What is an open bite?
In a normal bite, the upper front teeth slightly overlap the lower front teeth when the mouth closes. In an open bite, a vertical gap remains between the front teeth. This can make it harder to bite into foods such as sandwiches or pasta with the front teeth, and can affect how sounds such as “s” and “z” are pronounced.
Causes
- Thumb sucking and dummies: When these continue while the permanent teeth are coming in, they can prevent the front teeth from erupting fully.
- Tongue thrust: Pushing the tongue between the front teeth when swallowing and speaking
- Mouth breathing: Due to a blocked nose or enlarged tonsils and adenoids
- Skeletal causes: Excess vertical growth of the jaws
- Jaw joint problems: Rarely, changes originating in the joint
Treatment in children
In children, open bite is often linked to habits, and some cases correct themselves once the habit stops. Where needed, habit-breaking appliances, palatal expansion and tongue exercises can be used. If the child breathes through the mouth, an ear, nose and throat assessment is important.
Treatment in adults
Clear aligners
In open bites caused by the teeth, clear aligners can be used to bring the front teeth down in a controlled way and to intrude the back teeth slightly. The thickness of the aligners over the back teeth can also contribute to this movement.
Brackets and mini-screws
In more pronounced cases, brackets can be used and, where necessary, temporary mini-screws to intrude the back teeth.
Orthognathic surgery
In a marked skeletal open bite, orthodontics and jaw surgery may need to be planned together. For details, see the skeletal jaw problems page.
Long-term stability
An open bite tends to come back, especially if tongue thrusting continues. That is why monitoring tongue habits after treatment and regular retention are important; exercises for tongue posture may be recommended where necessary.