Written by Dr. Febin Mary George, BDS | Medically Reviewed by Dr. Shaista Salam, BDS, Dr. Zein El Hammouz, DDS, MFD/RCSI
1. Open bite: Definition, types, and causes
2. Fixing an open bite: Different treatment methods
3. What are the treatment options with Eon Aligner?
4. Open bite in kids: What should you consider?
5. Can open bite cause other problems?
Usually, an individual with a normal bite (known as ideal occlusion) has properly aligned upper and lower teeth that meet together when the jaw is closed. An open bite is a condition in which the upper and lower teeth do not make contact with each other (either at the front or back) when the mouth is fully closed, leaving a gap between them.
Before we jump into how to fix an open bite, let's understand what it actually means. An anterior open bite is when the upper and lower front teeth do not overlap while biting down, thereby creating a gap between the teeth even when the jaws are in a closed position. The normal overlap is around ⅓ of the lower teeth covered by the upper front teeth. This affects the patient’s smile, and consuming certain foods, particularly those that require tearing with the front teeth, can be quite challenging for people with anterior open bite. Additionally, it may result in speech difficulties or a lisp.
When the back teeth do not make contact while biting down, it results in a posterior open bite. However, the front teeth come in contact with each other. Due to the lack of proper contact between the back teeth, a person with a posterior open bite may find it challenging to chew food properly.
An open bite can happen due to various reasons, like the oral habits that you develop as a child. Genetics can also be held responsible in some individuals.
Here are some specific reasons for the development of open bite:
Sucking on the thumb, fingers, or toes can result in an open bite.(3) Most children typically discontinue thumb-sucking between the ages of two to four years. If the child persists with the habit even after losing milk teeth, the child is likely to develop an open bite.
Due to an existing underlying dental issue or an abnormally large tongue, children may develop the habit of pushing their tongue forward, thereby applying undue pressure on their front teeth. This habit is called tongue thrusting, and is one common reason for an open bite.
During early childhood, children tend to suck on everything they can put their hands on, including pacifiers or toys. This can affect the alignment of their teeth, leading to dental issues such as an open bite.
Generally speaking, an open bite is considered a relatively uncommon dental condition. The prevalence of open bite can vary depending on the population and geographic region studied. An article published in the American Journal of Orthodontics and Dentofacial Orthopedics reports that the prevalence of open bites can be anywhere in the range of 0.6% to 16.5%. (1)
Clear aligners are tailor-made removable trays that apply gentle, continuous pressure to guide teeth into their optimal position. The treatment involves a series of aligners designed and created to gradually shift the teeth. Aligners offer a convenient treatment option to improve the open bite.
Braces are one of the most conventional methods of treating various malocclusions, including open bites. It involves placing brackets on the teeth, through which metal wires are passed to move the teeth into the desired position.
An open bite of skeletal origin needs to be fixed with the help of jaw surgery. It is worth mentioning that braces alone cannot fix the open bite in most cases. Jaw surgery should be accompanied by braces or clear aligners to bring about changes in the position of the teeth.
TADs (Temporary Anchorage Devices) are small titanium mini-implants inserted into the jawbone to provide a stable anchor for orthodontic appliances. They help in treating anterior open bites by bringing about the intrusion of back teeth. (2)
The duration of the treatment depends purely upon the severity of the case. Hence, it may take between 8 to 12 months to correct simple cases of open bite with the help of clear aligners.
Eon aligners achieve relative or absolute extrusion of anterior teeth with the help of extrusion attachments. These are attached to the front teeth so that aligners can have a surface on which pressure can be exerted. When used along with elastics if necessary, attachments help in bringing about extrusion of front teeth for the correction of open bite.
To push the back teeth into the bone , horizontal rectangular beveled attachments are placed, and TADs could be advised to increase the predictability of the treatment. HRB attachments help in holding the aligners in place and anchor them to the neighboring teeth. After evaluating your dental condition, your doctor will choose the best treatment modality and how to fix an open bite for your case.
The timing of when and how to fix an open bite in a child depends on various factors, such as the severity of the open bite, the age of the child, the cause of the open bite, and the growth and development of the child's face and jaws.
Addressing an open bite as early as possible is recommended, ideally at the age of 8, while the child's jaws are still growing and developing. If left untreated, an open bite may become more difficult to correct as the child reaches adulthood.
In most cases, an open bite does not correct itself and requires orthodontic intervention.
Dentists can often detect an open bite during a routine dental exam by observing the patient's teeth and jaws. They may also use dental X-rays or other imaging tests to get a better view of the teeth and jaws.
Patient history can be of great significance. Therefore, dentists may ask the patient about their dental and medical history, including any previous orthodontic treatment or habits that could contribute to an open bite, such as thumb-sucking or lip-biting. After careful consideration of all the above, your dentist will decide how to fix an open bite.
Yes. An open bite can lead to other problems that directly impact your oral and overall health. It can also have a negative effect on your appearance, especially if it is an anterior open bite.
A person with an open bite (especially related to the back teeth) can experience issues while chewing food leading to diet-related health issues.
An open bite can affect speech and cause lisping or other speech impediments.
An open bite can lead to mouthbreathing as the lips are incompetent in most cases. Another reason for mouthbreathing could be structural issues in the throat and mouth, making it really difficult to breathe normally through the nose.
An open bite can put extra strain on the jaw joints, which can lead to TMJ disorder. This can cause pain and discomfort in the jaw, headaches, and difficulty opening and closing the mouth.
If left untreated, a malocclusion such as an open bite can become more excessive over time.