A relationship name does not identify its contribution
A dental contribution concerns tooth position. A skeletal contribution concerns the jaw relationship. A mixed contribution includes both. Those are different explanations of what the assessment has identified, not a severity scale for readers to apply to themselves.
The orthodontist considers the teeth and jaws together, using the examination and appropriate records. Growth context is another part of that assessment. It helps explain why a growing-patient discussion may include a method with a different purpose from an adult's tooth-movement proposal.
The two people below are original fictional teaching examples with findings already supplied by an imagined clinician. They are not SMILE-FX® patient records, treatment offers or a way to diagnose your own bite.
Maya: a mixed contribution with growth context
Maya's fictional orthodontist explains: “Your assessment identifies a mixed contribution: the upper teeth/jaw relationship and the positions of the front teeth both matter. The assessment also records remaining growth relevant to discussing a growth approach.”
The proposed discussion has a stated direction. A protraction approach would address bringing the upper teeth/jaw relationship forward. Tooth alignment is a different job to explain within the wider proposal. A separate upper-width finding is recorded for its own widening discussion; it is not renamed as forward movement.
Maya's interpretation is complete: “The front relationship has more than one contribution. I understand which proposed change is forwards and which is across the upper arch. A device name alone would not tell me both.” This describes the supplied proposal's purposes, not a change already achieved.
Alex: an adult proposal addressing a primarily dental contribution
Alex's fictional orthodontist explains: “Your assessment describes a mild underbite with a primarily dental contribution. The goal in this proposal concerns front-tooth positions. We are discussing aligners for that tooth-movement job, after considering the teeth and jaws together.”
Alex now understands: “The aligner proposal is about the tooth positions identified in my assessment. The fact that my lower front teeth are ahead does not, by itself, mean my plan has the same purpose as Maya's growth discussion.”
This is a positive explanation of a selected dental-aligner role. It does not say that every adult underbite is dental or that aligners change an adult jaw relationship. A different assessed jaw contribution may lead to a different discussion, including possible combined care where appropriate.
What the comparison explains
Maya and Alex share a broad underbite description, but their supplied findings and proposed jobs differ. Maya's account connects a mixed contribution with assessed growth context and separates forward and width goals. Alex's account names a primarily dental contribution and a tooth-position goal.
The assessment is the missing link between a relationship name and an individual proposal. Neither a photograph, a birthday nor a preference supplies it. You can follow the explanation by keeping the contribution, growth context and intended change together.
Sources for this lesson
Sources: AAO: Underbite causes and options (2026) · BOS: Protraction headgear leaflet (2019)