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Ground Floor 70 Great Russell Street, Holborn, London WC1B 3BNProblems of open bite and different treatment options
An open bite is a type of malocclusion that occurs when some teeth do not make contact when biting down. This condition often appears when a child transitions from milk teeth to permanent teeth. In many cases, the open bite resolves on its own and does not persist into adulthood.
However, if the open bite remains into adulthood, treatment may be necessary to avoid further complications. For many, the thought of dental work, including correcting an open bite, can be daunting. This guide aims to explain everything about open bites to help you achieve successful treatment.
The following sections will provide information on:
- What an open bite is
- Symptoms of an open bite
- Problems caused by an open bite
- Treatment options, including Invisalign, veneers, surgery, and braces
Table of contents
- What is an open bite?
- What are the symptoms of an open bite?
- What are the problems resulting from an open bite?
- What are the treatment options?
- Open bite surgery
- Conclusion
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What is an open bite?
An open bite is a dental condition where the upper and lower teeth do not meet when the mouth is closed. Typically, the upper front teeth should slightly overlap the lower front teeth, and the molars should come together. In an open bite, however, there is a visible gap between the upper and lower jaws, as they do not connect properly. You may also experience other bite problems, such as a crossbite, underbite, or overbite, along with an open bite.
Anterior Open Bite
An anterior open bite occurs when only the front teeth do not meet, while the back teeth come together. This type of open bite is relatively uncommon and varies in prevalence depending on the country.
Posterior Open Bite
In a posterior open bite, the opposite happens—the back teeth do not meet when biting down, but the front teeth do. Posterior open bite is rare and often results from orthodontic treatment with braces. If this issue arises during treatment, your dentist will correct it.
What are the symptoms of an open bite?
The most common symptom of an open bite is a visible gap between the upper and lower teeth when the mouth is closed. This gap can be present at the front, back, or sides of the mouth.
Open bites are usually caused by problems with the jawbone. Excess bone growth at the back of the upper jaw can push the teeth out of alignment, leading to protrusion of the front teeth, a condition known as overjet.
What causes an open bite?
Several factors can cause an open bite, including:
- Sucking on a pencil, dummy, or pen
- Tongue thrusting
- Improper eruption of milk or adult teeth
- Jawbone problems
- Genetics
- Temporomandibular joint (TMJ) issues
While genetics may not be directly linked to open bite, a family history of jaw development problems increases the likelihood of a child developing similar issues.
If the open bite is caused by bone issues, it is known as a skeletal open bite. When other factors, such as dummy use or tongue thrusting, are the cause, it is referred to as a dental open bite.
What are the problems resulting from an open bite?
An open bite can lead to several issues, including:
- Lisping and other speech impediments
- Wearing down of the back teeth
- Self-consciousness and low self-esteem
- Difficulty eating
What are the problems resulting from an open bite in children?
Many infants and young children have an open bite, which usually resolves by the age of four. It can also occur when children transition from milk to adult teeth. Once a few adult teeth have erupted, it’s a good idea to take your child for a dental examination. If potential problems are identified, appropriate treatment should be pursued.
Everyday habits such as prolonged dummy use or putting objects in the mouth can disrupt bite development and affect the teeth.
What are the problems caused by tongue thrusting?
Tongue thrusting is a common cause of open bite. It occurs when the tongue pushes forward during speech or swallowing, gradually forcing the front teeth outwards into an open bite. Children often exhibit tongue thrusting behaviour, but most outgrow it by the age of four.
What are the issues resulting from jaw problems?
The temporomandibular joint (TMJ) functions like a hinge, allowing the mouth to open and close. TMJ problems can cause discomfort, leading people to shift their mouth and tongue for relief. The most comfortable position is often resting the tongue forward, which can push the teeth outwards, resulting in an open bite.
To correct an open bite caused by jaw issues, the underlying joint problem must be addressed before treating the bite.
What are the treatment options?
Treating an open bite in childhood increases the likelihood of success without surgery. For adults, surgery is often the most effective solution.
Your dentist is best suited to recommend the appropriate treatment. Children under 18 may receive treatment on the NHS if it is deemed medically necessary. NHS treatment for open bites in adults is typically only available for medical reasons.
The cost of treatment depends on the severity of the open bite, the type of treatment, and where you live.
Here is a summary of treatment options based on the patient’s age:
|
Age |
Treatment or Intervention |
|
0 – 6 |
1. Tongue thrusting and open bite are normal. 2. No intervention needed. 3. Limit dummy and thumb-sucking habits. |
|
7 – 10 |
1. Speech therapy for tongue thrusting. 2. Tongue crib for persistent tongue thrusting. 3. Dental exam to assess adult teeth. |
|
11 – 17 |
1. Braces for open bite. 2. Tongue thrusting therapy. |
|
Above 18 |
1. Jaw surgery. 2. Braces or Invisalign. 3. Veneers. |
Braces for open bite
Braces are a common treatment for open bite, helping to align protruding teeth. Treatment typically lasts between six months and two years, followed by retainers to ensure the teeth maintain their new position.
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Tongue thrusting treatment
If your open bite is due to tongue thrusting, treating this habit is essential. Treatment options include:
- Tongue exercises
- Tongue therapy
- Tongue crib appliances
A tongue crib, similar to a retainer, attaches to the molars and acts as a barrier to prevent the tongue from pushing forward. Speech therapists can provide exercises and therapy.
Treating tongue thrusting alone will not fix the open bite but will prevent it from worsening.
Invisalign treatment for open bite
Invisalign aligners can correct most malocclusions, including open bite. These transparent plastic aligners gradually shift the teeth into proper alignment. You need to switch aligners every two weeks.
The NHS does not cover Invisalign for open bite treatment, so it must be arranged privately. Invisalign can treat 90% of orthodontic cases, but you’ll need a smile assessment from an Invisalign dentist to determine your eligibility.
Veneers for open bite treatment
Veneers can address mild open bite cases. Veneers are thin coverings made from ceramic or composite materials, bonded to the front of the teeth after removing a small amount of enamel.
However, veneers are a cosmetic fix and do not fully correct the open bite. Potential downsides include:
- Making the teeth appear larger
- Interfering with braces or jaw surgery
- Failing to address underlying issues like tongue thrusting or worn back teeth
It is crucial to discuss the long-term effects with your dentist before choosing veneers.
Open bite surgery
Surgery is often required for adults with open bite, as their bones have fused, making non-surgical options less effective. Surgery may be covered by the NHS for those under 18 or if medically necessary for adults.
The cost of private open bite surgery ranges from £2,000 to £6,000. You may need braces before and after surgery, with recovery involving a liquid diet and some swelling.
Risks of open bite surgery
All surgeries carry risks, but open bite surgery is relatively safe and well-understood. Surgeons use computer modelling to plan the adjustments. During the procedure, screws are inserted to reposition the bones, improving your ability to eat and speak.
Conclusion
Open bites are easier to treat in children, as their bones have not yet fused. Children under 18 can receive free treatment on the NHS if the open bite affects their ability to eat or speak. Adults may also qualify for NHS treatment if it is medically necessary.
If you opt for treatments like ceramic braces or Invisalign, these will need to be arranged privately. For more information or to explore treatment options, contact London Braces at 020 3745 7520 to book an appointment with one of our dentists.
