Overbite (Buck Teeth): Causes and the Best Treatment Options

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January 6, 2026

On January 6, 2026

An overbite is one of the most common dental conditions affecting both children and adults worldwide. Also referred to as “buck teeth,” this type of malocclusion occurs when the upper front teeth significantly overlap the lower front teeth beyond the normal range. While a slight overbite is perfectly normal and even beneficial for protecting teeth during biting and chewing, an excessive overbite can lead to functional problems and health complications that require professional treatment.

What Is an Overbite

An overbite refers to the vertical overlap of the upper teeth over the lower teeth when the mouth is closed. It is a type of malocclusion, meaning the teeth are not properly aligned when the jaws come together. A normal overbite measures approximately 2 to 4 millimeters. When the overlap exceeds this range, typically covering more than 30% of the lower front teeth, orthodontists consider it an excessive overbite requiring evaluation.

It is important to distinguish between an overbite and an overjet, as these terms are often used interchangeably but describe different conditions. An overbite refers to vertical overlap (how much the upper teeth cover the lower teeth from top to bottom), while an overjet refers to horizontal protrusion (how far forward the upper teeth stick out past the lower teeth). Many people who say “buck teeth” are actually describing an overjet, where the upper front teeth protrude outward at an angle beyond the lower teeth.

Overbites are also classified as either dental or skeletal. A dental health overbite is caused primarily by the positioning of the teeth themselves, while a skeletal overbite results from the shape or positioning of the jawbones. This distinction is crucial because it determines which treatment approach will be most effective.

How Common Are Overbites

Malocclusion, including overbites, is extremely common worldwide. A systematic review and meta-analysis published in the European Journal of Paediatric Dentistry (2020) titled “Worldwide prevalence of malocclusion in the different stages of dentition” found that the global prevalence of malocclusion is approximately 56%, with deep overbite being among the most common types observed.

A 2024 systematic review published in Healthcare (MDPI) titled “Prevalence of Malocclusion Traits in Primary Dentition, 2010–2024″ – Reported that deep overbite is the second most prevalent type of malocclusion in primary dentition, affecting approximately 23.79% of children globally. The prevalence varies by region, with Europe showing the highest rates of deep overbite at 33.08%.

Another systematic review published in Dental Press Journal of Orthodontics (2018) titled “Global distribution of malocclusion traits: A systematic review” found that in permanent dentition, deep overbite affects approximately 21.98% of the global population

What Causes an Overbite

Several factors can contribute to the development of an overbite, ranging from genetics to childhood habits.

Genetics and Hereditary Factors:

Jaw shape and size are largely determined by genetics. If one or both parents have an overbite, their children are more likely to develop the same condition. Inherited traits affecting jaw development, tooth size, and the relationship between the upper and lower jaws can all contribute to malocclusion. In some cases, the upper jaw may be overdeveloped or the lower jaw underdeveloped, creating a significant discrepancy between the two.

Thumb Sucking and Pacifier Use:

Prolonged thumb sucking or pacifier use beyond the age of three or four is one of the most common environmental causes of overbites in children. The constant pressure from these habits pushes the upper front teeth forward and can affect the development of the jaw.
A systematic review published in the Journal of Clinical Pediatric Dentistry (2024) titled “Effects of non-nutritive sucking habits on malocclusions: a systematic review” Analyzed 21 studies and found that persistent non-nutritive sucking habits are associated with increased chances of developing malocclusions, including anterior open bite, posterior crossbite, and increased overjet. The review also noted that breastfeeding provides protection against malocclusions.
A scoping review published in Children (MDPI) in 2024 titled “Pacifier Use and Its Influence on Pediatric Malocclusion” Examined 35 studies and found that pacifier use was consistently associated with an increased prevalence of malocclusions, including anterior open bite, posterior crossbite, and overjet. Duration and frequency of use were key risk factors.
The intensity of the sucking habit also matters. Children who vigorously suck their thumbs are more likely to experience dental problems than those who rest their thumbs passively in their mouths.

Tongue Thrusting:

Tongue thrust occurs when a person pushes their tongue forward against the back of their teeth during swallowing, speaking, or even at rest. This repetitive pressure can gradually push the upper teeth forward, contributing to both overbites and overjets.

A study published in the Journal of Dental Research, Dental Clinics, Dental Prospects (2012) titled “Effect of Tongue Thrust Swallowing on Position of Anterior Teeth” – Examined 193 subjects and found that overjet was significantly greater in individuals with tongue thrust compared to control subjects. The study noted that the incidence of tongue thrusting is higher than normal in subjects with open bite or overjet malocclusions.

A comprehensive review published in Cureus (2024) titled “The Influence of the Tongue on the Development of Dental Malocclusion” Emphasized that maladaptive tongue postures like tongue thrusting can cause malocclusion by altering the delicate balance of forces inside the oral cavity over time.

Other Contributing Factors

Additional causes of overbites include:

Teeth grinding (bruxism): Chronic grinding places excessive pressure on teeth and can alter their position over time
Nail biting: The repetitive motion and pressure from biting nails can gradually shift teeth
Missing or crowded teeth: Gaps from missing teeth allow surrounding teeth to shift, while overcrowding can push teeth out of alignment
Prolonged bottle feeding: Similar to pacifier use, extended bottle feeding can affect jaw development

Complications of an Untreated Overbite

While a mild overbite may primarily be a cosmetic concern, leaving a moderate to severe overbite untreated can lead to various health complications.

Jaw Pain and TMJ Disorders:

An overbite places excessive strain on the temporomandibular joint (TMJ), which connects the jawbone to the skull. Over time, this misalignment can contribute to temporomandibular disorders (TMD), causing symptoms such as chronic jaw pain, clicking or popping sounds when opening or closing the mouth, jaw stiffness, headaches, and difficulty chewing.

Tooth Damage and Wear:

When teeth do not meet properly, certain teeth bear more of the biting force than others. This uneven distribution leads to accelerated wear, increased risk of chipping or cracking, and heightened tooth sensitivity. People with overbites are also more prone to teeth grinding, which further accelerates enamel erosion.

Difficulty Chewing and Speaking:

A significant overbite can make it challenging to chew food properly, affecting digestion and nutrition. Additionally, the misalignment can interfere with proper tongue placement during speech, leading to difficulties pronouncing certain sounds.

Gum Disease and Tooth Decay:

The overlapping teeth in an overbite create areas that are difficult to clean properly with brushing and flossing. This allows plaque and bacteria to accumulate, increasing the risk of cavities and gum disease.

Breathing Problems:

Severe overbites, particularly those involving a recessed lower jaw, can restrict the airway. This may contribute to mouth breathing and can worsen conditions like obstructive sleep apnea.

Treatment Options for Overbites

The good news is that overbites can be effectively treated at any age, though treatment is often simpler and faster when started during childhood while the jaw is still developing.

Traditional Braces:

Traditional metal braces remain one of the most effective and widely used treatments for correcting overbites. They work by applying continuous, controlled pressure to gradually move teeth into proper alignment.

A systematic review published in the European Journal of Orthodontics (2013) titled “Stability of deep-bite correction: A systematic review” – Analyzed 26 studies and found that on average, patients underwent significant overbite improvement during treatment with fixed appliances, and most of the correction was maintained long-term.

For overbite correction, orthodontists may also use rubber bands (elastics) that connect the upper and lower arches to help reposition the jaw. Treatment time varies depending on severity but typically ranges from 18 months to 3 years.

Clear Aligners (Invisalign):

Clear aligners have become a popular alternative to traditional braces, particularly for adults and teenagers seeking a more discreet treatment option.

A study published in the American Journal of Orthodontics and Dentofacial Orthopedics (2022) titled “Comparison of clinical outcomes between Invisalign and conventional fixed appliance therapies in adult patients with severe deep overbite treated with nonextraction” Compared 50 adult patients and found that both Invisalign and conventional fixed appliances were effective in treating patients with severe deep overbite (greater than 5mm and 60% overlap). No significant differences were observed in peer assessment rating analysis or total health treatment duration between the two groups.

However, clear aligners are generally most effective for mild to moderate overbites. For severe overbites, particularly those involving skeletal issues, traditional braces may be more effective as they can apply stronger and more consistent forces to move teeth.

Palate Expanders:

For children with an overbite related to a narrow upper jaw, palate expanders can be highly effective. This orthodontic appliance fits in the roof of the mouth and gradually widens the upper jaw by applying gentle outward pressure.

A study published in the Journal of Clinical Orthodontics found that posterior crossbites are found in 7.7% of patients with baby teeth or mixed dentition. Palate expanders work best in children between ages 7 and 14, while the jaw bones are still developing and the palatal suture has not yet fused.

The expansion process typically takes three to six weeks, though the device remains in place for several months to allow new bone to form and stabilize the expansion.

Tooth Extraction:

In cases of severe crowding contributing to an overbite, tooth extraction may be necessary to create space for the remaining teeth to move into proper alignment. This is typically combined with braces or clear aligner treatment.

Orthognathic (Jaw) Surgery

For severe skeletal overbites in adults where the jaw bones are fully developed, orthognathic surgery may be the most effective treatment option. This procedure repositions the upper jaw, lower jaw, or both to achieve proper alignment.

Cleveland Clinic reports that orthognathic surgery has a success rate of approximately 93.9%, with most patients reporting improved quality of life.

A study published in the American Journal of Orthodontics and Dentofacial Orthopedics (2011) titled “Success rate of anterior open-bite orthodontic-orthognathic surgical treatment” Examined 15 patients treated with combined orthodontic-surgical approaches and found that average overbite improved from -3.2 mm before treatment to 1.8 mm after treatment.

Jaw surgery is typically reserved for cases where orthodontic treatment alone cannot achieve adequate correction.

Myofunctional Therapy:

For patients whose overbite is contributed to or worsened by tongue thrust or other oral muscle dysfunction, myofunctional therapy may be recommended as part of the treatment plan. This therapy involves exercises designed to strengthen the oral muscles and retrain proper tongue position and swallowing patterns.

When Should Treatment Begin

The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7. At this age, orthodontists can identify developing problems and determine whether early intervention would be beneficial.

Early treatment (Phase 1 orthodontics) during childhood can take advantage of the still-growing jaw to guide proper development and potentially reduce the need for more invasive treatments later. For example, a palate expander used during the optimal age window can correct a narrow upper jaw that might otherwise require surgery in adulthood.

However, adults should not be discouraged from seeking treatment. While treatment may take longer and some approaches (like palate expansion) may require surgical assistance, significant improvements can still be achieved through braces, clear aligners, or jaw surgery.

Prevention Tips

While genetic overbites cannot be prevented, you can reduce the risk of acquired overbites in children:

Limit pacifier use: Encourage weaning from pacifiers by age 2-3
Discourage thumb sucking: Work with your child to break the habit before age 4
Address tongue thrust early: Consult with a speech therapist if you notice abnormal swallowing patterns
Promote breastfeeding: Research suggests breastfeeding may provide protective effects against certain malocclusions

Conclusion

An overbite is a common dental condition with multiple potential causes, from genetics to childhood habits like thumb sucking and pacifier use. While mild overbites may be primarily cosmetic concerns, moderate to severe cases can lead to complications including jaw pain, TMJ disorders, tooth damage, and difficulty eating or speaking.

Fortunately, effective treatments are available for patients of all ages. Traditional braces, clear aligners, palate expanders, and jaw surgery each offer solutions depending on the type and severity of the overbite. Early evaluation and intervention can often simplify treatment and achieve better outcomes.

If you or your child has an overbite, consult with an orthodontist to discuss your specific situation and develop an appropriate treatment plan.

References:

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Fujiyama K, Kera Y, Yujin S, et al. Comparison of clinical outcomes between Invisalign and conventional fixed appliance therapies in adult patients with severe deep overbite treated with nonextraction. American Journal of Orthodontics and Dentofacial Orthopedics. 2022;161(4):542-547.
Janson G, Valarelli FP, Cançado RH, et al. Success rate of anterior open-bite orthodontic-orthognathic surgical treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;139(4):562-571.
Cleveland Clinic. Overbite: Causes, Symptoms & Treatment.