Identifying a Bad Bite

Overbites, Underbites, Pushed in front teeth, Crossbites, Openbites, and controlling the tongue.


The facial profile commonly associated with a deep overbite is that of a receded lower jaw. This could mean that the lower jaw is underdeveloped at this age, or is displaced in a “backward” relationship compromising the integrity of the developing jaw joint. Images of the jaw joint are recommended to assess the

Early intervention provides the best outcome without comprise or surgery:

Before and after photo of a girl with orthodontic treatment

The Openbite

Well, what about the opposite extreme………………………………the openbite?

The six views below represent various openbite conditions; most of which are due to abnormal tongue position and airway obstruction. Inadequate vertical overlap of the upper front teeth over the lower front teeth can be caused by digital habits as well, but the most common cause is the airway/tongue position relationship.

examples of an openbite

For comparison:


Crossbites: From Simple To Complex

Simple crossbite examples


example of a complex crossbite

The “Underbite” or anterior crossbite: more complex

5 ½ year old presented with a concave facial profile with a prominent chin.

This young 5 ½ year old presented with a concave facial profile with a prominent chin. Her front teeth were in a crossbite relationship. Failure to address this problem at a young age when the specialist can “ re-direct” growth, will predispose a patient to a more significant imbalance involving the jaw bones, teeth, and jaw joints necessitating surgical assistance at a later date when growth has been completed. This is a good example of the FORM <--> FUNCTION model of growth and development.

After photos of young girl with improved facial profiile
bilateral crossbites

Class III before and after case

Oftentimes, a crossbite can occur just on one side, which will cause the lower jaw to be positioned to the right or the left, but not on center. If the crossbite persists, the lower jaw will grow more on one side than the other leading to a jaw asymmetry requiring surgical assistance for correction

Crossbite examples on one side

Again, facial profiling:

For comparison: facial profiles….sometimes the differences are quite subtle and oftentimes not so subtle

Facial profiling the jaw

A Holistic Approach to Orthodontics

Call us at (678)352-0919

Dr. J. Michael Dierkes, DDS, MS, NMD is a nationally recognized orthodontic specialist who has been creating beautiful smiles for over 30 years. His services have improved the lives of people from Roswell and the surrounding areas, including residents of Sandy Springs, Alpharetta, Marietta, and Atlanta. Whether you are an adult, a child, or a teenager, our knowledgeable staff is committed to helping you achieve the radiant, beautiful smile you deserve. Please call us today to schedule your initial consultation!