Happens If You Don't Treat an Underbite?
Underbites don't stay the same — they get worse. In kids, a jaw imbalance that's manageable at age 8 can become a surgical case by age 16 once the bones stop growing. That's not a scare tactic. It's just how jaw development works, and it's the single biggest reason early evaluation matters.
In teens and adults, an untreated underbite puts uneven stress on the teeth and jaw joint. Over time, that leads to:
- Accelerated enamel wear (especially on the front teeth)
- Chronic jaw pain and TMJ issues
- Headaches
- Difficulty chewing that only gets harder to ignore
The teeth involved can also become harder to keep clean, which means more cavities and gum problems in the areas that are already under the most stress.
The frustrating part? The longer you wait, the fewer options you have — and the more involved treatment becomes. An underbite that could have been corrected with braces at 14 might require surgery at 24. That's not always the case, but it's common enough that Dr. Borda sees it regularly.
Underbite Treatment Options on Mercer Island
There's no single "best" treatment for every underbite because it depends entirely on what's causing yours. A dental underbite requires a different approach than a skeletal one, a child's growing jaw opens up options that an adult's doesn't, and severity ranges from barely noticeable to significant.
That's why Dr. Borda starts every case with a thorough evaluation — the diagnosis drives the recommendation, not the other way around.
Treatment at a Glance
| Treatment | Best For | Timeline | Why It Matters |
|---|---|---|---|
| Early intervention | Kids ages 7–10 | 6–18 months | Can prevent surgery later |
| Metal braces | Teens and adults | 18–30 months | Most predictable results for complex cases |
| Clear aligners | Mild to moderate | 12–24 months | Nearly invisible, removable |
| Surgical orthodontics | Severe skeletal | 2–3 years | Coordinated with local oral surgeons |
Dr. Borda won't recommend a more involved treatment when a simpler one will work. Your free exam determines exactly which approach fits your case.
Early Evaluation for Kids (Ages 7–10)
This is where underbite treatment can make the biggest difference — and where timing really matters.
In young children whose jaws are still growing, orthodontic appliances can actually influence how the jaw develops. This works because we're guiding bones that are still forming — something that's only possible during childhood.
Depending on the case, Dr. Borda may recommend appliances that:
- •Widen the upper jaw so it matches the lower jaw proportionally
- •Encourage the upper jaw to grow forward
- •Guide the relationship between the upper and lower jaws during the growth years
Here's the key thing to understand about underbites specifically: once the jaw stops growing (usually around 14–16 for girls and 16–18 for boys), the only way to change jaw position is surgery. Intercepting an underbite while your child is still growing may mean correcting it without surgery down the road. That alone makes an early evaluation worth your time.
Parents consistently tell us Dr. Borda is patient with kids who are nervous or can't sit still — which matters a lot when you're starting orthodontic treatment at a young age.
Braces for Underbites
For dental underbites — where the jaw is proportional but the teeth are out of alignment — braces are often the most effective path.
Metal braces give Dr. Borda precise control over tooth movement, which is critical for underbite correction. Treatment typically involves brackets and wires combined with elastics (rubber bands) that connect the upper and lower arches.
These elastics apply gentle, steady pressure that pulls the lower teeth back and the upper teeth forward into proper alignment.
Braces for underbites usually take 18 to 30 months depending on severity, with adjustment appointments every 6 to 8 weeks. The office opens at 7:00 AM Tuesday through Friday and 8:00 AM on Mondays, so Mercer Island families can get adjustments done before school at MIHS or before heading to work across the bridge in Bellevue or Seattle — no need to rearrange your whole day.
Clear Aligners for Underbites
Can clear aligners fix an underbite? For mild to moderate dental underbites — yes. Clear aligners use removable trays combined with special attachments and elastics to gradually shift teeth into proper alignment.
Here's where Dr. Borda's background becomes directly relevant: she published peer-reviewed research comparing clear aligners to traditional braces in teenagers.
She knows exactly when aligners will deliver great results and when braces are the stronger choice. That's the kind of expertise that comes from treating patients and studying the science behind it.
For adults correcting an underbite, clear aligners are especially popular because they're virtually invisible. You're never too old to fix a bite issue — and Dr. Borda will tell you honestly during your free exam whether aligners can handle your specific case or whether braces would get you a better result.
When Surgery Is Needed
Some underbites involve a significant skeletal discrepancy — the lower jaw is substantially larger or further forward than the upper jaw. When the jaw size difference is too great for braces or aligners to correct on their own, surgical orthodontics (orthognathic surgery) becomes part of the conversation.
The typical process: braces go on first to align the teeth within each jaw, then an oral surgeon repositions the jaw(s), followed by orthodontic refinement to fine-tune the bite.
Not every underbite needs surgery — and Dr. Borda won't suggest it unless it's genuinely necessary. Many patients come in expecting the worst and find out their underbite can be corrected with braces or aligners alone.
If surgery is the right call, she'll explain exactly why and work with experienced oral surgeons to coordinate your care.
Find Out Which Treatment Fits Your Underbite
Get a personalized treatment plan with your free evaluation
What Does Underbite Treatment Cost on Mercer Island?
Cost is probably one of the reasons you're still reading this page instead of already scheduling. That's fair — so here's the straight answer.
Braces: $3,000–$7,000. This covers the full course of treatment including all adjustment appointments and retainers.
Clear aligners: Priced comparably to braces. Whether you choose aligners or brackets, your investment is in the same range.
Early intervention: Varies depending on the specific appliances needed. Your free exam includes a complete breakdown.
Surgical orthodontics: Higher cost due to the surgical component, which is often partially covered by medical insurance on top of dental/orthodontic coverage.
At Islander Orthodontics, your free exam includes digital photos, a bite evaluation, and a complete financial breakdown before you commit to anything. Dr. Borda's team checks your insurance benefits and gives you the full picture — what insurance covers, what your out-of-pocket will be, and what your monthly options look like.
- All orthodontic insurance accepted
- In-house financing available with flexible payment plans
- Pay-in-full discount if you prefer to handle it all up front
No surprises. No hidden fees. You'll know exactly what you're looking at financially before treatment starts.
Why Mercer Island Families Choose Islander Orthodontics
Underbites aren't a one-size-fits-all correction. They require an orthodontist who understands the difference between a dental underbite and a skeletal one, who can identify the right treatment timing for kids, and who has the training to handle cases across the full range of severity.
Dr. Borda is board-certified by the American Board of Orthodontics — a voluntary credential that represents the highest standard in the specialty. Not all orthodontists pursue it. She completed her orthodontic residency at Oregon Health and Science University (OHSU) and holds three graduate degrees (DMD, MPH, MS).
Before specializing, she practiced general dentistry at the Greater Puget Sound VA Hospital — giving her a broader clinical perspective that most orthodontists simply don't have.
She's also a published researcher. Her peer-reviewed study on clear aligners vs. fixed appliances in teenagers means her treatment recommendations are backed by evidence, not just habit or preference.
You see the same orthodontist at every single visit. That matters with underbite treatment because consistency in monitoring jaw growth and tooth movement leads to better outcomes. Dr. Borda knows your case because she's the one managing it — start to finish.
And here's what really sets this practice apart for Mercer Island families: Dr. Borda is from here. She grew up on the Island — Pixie Hill through MIHS, class of 2002. Played basketball and softball for the Islanders, trumpet in the marching band. This isn't a corporate chain or a multi-location franchise. It's a hometown orthodontist who came back to take care of the community she grew up in.
Patients notice the difference. The consults are professional, clear, and efficient. The staff gets back to you quickly. And if your kid is nervous? Parents say it over and over — Dr. Borda is thoughtful, caring, and genuinely patient with kids who are anxious or fidgety.
See what Mercer Island families are saying in our Google reviews, or check out real before-and-after results from patients like you.
Frequently Asked Questions About Underbite Treatment
No. Underbites don't resolve on their own, and in most cases they worsen over time — especially in growing children. The earlier an underbite is evaluated, the more treatment options are available. The American Association of Orthodontists recommends a first orthodontic evaluation by age 7.
Many underbites can be corrected without surgery, especially dental underbites where the teeth are misaligned but the jaws are proportional. Braces or clear aligners with elastics can shift teeth into proper alignment. For children, early intervention with growth-modification appliances can sometimes prevent the need for surgery later. Severe skeletal underbites may still require surgical correction.
Most underbite treatment with braces or clear aligners takes 18 to 30 months depending on severity. Early intervention in children may be shorter (6–18 months). Surgical cases require additional time for pre-surgical alignment and post-surgical refinement. Dr. Borda gives you a realistic timeline during your free exam — not a vague estimate.
Most orthodontic insurance plans cover a portion of underbite treatment since it's a functional concern, not purely cosmetic. Islander Orthodontics checks your benefits before your visit and provides a complete financial breakdown at your exam. If surgical correction is needed, medical insurance may cover part of the surgical component as well.
Most patients describe it as uncomfortable rather than painful — especially in the first few days after braces are placed or a new set of aligners is started. Your teeth are moving, so some pressure and soreness is normal and usually manageable with over-the-counter pain relief. It fades quickly. Dr. Borda's patients consistently mention her gentle approach, and she'll walk you through exactly what to expect at each stage.
It depends on the cause. The ideal window for growth-modification treatment in children is ages 7 to 10, when the jaw is still developing. For dental underbites that don't require jaw modification, treatment with braces or clear aligners can happen at any age. Adults regularly have underbites corrected — it's never too late.
It can, and usually for the better. Correcting an underbite improves facial profile balance by bringing the lower jaw into proper alignment with the upper jaw. Many patients notice a more balanced, natural appearance after treatment. How much visible change depends on whether the correction involves teeth only or jaw repositioning.
Your free exam at Islander Orthodontics includes digital photos of your teeth and jaws, a bite evaluation, and a conversation with Dr. Borda about what she's seeing. She'll determine whether your underbite is dental or skeletal, recommend the most effective treatment approach, and give you a specific plan with an estimated timeline. You also get a complete financial breakdown — insurance, out-of-pocket costs, and payment options — before you commit to anything. No obligation, no pressure.
Serving Mercer Island, Bellevue, Seattle, and the Eastside
Islander Orthodontics is located in the Mercerdale Professional Center on Mercer Island — right off I-90 with easy access from both sides of Lake Washington via the floating bridges. Whether you're coming from Bellevue, Seattle, Renton, Newcastle, or anywhere across the Eastside, you'll find a board-certified orthodontist who treats your family like neighbors — because you are.
Schedule Your Free Underbite Evaluation
Ready to find out what it'll take to correct your underbite — or your child's? Your free exam includes digital photos, a bite evaluation, a personalized treatment plan with timeline, and a full cost breakdown. No obligation, no pressure.
Islander Orthodontics
Mercerdale Professional Center
3236 78th Ave SE #102, Mercer Island, WA 98040
Open Monday 8:00 AM – 3:30 PM | Tuesday–Friday 7:00 AM – 4:00 PM
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What Our Patients Say
"I've had an amazing experience at Islander Orthodontics! The entire team is personable, attentive, and truly top-notch. They make every visit comfortable and easy, and you can tell..."
Carl V.
a month ago
"Dr. Borda and her staff are amazing! Always very friendly, communicative, and make you feel informed. I've been going to her clinic for about a year now, and I offer a genuinely hi..."
Tyler B.
2 months ago
"This is such a helpful and professional office & they work so great with kids. Dr. Borda is immensely kind & knowledgeable… And they have beautiful offices. Highly recommend Island..."
Olivia L.
3 months ago
Islander Orthodontics
Mercerdale Professional Center (lower level)
3236 78th Ave SE #102, Mercer Island, WA 98040