Can “buck teeth” be corrected? First find out whether the protrusion is in the teeth or the jaw

Can “buck teeth” be corrected? First find out whether the protrusion is in the teeth or the jaw

Direct answer in 60 characters

“Buck teeth” is a lay term. Clinically, it maps to at least three situations: excessive overjet, dentoalveolar protrusion, and skeletal Class II [F4][F5][F6]. Classification determines the management direction and requires a dentist’s examination and imaging assessment; you cannot determine it yourself [F3].

This guide is general health education based on international literature and does not address any particular country’s insurance or legal system; care and payment arrangements depend on the place where you seek care. The classification, trauma-risk, and management evidence in this card comes from international journals (fact units marked geo: universal). Only the duty to explain and the health-education positioning at the end cite Taiwan law (marked geo: TW); when care is received elsewhere, use the applicable local rules for those two points [F34][F35].

First, the boundaries: what this card covers

Orthodontic topics on this site are divided among several cards. Locate this card’s place before reading on [F2].

• How costs are made up and how to read a quotation: see the orthodontic-cost cards. This card lists no amount, discusses no fee item, and makes no judgment about whether any quotation is reasonable [F2].
• What movements clear aligners themselves can achieve and their limitations: see the clear-aligner-limits card. This card answers only “what categories of management direction exist.” Its main text gives neither appliance-comparison advice nor brand names. If the risk section names appliance types (for example, a comparison of root resorption by appliance), that is solely to report the source conditions of that risk evidence, not an appliance recommendation [F2].
• Mandibular prognathism (often called an underbite): this is the opposite skeletal relationship and belongs to a separate canonical card. This card gives one contrast only and does not expand on its causes, classification, or management [F2].
• An incisor has already fractured, loosened, or been knocked out: that is an emergency. Timing of management is outside this card; go directly to the dental-trauma emergency card [F2].

This card does four things: maps a lay term to clinical terms, explains what classification relies on, synthesizes the health-based core reason for considering orthodontics (anterior-tooth trauma risk), and sets out the evidence strength and known risks of four management directions [F2].

1. “Buck teeth” is not a clinical diagnosis

What a patient calls “buck teeth” falls into at least three distinct levels in the literature. They can occur separately or together, and their management directions differ greatly [F2].

Level 1: excessive overjet. This is closest to what patients intuitively mean. This card uses “overjet” for the horizontal distance by which the upper anterior teeth project ahead of the lower anterior teeth; this wording is this site’s editorial terminology, not a verbatim definition from any source [F2]. In the studies cited here, overjet is measured in millimetres [F9][F13]. The Cochrane review on this topic places the lay description “prominent upper front teeth” alongside Class II malocclusion, and one primary measure of treatment effect is reduction in overjet [F4][F14][F17]. Its background says that prominent upper front teeth are common, affecting about one quarter of 12-year-old children in the UK, and develop as permanent teeth erupt [F4]. This is a UK population figure and cannot be directly applied to other countries [F4].

Level 2: dentoalveolar protrusion. This does not describe the front–back relationship of the jaws; it describes the inclination of teeth and alveolar bone. A cephalometric study of patients with bimaxillary protrusion recorded increased incisor proclination and protrusion, a vertical facial pattern, increased lip procumbency, a smaller nasolabial angle, and thin, elongated anterior alveoli in both jaws [F5]. The population must be stated honestly: it was 48 ethnically diverse patients with bimaxillary protrusion, and all were treated by extraction of four premolars. It describes morphological features of that category, not diagnostic criteria for any individual [F5].

Level 3: skeletal Class II. This is the front–back relationship of the upper and lower jaw bones. A systematic review comparing camouflage orthodontics with orthognathic surgery explicitly included patients with skeletal Class II malocclusion, retrognathic mandible, and completed growth [F6]. Another systematic review of functional appliances describes the condition it evaluated as “skeletal Class II malocclusion” [F20]. The available categories of management differ by whether growth has or has not finished; the “management directions” section separates them [F2].

Mandibular prognathism (often called an underbite) is the skeletal relationship in the opposite direction and follows different management logic. See its canonical card; it is not expanded here [F2].

2. What classification relies on: not a mirror

Studies comparing skeletal outcomes use angular measures from lateral cephalometry—for example, the angle of the maxilla to the cranial base, the angle of the mandible to the cranial base, and their difference [F6][F26]. In other words, the research classification of “dental or skeletal” is measured, not merely seen [F3].

A second point is essential, otherwise the tool would be portrayed as stronger than its evidence. A systematic review of the validity of two-dimensional lateral cephalometry found many records in the preliminary search but only 17 eligible papers. Its authors concluded that, despite 968 peer-reviewed articles having been published, the scientific evidence for the usefulness of this radiographic technique in orthodontics related peer-reviewed articles, scientific evidence for the usefulness of this radiographic technique in orthodontics remained lacking and contradictory [F7].

Taken together, the conclusion this card can give is this: classification is a clinical synthesis (clinical examination, models, and imaging), not an automatic result from one image or a single cut-off angle; it is also not something you can classify yourself in a mirror [F3]. That is why the same phrase “buck teeth” can lead to very different management routes after different examinations [F2].

3. Whether to seek orthodontics: the health-based core reason is trauma risk

This is the part patients should know but that is often not clearly explained. It is not an appearance question; it is a question about the chance of dental trauma [F3]. The literature category is traumatic dental injury, which includes fracture, loosening, avulsion, and other forms, not only a “broken tooth.”

A 2019 systematic review and meta-analysis used the Joanna Briggs Institute method for association reviews, preregistered its protocol in PROSPERO, included only studies with high methodological quality and low risk of bias, and included 41 studies from more than three thousand records [F8]. It reported an odds ratio for trauma of 3.37 (95% confidence interval 1.36 to 8.38) among children aged 0–6 years with overjet greater than or equal to 3 mm; 2.43 (95% confidence interval 1.34 to 4.42) for mixed and permanent dentitions with overjet greater than 5 mm; and 1.81 (95% confidence interval 1.44 to 2.27) for 12-year-old children with overjet greater than 5 mm [F9].

How to read these numbers determines whether they will be misunderstood [F3]:

• An odds ratio is a population-level association measure, not the probability that your child will be injured, and it does not establish causation [F9].
• The review’s conclusion calls an overjet greater than or equal to 3 mm in primary dentition and greater than or equal to 5 mm in early permanent dentition thresholds at risk for trauma. Its results section, however, says “greater than 5 mm” for permanent dentition [F10]. The results and conclusion use different endpoint wording within the same article. This card reports both as written rather than selecting one; a case near a boundary needs a dentist’s whole-case assessment [F10][F3].
• An overview of systematic reviews (19 reviews) lists greater overjet, inadequate lip coverage, anterior open bite, and other factors as associated with a greater chance of trauma, but says that most included reviews were methodologically low quality and may not provide an accurate, comprehensive evidence summary [F11].
• A systematic review and meta-analysis in Brazilian children and adolescents reported trauma likelihoods of 1.94 to 3.11 times with increased overjet, 1.86 to 2.36 times with inadequate lip coverage, and 1.76 times (95% confidence interval 1.20 to 2.59) with anterior open bite in primary dentition. Evidence certainty ranged from very low to moderate, and the population was Brazilian [F12].
• A narrative review of the consequences of severe malocclusion found firmer evidence for only two of ten topics: poorer oral-health-related quality of life in adults with severe malocclusion than with normal occlusion, and increased traumatic-dental-injury risk with overjet greater than 5 mm in permanent dentition and 3 mm in primary dentition. The other conclusions rested on low-to-moderate-quality evidence at high risk of bias [F13]. This is a narrative review, with a lower evidence level than the preceding meta-analyses; its quality-of-life item is a population-level cross-sectional comparison, not a causal claim that orthodontics will improve it [F13][F3].

Can orthodontics reduce trauma? One evidence source addresses that directly. The 2018 Cochrane review included 27 randomized controlled trials and more than twelve hundred participants [F14]. In trials comparing one early phase in childhood with one later course in adolescence, final overjet did not differ after both groups completed treatment (mean difference 0.21, 95% confidence interval −0.10 to 0.51, P = 0.18; low-certainty evidence) [F14]. But functional-appliance early treatment had a lower incidence of incisal trauma than later treatment (odds ratio 0.56, 95% confidence interval 0.33 to 0.95; moderate-certainty evidence): 30% (51/171) of the late-treatment group reported new trauma versus 19% (31/161) of the early-treatment group [F15]. The headgear comparison reported a similar direction (odds ratio 0.45, 95% confidence interval 0.25 to 0.80; low-certainty evidence) [F16].

The review authors concluded that low-to-moderate-certainty evidence suggests early orthodontic treatment for children with prominent upper front teeth is more effective than one adolescent course for reducing the incidence of incisal trauma, and that no other advantage of early treatment was found compared with later treatment [F18].

A 2025 systematic review and meta-analysis adds a limitation from another angle. It included 18 studies, nine with sufficient overjet data for meta-analysis, and found no statistically significant long-term difference in overjet, jaw-relation angle, or peer-assessment score between early treatment and controls (overall moderate certainty). Its authors concluded that early orthodontic treatment improves occlusal and skeletal parameters in the short term, but current evidence does not support consistent long-term benefits over delayed intervention. They said decisions should be individualized and reserved for specific indications, including functional crossbite, increased dental-trauma risk, and psychosocial concerns [F19].

The conclusion you can take away from these studies together is: trauma risk is one literature-supported reason to address the issue earlier; it is not a universal conclusion that earlier treatment works better. The decision belongs to clinical judgment after complete assessment, not to one millimetre figure on the internet [F3][F18][F19].

4. What categories of management direction exist

This section describes strategy categories, not appliance selection or a treatment recommendation. Which category applies, and whether they are combined, must be assessed by a dentist from your examination findings [F3].

(1) Change the position relationship of the anterior teeth with orthodontic appliances. This is the category most people have in mind. The directly cited evidence here that compares with “no treatment” comes from the adolescent functional-appliance group in the Cochrane review, not from all orthodontic appliances generally [F17]. It recorded a reduction in final overjet with fixed functional appliances (mean difference −5.46 mm, 95% confidence interval −6.63 to −4.28; two trials, 61 participants) and removable functional appliances (mean difference −4.62, 95% confidence interval −5.33 to −3.92; three trials, 122 participants); both were low-certainty evidence [F17]. These are between-group differences in population averages, not your expected result, and the review rated the evidence low [F17].

(2) Retract the anterior teeth en masse after extraction. A systematic review and meta-analysis in adults with maxillary or bimaxillary dentoalveolar protrusion recorded lower maxilla-to-cranial-base and interjaw-difference angles after en-masse retraction, with no significant difference between retraction methods [F22]. When its conclusion said that methods could improve the facial profile and achieve similar skeletal corrections, its evidence rating was “weak to moderate.” This card preserves that as the study authors’ wording, not as this site’s judgment about appearance outcomes [F22]. Whether to extract is a clinical judgment; this card gives no preference. The next section explains why.

(3) Growth modification: only for children who are still growing. A long-term systematic review included eight non-randomized studies (published in 12 papers). It recorded improvement in the interjaw relationship with functional appliances at almost all time points (Wits appraisal at the end of growth, mean difference −3.52 mm, 95% confidence interval −5.11 to −1.93). The greatest increase in mandibular length was in the group aged 18 years and above (mean difference 3.20 mm, 95% confidence interval 1.32 to 5.08), but the same paper states that improvement in mandibular projection was negligible or not significant. Its conclusion says the appliances “may be effective,” and directly states very-low-quality evidence and limited clinical significance [F20]. A systematic review of the Twin-block appliance consistently recorded lower-incisor proclination, upper-incisor retroclination, distal upper-molar and/or mesial lower-molar movement, increased mandibular length and/or forward mandibular movement. It found no clinically significant restraint of maxillary growth. Although mandibular body length increased, its facial effect was offset by simultaneous increase in facial height. For lip position, the review says there is insufficient evidence for a clear change. Individual changes had limited clinical significance; only together did they reach clinical importance, and no long-term data were available [F21].

(4) Camouflage orthodontics or orthognathic surgery: two routes after growth is complete. The earlier camouflage-versus-surgery review included nine articles, seven in the meta-analysis. It found no statistically significant difference for some measures (maxilla-to-cranial-base angle, lower-lip-to-aesthetic-plane linear measurement, skeletal-profile convexity, and soft-tissue profile excluding the nose). Surgical-orthodontic treatment was more effective for interjaw-difference angle, mandible-to-cranial-base angle, mandibular-plane angle, and the soft-tissue profile including the nose. Differences in overjet and overbite treatment effects depended on the severity of initial values [F26]. The authors asked for cautious interpretation because studies were few and all were non-randomized clinical trials [F26].

The surgical route must also be considered with its complications. A 2026 systematic review and meta-analysis included 47 studies and more than five thousand patients. It reported a pooled incidence of persistent neurosensory disturbance one year after sagittal split osteotomy of 21% (95% confidence interval 13% to 32%). Older age, greater mandibular advancement, and intra-operative nerve exposure or manipulation had statistically significant associations with higher risk [F27]. State the population: this synthesis included patients undergoing that procedure, not only skeletal Class II cases; it also found no significant association between skeletal classification and persistent neurosensory disturbance [F27]. This is a pooled population estimate, not a prediction for any individual. Choosing surgery is a shared decision with oral-and-maxillofacial surgery and orthodontic clinicians [F27][F3].

5. Extraction or no extraction, and appearance: why this card gives no direction

This is common in consultations and easy for internet content to overstate. The actual state of the literature is:

• A systematic review and meta-analysis of 24 studies and more than fourteen hundred patients associated extraction treatment with greater lower-lip retraction (mean difference 1.96 mm), upper-lip retraction (mean difference 1.26 mm), and increase in nasolabial angle (mean difference 4.21 degrees). The same passage says the evidence quality for every result was very low; its conclusion says that although extractions seem to affect profile, the studies are heterogeneous and no consistent prediction of profile response can be made [F23].
• A systematic review of soft-tissue changes after premolar extraction in Class II division 1 patients recorded increased nasolabial angle and retrusion of both lips, with less lower-lip retraction in a two-maxillary-premolar protocol. It also noted that most articles described pretreatment malocclusion severity inconsistently [F24].
• A 2021 systematic review and meta-analysis pooling four controlled trials found no statistically significant extraction-versus-nonextraction difference in several cephalometric measures; only the interjaw-difference angle was higher in the extraction group (mean difference 0.78, 95% confidence interval 0.25 to 1.31). Its authors used the wording that non-extraction protocols are a safe and effective alternative to extraction protocols, while also calling for individually tailored treatment [F25]. This card retains that as the original authors’ wording, not as this site’s safety or superiority judgment; the synthesis included only four controlled trials [F25].

Accordingly, this card’s position is: whether to extract is a clinical judgment; this site gives neither a preference nor a prediction. Appearance is the same. The three studies above report population-level changes (two pooled mean differences and one range across studies), and the study that explicitly rated evidence quality itself says it cannot consistently predict profile response [F23][F24][F25]. These data do not support any promise about an individual facial result [F3].

One honest addition: appearance-related distress is indeed one motivation for seeking care. The Cochrane review background says these teeth are more likely to be injured and their appearance can cause significant distress [F4]. Recording a motivation is not promising an outcome. Therefore, this card states only what evidence supports; it gives no before-and-after appearance comparison and describes no direction of appearance change [F3].

6. Can I do this myself at home?

It is not recommended, and documented consequences exist [F3].

Orthodontics is a medical intervention that moves teeth within alveolar bone. The literature describes root resorption as a common adverse effect of orthodontic treatment [F29]. Among orthodontic patients, the pooled prevalence of white-spot lesions (enamel demineralization) was 55.06% (95% confidence interval 47.7% to 63.6%) and incidence was 34.2%; pooled prevalence in untreated patients was 29.1%. Compared with no treatment, conventional fixed appliances had seven times the odds of white-spot lesions (95% confidence interval 2.6 to 18.5), and prevalence rose with longer treatment duration [F28]. These require professional monitoring and management; mailing an appliance to a home cannot provide that by itself [F3].

Three studies directly assessed direct-to-consumer orthodontics without an in-person examination:

• An evaluation of 21 direct-to-consumer orthodontic websites found that only 38.1% mentioned pretreatment dental-health requirements and only 23.8% mentioned indefinite post-treatment retention; 95.2% were rated poor or very poor on the information-quality scale. The authors concluded that consent based only on website information was likely invalid [F31].
• A user survey analysing 470 responses found that 87.5% were satisfied with treatment, but 6.6% had to visit a dentist because of the severity of adverse effects [F32]. This was a self-selected sample recruited through social media and related forums, not a representative sample; neither figure can be read as an incidence rate in the general population [F32].
• A cross-sectional Spanish survey with 101 valid responses found that most respondents said expectations were unmet and they would not recommend the service; cost was the main motivation, convenience second, and many users experienced complications leading to dental consultations [F33].

This site’s position: tooth movement needs diagnosis, monitoring, and someone responsible for managing problems. Skipping assessment to save time or trouble skips exactly the part that should not be skipped [F3]. If you are already using such a service and have worsening pain, tooth mobility, a bite change, or swollen, red, bleeding gums, stop adjusting it yourself and seek care promptly [F3].

Risk factors, known adverse effects, and what should be explained

Orthodontic treatment has risks and contraindications. Whether it is suitable and which approach is used require a dentist’s individual assessment. The literature records these areas:

• White-spot lesions (enamel demineralization): pooled prevalence 55.06% and incidence 34.2% among orthodontic patients; compared with no treatment, conventional fixed appliances had seven times the odds, and prevalence increased with longer treatment [F28]. The review also recorded pooled prevalence of 29.1% in untreated patients, so its authors said documentation at treatment start is essential [F28].
• Root resorption: orthodontically induced inflammatory root resorption is described as a common adverse effect. A cone-beam-computed-tomography-based meta-analysis of five studies and 334 participants found no statistically significant difference between aligners and fixed appliances; neither group had a clinically relevant degree (less than 1 mm), with moderate-to-high risk of bias [F29]. This is a result in the population studied, not a guarantee for a high-risk case [F29].
• Relapse and retention: the 2023 Cochrane retention review included 47 studies and more than four thousand participants. Its conclusion was low-to-very-low certainty evidence, so no firm conclusion can be drawn that one retention method is better than another; most studies followed patients for less than one year [F30]. Follow your treating dentist’s retention plan after treatment [F3].
• Neurosensory disturbance after orthognathic surgery: the pooled incidence persistent at one year was 21% (95% confidence interval 13% to 32%); greater mandibular advancement and intra-operative nerve manipulation were associated with higher risk [F27].
• Limits of growth modification: long-term evidence was rated very low quality with limited clinical significance. The Twin-block review says there are no long-term data and insufficient evidence for a clear change in lip position [F20][F21].

Under Article 81 of Taiwan’s Medical Care Act, when a medical institution diagnoses and treats a patient, it must inform the patient or the patient’s legal representative, spouse, relatives, or related person of the condition, treatment policy, procedures, medication, prognosis, and possible adverse reactions [F34]. This is the basis for asking in the consultation room for the diagnostic classification, management options, expected course, and possible adverse reactions to be explained clearly [F34].

Pre-visit checklist: ask all seven questions in the room

1. From my examination, is my situation mainly about tooth position and inclination, or the relationship of the upper and lower jaw bones? What is the basis for that judgment? [F6][F7]
2. What is my (or my child’s) overjet measurement? How much weight does it carry in your assessment of trauma risk? [F9][F10]
3. If this is for a child, what differs between acting now and waiting until later? How do you view the incisal-trauma outcome? [F15][F18][F19]
4. Does my age and growth status still allow the category of growth modification? If not, what options remain? [F20][F6]
5. Does this treatment plan require extraction? If both extraction and non-extraction are possible, what are the differences and trade-offs? [F23][F25]
6. What adverse effects may occur in this course (for example enamel demineralization and root resorption)? How will you monitor them, and how often will you review them? [F28][F29]
7. How long will retention be needed after treatment, and which type? What happens if I cannot follow it? [F30][F31]

How to find a clinic that provides this service

This site lists no clinics and does not recommend, rate or compare any medical institution.

To find a clinic that provides this service, use the following official lookup channels yourself —

they are maintained by the competent authorities and are more current than any list:

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- The Ministry of Health and Welfare's medical-institution lookup: search by city or county,

township and specialty (dentistry) for institutions that have completed practice registration.

The results show the institution's name, address and registered specialty. This is the first place

to confirm whether a clinic is lawfully registered.

- The National Health Insurance Administration's contracted-institution lookup: check whether a

clinic is under contract with National Health Insurance. This determines which items are covered

and which are self-paid, and therefore what kind of fee explanation you will be given.

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Both systems are on the respective authorities' official websites; searching for the

medical-institution lookup or the contracted-institution lookup will find them. This site does not

reproduce the URLs, because they change; use whichever entry point the authority currently publishes.

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In an emergency, do not spend time looking up lists. If your breathing, swallowing or speech is

affected, or swelling is spreading, go to the nearest emergency department.

Chinese labels to look for on the official pages

These official systems, datasets and files are published in Chinese only. The English names above are this site's renderings; on the page itself you will see the following strings, so search for these:

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- 「醫事機構查詢」

- 「特約醫事機構查詢」

- 「特約院所查詢」

Compliance note

This is health education information under Article 87 of Taiwan’s Medical Care Act, not medical advertising, and it does not recommend any particular institution. Orthodontic treatment has risks and contraindications; actual treatment approach and outcome vary by person and require a dentist’s assessment. [F35]

Every clinical statement in this article is mapped line by line to its cited source (see the sources and evidence chain below). It has not been clinically reviewed by a licensed practitioner. This is health information, not individual advice; assessment by a clinician is required.