What Is An Open Bite? | How Is It Treated?

An open bite is when the upper and lower teeth do not touch when the mouth is at rest. This can happen on either side of the mouth but is most common with the front teeth. Open bites are quite rare. One study discovered that they are the least prevalent type of misalignment. If you have an open bite, you may feel as though your mouth is always open or as if it cannot close completely. This can make anyone feel uncomfortable and self-conscious about their smile, breath, and general appearance.  In addition, an open bite can make it difficult to bite and chew and may affect speech and pronunciation. An open bite can also lead to other oral health issues including uneven wear on your teeth and fractured teeth.

What Is The Difference Between Anterior vs. Posterior?

There are two types of open bite: anterior and posterior.

• An anterior bite occurs when your front teeth do not overlap when biting down. This can happen with all, or even just some of your teeth. An anterior bite can make it difficult to eat certain foods and can lead to speech issues or result in a lisp.
  
• A posterior bite occurs when the back teeth do not touch while biting down. Unlike anterior open bite, the front teeth do touch. A posterior open bite makes it difficult, if not impossible, to chew food properly.

What Causes An Open Bite?

Both anterior and posterior bites have many causes, often being genetics. An open bite can be caused by certain oral habits and behaviors, particularly those developed in childhood:

• Excessive pacifier, bottles, and other objects (such as toys). Sucking can impact tooth alignment and cause an open bite, among other oral health issues later in life.
• Sucking on the thumb, fingers, or toes. Most children stop sucking their thumb between two and four years of age, but if they continue this habit after losing their baby teeth, it can result in an open bite.
• Habitual mouth breathing is associated with a number of oral health issues, including open bite. When children breathe primarily through their mouths, it can impact the growth and development of the teeth and jaw.
• Sucking on the lower lip pushes the lower lip backward while forcing the upper lip forward. When done chronically, this can result in a variety of oral health issues, including lip incompetence and open bite.
• Incorrect tongue posture, placement, and movement can lead to an open bite. When children push their tongue between their teeth while speaking or swallowing can cause an open bite as well as gaps between the teeth.

Teaching children proper oral hygiene habits can have a strong impact later into adulthood. Many of the behavioral causes of an open bite may not seem alarming, but they can have lifelong impacts for your child if left to become chronic conditions.

An open bite can also be caused by external factors, such as an injury to the head, jaw, or teeth. These can happen at any age, but again, if in a child and left untreated, the injuries can cause multiple oral health issues including open bite. Certain health conditions may also contribute to the development of an open bite, such as TMJ. As a way to find comfort, some patients may use their tongue to reposition their jaw, leading to an open bite. However, these tend to be less common than genetic or behavioral causes.

How To Correct An Open Bite?

Preventative treatment at home is always best to ensure open bite issues do not occur. If behaviors such as thumb-sucking or mouth breathing are addressed early enough in childhood, an open bite may be nothing to worry about. If the habit continues after adult teeth come in, or is caused by an external injury, you may need corrective treatment.

There are several ways to treat either an anterior or posterior bite. Common orthodontic treatments for an open bite include:

• High-Pull Headgear | High-pull headgear is used to control the growth of the jaw and to properly align teeth. Typically used in conjunction with braces, the headgear is attached to the top and back of the head, as well as the upper jaw. This treatment works better on children whose jaws are not fully-formed. High-pull headgear must be worn for 12-to-16-hours each day.
• Vertical Chin Cups | Vertical chin cups, also called vertical pull headgear, is used to guide the growth of the lower jaw. It prevents the chin from growing backward or downward by holding the mouth in a closed position. It attaches with straps over the chin and back of the head. The device must be worn for 16-to-18-hour each day and it is best for children whose jaws are still developing.
• Roller Appliances | Roller appliances consist of a small bead connected to braces that are attached to a molar on each side of the upper jaw. They block the tongue from pressing against the teeth. Because this appliance is attached to braces, it is worn during all hours of the day. Roller appliances can also be used to discourage older children from sucking their thumbs.
• Bite Blocks | Bite blocks are two pieces of plastic or wire that are used to treat anterior bites. They are affixed to two back molars on either side of the lower jaw. They help move the teeth back and remove the space between the upper and lower teeth. Bite blocks work well for children who still need most of their adult teeth to erupt.
• Braces and Clear Aligners | Braces and clear aligners can be used to treat an open bite for both children and adults. Braces are cemented in places to ensure they cannot be removed, however, since clear aligners are removeable, it is important to know that the aligner must be worn for 20-22-hours each day. Both options are great for both adults and children (as long as the child has all of their permanent teeth).
• Surgery | Surgery on the jaw can be used to treat severe or persistent open bites, including those caused by an injury or genetics. During the surgery, your orthodontist, or oral surgeon, will reposition the jaw and secure it in place using metal plates, brackets, and screws. Generally, surgery is best for adults who have all their permanent teeth and are no longer developing the structure of their jaw and face.