02/09/2026
Case of Underbite and Asymmetry
This patient has both underbite and asymmetry of occlusion. After a detailed examination and diagnosis, braces treatment (without jaw surgery) was performed to correct his underbite and asymmetry problems. Patient was very happy and satisfied with the treatment results. He can now smile confidently, and most importantly, he also has a more healthy bite that is better in chewing food.
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1. What Is Facial Asymmetry?
Picture a vertical line running down through the center of your nose, splitting your face into a left half and a right half. Facial asymmetry is when those two halves do not match. A little difference is normal and human. It only becomes something to address when the imbalance is pronounced enough to affect your confidence or your bite.
2. What Causes Facial Asymmetry?
➡️Genetics come first, since your facial features are largely inherited and conditions like cleft lip and palate have a genetic link. Faces also change naturally as we age.
➡️Injuries and accidents that damage the face can create asymmetry, as can medical events such as stroke, Bell’s palsy and torticollis.
3.How Teeth and Bite Problems Contribute?
Improper bites can pull the bones and soft tissue around the mouth and jaw out of balance, which is how a bad bite can lead to a receded chin, sunken cheeks or a lopsided smile. Untreated temporomandibular joint dysfunction, often shortened to TMJ, can contribute to asymmetry as well.
4. When Braces Can Fix It, and When You Need More?
The cause of the asymmetry determines the treatment.
➡️Dental asymmetry comes from the teeth and bite. When the imbalance traces back to a malocclusion like an overbite, underbite or crossbite, braces and aligners can shift the teeth into place, correct the bite and bring the lower face into better balance. These are the cases where orthodontics shines.
➡️Skeletal asymmetry comes from the jawbones themselves growing unevenly in size or position. Braces move teeth, not bone, so on their own they can only camouflage a true skeletal difference. Significant skeletal cases are usually treated with a combination of orthodontics and jaw surgery, where braces align the teeth first, a surgeon repositions the jaw and braces fine tune the bite afterward.
The honest takeaway is that braces help a great deal with dental asymmetry and play a supporting role in skeletal cases. An evaluation with imaging is what tells us which situation you are in.
5. Does Age Matter?
It does, especially for children. A young jaw is still growing, which gives orthodontists a window to guide that growth. In a child with a narrow upper jaw, for example, a palatal expander can widen the arch and encourage more symmetrical development, sometimes heading off problems that would need surgery in an adult. This is one reason the American Association of Orthodontists recommends a first orthodontic visit by age 7.
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