Underbite - Underdeveloped Upper Jaw

I had a strong underbite that wasn't addressed until high school. When I was 16, I had a palate separator installed, which is a device that anchors to your top molars and presses against the roof of the mouth. There is a piece in the middle into which I would insert a "key" and turn that piece once a day, which would apply pressure to the anchors to spread the two halves of the upper palate apart, expanding the width of the upper jaw. By the time I was done, I could fit a stack of 4 quarters (turned sideways) between my front teeth. Pretty! Then over a few months my teeth spread into their new positions and filled the gap. That was the standard treatment 20 years ago and frankly, it didn't work very well. So that little adventure was followed with surgery to reduce the size of my bottom jaw. A few millimeters of bone was removed from each size, plates were screwed in at the cuts on both sides to rejoin the bomes, then my jaw was wired shut for weeks while everything healed. It was major surgery that required a day of recovery in ICU plus another 3-4 days in the hospital. I didn't expect the ICU and long hospital stay, but given the proximity of the surgery site to the brain and airway, they have to watch carefully for swelling and infection. After the surgery, my top jaw fits over my bottom - my teeth don't actually touch, but they look normal.

Anyway...my two younger sons have the same face/jaw structure that I have. They are 7 & 9 and their treatment has started already. The new standard of care in the US is that once the 6 year molars are in, the child can have braces that will work on pulling the lower jaw back and in while pushing the top teeth forward. Basically, the growth of the bottom jaw determines the growth of the top. The top doesn't really grow on its own - the bottom one is normally under and inside the top so that as that grows, it pulls and stretches the top along with it. If this repositioning can be accomplished when a child is 7 or 8, there will be less of a problem later because the lower jaw will be better positioned to influence the growth of the top. Then it's expected that after a short round of braces at 7/8, the braces come off and then the process is repeated again at around age 12 or 13. The second process is longer (2 years) and hopefully permanent, but some patients repeat this again for a brief period at around age 17/18 or still need surgery.

If I were you, I would research the care that's being done here with children your daugther's age and ask the orthodontists if they're familiar with this mode of treatment and if they are, why they would or wouldn't recommend this for your daugther. There could be something structural about her jaw that would make her not a candidate for this. If you still have contacts here in the US, perhaps someone could recommend an orthodonist in a community that you have ties in to review the images of your daugther and make a recommendation of what the course of treatment would be if you lived here? If their take on treatment is dramatically different than what you are hearing, perhaps it's worth it to try to seek out an ex-pat orthodontist where you are living now to do the work?

I had a severe underbite and crossbite when I was a kid. When I was in preschool through 1st grade I wore permanent retainers on both to and bottom of my mouth. 6 months out of the year my parents would have to take a key and turn it inside the retainer to both stretch my mouth wider and strengthen my upper jaw.

They told my parents there was a chance I would have to have my jaw reset but that they wanted to see what they could do with braces first. I got braces when I was 12 that I wore until I was almost 15. It was painful because I would have to wear these rubberbands that pulled my jaw in a certain direction and then back and all that kind of stuff but it worked!! When I got my braces off my teeth were straight my underbite was gone and I didn't have a crossbite anymore either. I wore a retainer like everyone does when they get their braces off at night for 2 years. Its been almost 15 years since I had my braces off and I haven't had any problems with my teeth.

Orthodontics corrected the problem for me so I would say it is worth a try!

My daughter has a slight underbite. However, she is only four and we're unsure how it will be when she gets older.

I don't have any advice to give but I do offer my support! I know it's frustrating.
Hang in there.

I've heard of doc's using a device called a Bionater, not sure how it's spelled, sorry. Sounds like Bio-nate-er. It looks a bit like a shock absorber and is attached to both the top and bottom teeth. It gently pushes apart so that the recessed jaw has constant pressure placed on it. The idea is that it will encourage the bone to stretch and grow more.

I know of a couple of teens that have used this device starting very young, like 7 or 8, and it helped their jaw grow to make room for larger teeth.

I think that next time you are in the US, you need to see an orthodontist, facial specialist, and bone specialist. For the orthodontics, I recommend a dental school like Tufts in Boston. They know about the latest and greatest. There are also excellent specialists right next door at the Floating Hospital for Children. I also suggest you do this sooner rather than later.