Introduction

Prognathism is a congenital condition in which your jaw sticks out. In other words, the condition is passed down to children by parents and isn’t linked to any underlying medical conditions. It can range from mild to severe. Although symptoms may be present at birth, they also emerge at a later stage of life due to dental injuries or childhood habits like thumb sucking.¹ 

Types of prognathism

There are different types of prognathism including:

• Mandibular prognathism. A condition where the lower jaw protrudes out farther than your upper jaw
• Maxillary prognathism. When your upper jaw juts out farther than your lower jaw. It is also called alveolar prognathism
• Bimaxillary prognathism. In this condition, both upper and lower jaw stick out¹

Causes of prognathism in children

Genetically inherited, abnormally protruding jaw is one of the major reasons behind prognathism. Apart from that many other underlying medical conditions directly affect jaw health, such as:

• Acromegaly. In this condition, the pituitary gland produces excess growth hormone leading to enlarged tissues such as an oversized jaw² 
• Basal cell nevus syndrome. It is an inherited condition which gives rise to abnormal facial development. In some cases, this includes abnormal and unhealthy jaws
• Acrodysostosis. This affects bone growth and people suffering from this condition usually have smaller bones in the upper jaw, nose, arms, and legs. As a result, the face looks disproportionate²
• Genetic Disorders. Excessive jaw growth can also be caused by abnormalities in genetic makeup such as Down and Crouzon syndrome. In Down syndrome, an extra chromosome is present in people, which affects normal development and can result in excessive growth of the jaw. Premature fusion of skull bones is caused by the Crouzon syndrome. Prognathism develops as a result of both these conditions discovered only in children as genetic diseases, so treatment can begin early in this scenario³ 
• Misaligned Teeth. In this case, misaligned teeth modify the form of your jaw, leading to a prognathic jaw and resulting in the growth of deformed teeth. It is important to treat your child's misaligned teeth as soon as possible by using different ways including braces, retainers, tooth extension, and jaw surgery³ 

Diagnosis of prognathism in children

Visit an orthodontist if you notice any of these symptoms in yourself or your kid:⁴

• Any visible abnormalities in the shape of the lower and the upper jaw 
• Facing any difficulty in breathing, talking, eating and chewing
• Experiencing overbite or underbite due to misaligned teeth

When you visit your orthodontist or healthcare provider for a diagnosis, a physical examination is the first step. To get a better understanding doctors will ask about your symptoms along with your medical and family history. If required the doctor may take X-rays and dental impressions. In some cases prognathism results from other underlying medical conditions. Such situations require a wide range of treatments.⁵ 

Effects of prognathism on children

Prognathism can cause malocclusion, which means your teeth don't properly fit together. This can give a person an angry or fighter's appearance. It leads to a number of health issues like chewing difficulties, speech problems, and dental wear and tear.⁶ On a regular basis a person with misaligned teeth experiences difficulty in brushing and flossing, which leads to an increased risk for tooth decay and gum diseases.¹ 

In severe conditions of prognathism, patients face problems with psychosocial adjustment, teasing from other children, and speech and masticatory difficulties. In such cases, children and adolescents require surgical correction before the completion of growth.⁷ 

Can you prevent prognathism?

Unfortunately, genetic prognathism is a part of a person’s appearance and you can't prevent it. However, changes in jaw shape caused by teeth misalignment can be preventable. Alveolar prognathism in your child can be prevented by controlling habits like thumb sucking. Before the problem becomes more severe, misaligned teeth can also be corrected by early orthodontic treatment.⁸ 

Treatment options

Although prognathism caused by genetic factors can't be prevented, some cases of prognathism do not require treatment. 

However,  prognathism may require specific approaches depending on the severity and underlying cause of the condition including:

Orthodontic care

At the initial stage, orthodontists would correct misaligned teeth by using braces, a retainer, or Invisalign to try to prevent prognathism. This ensures that the mouth and jaw develop correctly and that the jaw does not jut out far enough to cause discomfort or impede functionality. 

They will work with facial surgeons and take diagnostic tests to determine the shape of the skull and how the jaw develops over time.⁹

Specific therapy and treatments

Specific therapies may be applied depending on the condition and cause of prognathism, like muscle exercises and treatments to correct oral habits that contribute to the condition.¹⁰

Corrective surgery

Facial surgery is required in some cases of prognathism. During the surgery, the doctor will remove a piece of the jawbone and reposition the bones, which can change the shape and appearance of the jaw so that it does not protrude.⁹ 

Medical care

Sometimes prognathism is a result of any other underlying condition, so a medical professional will take steps to treat that problem.⁹ 

FAQ’s

Will a toddler underbite correct itself? 

Occasionally, a child may naturally resolve an early underbite over time, but typically, orthodontic treatment is necessary to correct the underbite before it leads to further complications.

What are toddler underbite habits?

Various factors can contribute to the development of an underbite, with genetics being the primary cause. If one or both parents have underbites, there's a strong likelihood that the child will inherit this trait. Additionally, overuse of a pacifier or thumb sucking can also lead to the development of an underbite in children.

What causes underbite in toddlers?

In addition to genetics, prevalent triggers for underbites in children involve habits such as thumb sucking, persistent tongue thrusting against the teeth, and prolonged reliance on pacifiers or bottles. Addressing underbites promptly is advised due to their potential to impede chewing and induce strain in the teeth and jaw muscles.

Will my baby’s underbite go away?

Ideally, underbites would naturally resolve over time, but in reality, most underbites persist and require treatment. The good news is that there are numerous effective treatments available to address your child's underbite and promote a healthy smile.

What age does underbite stop?

As children grow older, underbites typically worsen, especially during the growth spurt between the ages of 9 and 14. Following this period, jaw growth stabilises, ceasing around the mid-teen years for females and the late teenage years for males.

Is it normal for kids to have underbites?

Underbites are a prevalent concern among young individuals. If you observe that your child has an underbite, it's advisable to discuss it with your dentist and promptly schedule an appointment with an orthodontist.

Summary

Prognathism is an inherited condition characterised by the protrusion of the jaw. It can vary in severity and may manifest from birth or develop later in life due to factors such as dental injuries or childhood behaviours that can influence jaw development, such as thumb sucking, prolonged pacifier use, tongue thrusting, or prolonged bottle feeding beyond infancy. While genetic prognathism cannot be prevented, some cases may not require treatment. However, treatment options depend on severity and cause. Orthodontic care, including braces or aligners, can align teeth and correct jaw development. Specific therapies address oral habits contributing to prognathism. Corrective surgery involves repositioning the jawbones. Medical care targets underlying conditions associated with prognathism.