Overcoming Open Bite: 4 Types, Causes & Treatment Options

Overcoming Open Bite: 4 Types, Causes & Treatment Options

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH
Medical Reviewed on Oct 18, 2023
byDr. Matthew Hannan DDS
🔬 Evidence Based
Overcoming Open Bite: 4 Types, Causes & Treatment Options

Do you or your child have an open bite? Understanding what causes open bite and other atypical growth discrepancies can help equip parents and caregivers with a head-start in their child’s oral development. Or to manage the condition if it’s affecting you personally.

What Is An Open Bite?

An open bite is when you or your child’s jaws are closed together—where the teeth should be biting down completely—but some of the teeth don’t touch. It creates an opening in one or more areas of their bite, with a visible gap between the teeth.

A properly developed bite (“occlusion”) allows for all of the teeth to close together properly throughout the entire mouth. But with an open bite, they don’t.

Normally, open bites are located at the front of the mouth. When your teeth are biting down, you can see between the upper and lower teeth. Sometimes open bites are on the side of the mouth, where the back chewing teeth like molars and premolars don’t occlude/hit one another.

Ideally, if you’re wondering “what is an open bite,” you’re probably catching it early, like in your child. If you’re an adult who has an open bite, you probably noticed issues like TMJ pain or worn-out teeth, which are direct effects of the condition.

Causes for Open Bite

Typically, an open bite develops because there is something physically impeding the formation of your “bite.” Just like your teeth are moved with braces, another issue may be preventing your teeth or jaw bones from properly forming early on during childhood. As a result, your bones and teeth are permanently displaced, creating an opening in your bite where it shouldn’t be.

1. Poor Oral Habits (Thumb Or Pacifier Sucking) 

Usually, what causes open bite conditions is pacifier or thumb sucking. While some sucking is a normal part of oral development, prolonged sucking on a pacifier, finger, or thumb past 18-24 months of age will physically reshape a child’s jaw, palate (roof of the mouth), and facial profile. These skeletal changes contribute to the open bite.

When a child is constantly keeping a pacifier or thumb in their mouth, their front teeth can’t close together properly like they’re supposed to. So, when your child bites down, you can see a large open bite between their upper and lower front teeth. This is not normal, healthy, or developmentally appropriate.

2. Genetics Or A Skeletal Problem

There are certain genetic conditions that can cause atypical skeletal development. In some cases, a child might “inherit” a poor skeletal relationship between the upper jaw and lower jaw from one of their parents, causing their teeth to not fit together properly whenever they’re biting down.

Most of these causes of an open bite are observed during childhood and adolescence. Those prime times are some of the best opportunities to help correct or limit the extent of developmental adult teeth and jaw issues.

3. Poor-Fitting Dental Restorations

Does your bite feel “high” when you’re closing down on a new crown or dental filling? If the shape of your restoration doesn’t occlude properly with the opposing permanent teeth—usually because it’s too high or there’s too much material—it can prevent other teeth from closing together all the way.

While it’s fairly normal for a temporary crown to not feel perfect around a tooth, permanent restorations shouldn’t cause these symptoms. Let your dentist know if you feel like you have an open bite. Normally they can check your occlusion with a special paper to see where things need to be adjusted.

4. Tongue Thrusting

Behind thumb sucking and pacifier use, tongue thrusting is one of the biggest causes of open bites. Tongue thrusting is when someone does not swallow correctly; instead of pressing their tongue up toward the top of their mouth when swallowing, the tip of their tongue presses forward into their front teeth.

When someone's tongue thrusts, you can usually see the tip of their tongue through their front teeth. This is not “correct” or “normal” swallowing and is usually the result of prolonged finger/pacifier/thumb sucking.

The constant pressing of the tongue against the front teeth causes those teeth to not close together properly. It’s like the reverse of wearing braces.

5. Temporomandibular Joint Disorder

A lot of the time, TMJ disorder (TMD/TMJD) is a side effect of having an open bite because you have to work your jaw joints harder in order to grind up your food.

But sometimes, it’s the other way around.

If there is some type of abnormality inside of your jaw joints (TMJ), it can prevent you from occluding/biting your teeth together all the way. The open bite might only be in one area or several spots throughout your mouth.

6. Facial Trauma

Suppose you’ve suffered a serious facial injury—like from a car wreck, athletic accident, or even domestic abuse—it can lead to broken bones and changes in how your teeth bite together. Jaw fractures can heal, but the bone might not always repair itself the way you want it to.

Whenever traumatic injuries cause noticeable changes in your bite, it’s important to act quickly. There could be swelling or bone damage that isn’t visible. Your dentist or an oral surgeon can take a full-mouth X-ray or 3D scan to see what’s going on and determine the extent of the damage.

Types Of Open Bite

Open bites are classified based on which part of your mouth is affected. Ultimately your entire mouth is changed by an open bite, but different types of open bites can come from different underlying issues. And that means the type of treatment that works for one might not work for another. When your dentist classifies the type of bite you have, it’s easier for other professionals to understand how to collectively treat the condition no matter which office you’re visiting.

In general, whenever you have an open bite, it’s going to fall into one of these categories:

1. Dental Open Bite

This is your “general” term used to describe any type of open bite that involves teeth but not jaw bones. Dental open bites mean that somewhere in your mouth, there are upper and lower teeth that aren’t biting together or overlapping each other correctly. They can be anterior dental open bites or posterior dental open bites.

You can tell that your dentist is checking for an open bite during your exam when they ask you to bite down. Sometimes they’ll even ask you to bite down and swallow while they’re holding your lips back.

2. Anterior Open Bite

Anterior Open Bite

An anterior open bite is the most common type of dental open bite. These open bite malocclusion (unhealthy bites) are where your front teeth don’t close together properly.

In an ideal situation, your front upper teeth will slightly overlap the lower front teeth. In an anterior open bite, you can see open space between your upper and lower front teeth, as well as visibly see all of the biting edges in those teeth.

An anterior open bite is usually what you see any time you have a child who is still using a pacifier, sucking their finger/thumb, or using a sippy cup well past 18-24 months of age. An anterior open bite tends to be self-induced in most cases because of the way those foreign objects reshape the baby teeth and jaws or alter how your child swallows.

3. Skeletal Open Bite

Skeletal open bite occurs when the jaws form incorrectly, growing away from one another instead of together. Other types of open bites are usually isolated to specific teeth in the mouth. But with a skeletal open bite, an extremely large area may be affected.

Most skeletal open bites are genetic. If one parent has them, their child is more likely to suffer from the condition as well.

This type of open bite is easiest to see on a profile X-ray called a “cephalometric” film. When you look at it, the back teeth are closest together, but the teeth get further apart as you move toward the front of the mouth, almost as if a triangle-shaped wedge were between the upper and lower jaws.

4. Posterior Open Bite

A posterior open bite is the opposite of an anterior (front tooth) open bite. These open bites involve the back teeth, like the molars and premolars.

Posterior Open Bite

With a posterior open bite, the front teeth close together properly, but even when you’re biting all the way down, the back teeth don’t touch each other.

Since the back teeth are important for grinding down food for digestion, this type of open bite can cause serious issues with nutrient absorption.

Signs Of An Open Bite

The most noticeable open bites are those in the front of your smile (anterior open bites.) When you or your child bites down, there’s a visible opening between the upper front and bottom front teeth. And when you swallow, you probably see the tongue push up against that area.

Another common symptom of an open bite is one you probably won’t notice unless you’re specifically looking for it: it’s the way you bite down into your food. Do you always move your food to one area of your mouth when you need to bite into it? For example, instead of biting straight into a sandwich with your front teeth, you might hold the food closer to one side of your mouth or another. This is an instinctive result of an open bite since those teeth aren’t hitting each other when your jaws occlude (bite down.)

People with open bites usually have worn-down teeth in one area of their mouth but not another. The teeth with the open bite may look perfectly healthy, but the other ones are flat, have sharp edges, or are chipped. That’s because they’re taking on most of the biting pressure every time you eat.

Is An Open Bite Bad For Your Teeth?

Yes. Having an open bite is bad for your teeth, jaws, diet, and even your quality of life if it’s causing chronic headaches or pain. Open bites shouldn’t be ignored, even if you feel like they aren’t hurting anything or aren’t visible. They’re bad for your teeth, jaws, muscles, and existing dental work.

Physically, an open bite makes your jaws/TMJ work harder when it comes to grinding and breaking down your food for digestion. This can lead to nutrient malabsorption. But orally, all of that uneven chewing can wear down certain teeth so that your bite is permanently “off” until those teeth are restored.

An open bite can contribute to:

  • snoring and sleep apnea
  • problems breathing properly
  • increased stress on teeth
  • tooth decay
  • gum disease
  • misalignments in other teeth
  • jaw misalignment
  • chipped or cracked enamel

Even though teeth are made out of the strongest and densest material in the human body, they aren’t invincible. Uneven pressure and biting patterns will cause teeth to wear down, break, and lead to fractures in any dental work in those areas.

How To Treat An Open Bite

The best way to treat an open bite is to first assess what is causing it. Maybe it’s because of an injury or is solely developmental. Ideally, you’ll be treating the open bite during childhood before full jaw development is complete.

Treatments for an open bite can be interceptive—like modifying growth patterns while they’re taking place—or with more conventional options like braces, high-pull headgear, and/or jaw surgery.

Depending on your age, the cause of your open bite, and the extent of your situation, your dentist or dental specialist might recommend one or more of the following common treatments:

1. Growth Modification/Oral Appliances

The best way to treat most open bites is with growth modification when children are young, while their mouths are still growing. These early interceptive appliances help correct growth patterns, which can prevent the need for jaw surgery or major orthodontic treatment a few years down the road.

2. Myofunctional Therapy

Normal muscle movements in your tongue and lips—like when you swallow—can move your teeth and influence how they bite together. Myofunctional therapy can help re-train your tongue on how to swallow correctly, allowing your open bite treatment to be more effective.

3. Braces & Headgear

Almost every treatment for open bites will involve some type of traditional braces or variation of orthodontic treatment. Since braces provide necessary tooth movement forces, as well as stability, they can be used independently or alongside other open bite treatments to correct the way your teeth fit together.

The brackets used for traditional braces can be bonded to specific points on your teeth, making those areas easier to “pull” down and close your bite together. Getting your open bite treated with this method even works for adults whose jaws are fully developed. 

Headgear is often used in conjunction with braces or other orthodontic appliances to correct an open bite. It is a device that consists of a strap or bands that go around the back of the head, and it is attached to a wire or other appliance in the mouth. The headgear applies pressure to the upper teeth and jaw, pulling them back and creating more overlap between the upper and lower teeth.

4. Clear Aligners

Removable clear aligners may be able to treat certain types of open bites but not others. If you have any type of open bite, your orthodontist or dentist will need to put tooth-colored “buttons” on your teeth for the aligners to grip onto. But don’t worry; they blend right in with your smile!

5. Jaw Surgery

Severe open bites—especially skeletal ones—may need to be treated with jaw surgery. In these instances, the oral surgeon will reposition your jaw and then splint it in place while the bones fuse back in the correct position. Similar to treating a broken bone that healed incorrectly.

Talk To Your Dentist

Ideally, the early signs of an open bite should be screened for by your child’s pediatric dentist, family dentist, or orthodontist. But if that wasn’t the case, it’s important to go ahead and seek out a professional evaluation to see if you or your child has an open bite.

Since open bites can cause challenges with eating, food absorption, TMJ disorder, and premature tooth wear, the earlier you seek out treatment, the better.

Your dentist can diagnose an open bite during your routine dental exam. Either through a visual inspection or by using occlusal paper to mark where your teeth are hitting (or not hitting) one another.

Overcoming Open Bite

What is an open bite? A condition where your teeth don’t close all the way together like they’re supposed to.

What causes open bite problems? Usually, something physically alters the growth patterns of your teeth and jaws. Thumb sucking, pacifier use, and tongue thrusting are the most common reasons.

How do you fix an open bite? The best solution is growth modification or orthodontic therapy when the individual is younger since their bones are still forming and growing. As an adult, the process can be a little more complex; orthognathic surgery might be required.

If you suspect that you have an open bite or your teeth aren’t closing together the same way on both sides of your mouth, talk to your dentist. And since children don’t “grow out of it” on their own, make sure your family is not skipping regular checkups!

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Dr. Matthew  Hannan DDS
Medical Reviewed byDr. Matthew Hannan DDSDr. Matthew Hannan is a board-certified dentist and graduate of UT Health San Antonio School of Dentistry.
Last updated onOctober 18, 2023Here is our process

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