Overbite, Underbite, Smile Not Aligned? 5 Signs It’s Time to See an Orthodontist

Howard Fine, D.M.D., Director of Orthodontics and Clinical Assistant Professor of Dental Medicine

August 09, 2021
Howard Fine headshot, in black suit with blue shirt and tie

Two of the widely held misconceptions of dentistry happen to fall under the same specialty - orthodontics. First, that braces are just for kids, and second, that the need for braces comes down to one thing, a smile that isn’t straight. But a better bite, and proper jaw alignment, can lead to better overall hygiene and can reduce the chance of tooth decay, gum disease and other conditions.

The tricky part is knowing when a consultation with the orthodontist should be on your to-do list.  Touro College of Dental Medicine (TCDM) Director of Orthodontics and Clinical Assistant Professor of Dental Medicine, Howard Fine, D.M.D., says it’s not always as obvious as you’d think. And while adults are missing the signs in themselves, they’re probably also missing it in their children. “It may seem simple but the truth is, most parents miss the signs or wait too long to address the issues.” 

According to Dr. Fine timing is key. “A child displaying any of the issues described below should see an Orthodontist no later than the age of 7.” According to the American Association of Orthodontists early orthodontic exams, as the face and jaws are developing, allow orthodontists to advise you on whether treatment is recommended, what form it will take and estimate its length. But orthodontic treatment is not limited to children - one in four orthodontic patients is an adult, and that’s when treatments become more complicated.

While signs like difficulty chewing and jaw shifting, or clicking, are signs of improper alignment and can require the need to see a different dental specialist as well as an orthodontist, the following signs are an indication that an orthodontic consultation may be your best bet.

An Overbite

The term overbite, also known colloquially as buck teeth, refers to a condition in which the upper set of teeth significantly overlap the lower set of teeth. Patients, especially young, or active patients, run the risk of injury to the top teeth because they stick further out than they should. 

An Underbite 

Just as with an overbite, an underbite refers to the condition in which the lower set of teeth stick out past the upper set of teeth. While both are caused by uneven growth of the jaw, an underbite is more complicated than an overbite to treat, especially when the patient is older. 


While overcrowding, which sometimes looks like crooked teeth, seems like a fairly common condition, it comes with it’s own set of issues. Aside from being more difficult to clean, overcrowding may cause aesthetic issues for the patient in which they feel less confident about the way they look. 

Aesthetic Issues

This refers to a range of problems from excessive spacing to gaps. Both children and adults are susceptible to low self-esteem stemming from a smile they aren’t comfortable with. “Everyone deserves to have confidence in their smile,” says Dr. Fine. “Seeing an orthodontist can set them on that path.”

Missing Teeth (Adults)

While orthodontists are not in the business of placing implants, an orthodontic consultation can help to establish a good framework for future restorations so that the overall results can be as aesthetic and functional as possible.  Missing teeth can also be a sign restorative treatment is necessary. 

At Touro Dental Health, TCDM’s dedicated teaching practice, planning to see an orthodontist is simple. If you think you or your child could benefit from a consultation, you’ll need to first become a patient of the practice. Once evaluated by a general dentist, seeing an orthodontist will be the potential first step towards a healthier and happier smile and a chance to meet Dr. Fine.  “A large number of my patients over the years didn’t know the signs.  They didn’t know to look for an orthodontist in the first place. After treatment they have confidence in their smiles again.”