Dental issues can be worrying, but dealing with an open bite can be especially challenging for both children and parents alike. An open bite can impact more than just your smile — it can have effects on self-esteem, oral hygiene, and overall health that last well beyond childhood.
Depending on your child’s age, an open bite may not be as big of a cause for concern as you initially thought. However, if left untreated, it can have serious and life-long health consequences for your child. Either way, it’s important to learn more about open bites so you can make the best possible decision for your child and family.
What Is an Open Bite?
An open bite occurs when the upper and lower front teeth lean outwards and do not touch when the mouth is closed or when biting down. This is a type of malocclusion (or misalignment) that is characterized by a vertical gap between the upper and lower teeth — thus the name “open bite.”
Open bites are relatively rare. One study discovered they are the least prevalent type of malocclusion. In general, young children are most likely to develop an open bite, but adults can have an open bite if it isn’t treated properly during childhood.
If you have an open bite, you may feel like your mouth is always open or like you can’t close it completely. In addition to being uncomfortable, an open bite can make it difficult to bite and chew and may affect speech and pronunciation. This can lead to other dental problems, particularly uneven wear and tear on your teeth and fractured teeth, if left untreated.
Anterior Open Bite vs. Posterior Open Bite
There are two main types of open bite: anterior and posterior. Anterior open bite occurs when your front teeth don’t overlap when biting down. This can happen with all, or even just some, of your front teeth. An anterior open bite can make it difficult to eat certain foods, especially those that need to be torn with the front teeth. It can also lead to speech problems or result in a lisp.
Posterior open bite, on the other hand, occurs when the back teeth do not touch while biting down. Unlike anterior open bite, the front teeth do touch. Further, a posterior open bite does not include other malocclusions, such as an overbite or an overjet. A posterior open bite makes it difficult, if not impossible, to chew food properly.
What Causes an Open Bite?
Both anterior and posterior open bites can be caused by several different things. Often, your genetics are the culprit; for example, if your jaws grow apart rather than parallel to each other.
An open bite can be caused by certain oral habits and behaviors, particularly those developed in childhood:
- Excessive pacifier use: When they’re young, children often suck on pacifiers, bottles, and other foreign objects (such as toys). Sucking can impact tooth alignment and cause an open bite, among other dental problems.
- Thumb-sucking: Additionally, sucking on the thumb, fingers, or toes can have the same effect. 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.
- Mouth breathing: Habitual mouth breathing is associated with myriad dental and oral problems. When children breathe primarily through their mouths, it can impact the growth and development of the teeth and jaw, resulting in an open bite.
- Sucking the lower lip: Similarly, sucking on the lower lip works to push the lower lips backward while forcing the upper lip forward. When done chronically, this can result in a variety of dental issues, including lip incompetence and open bite.
- Tongue thrusting: Incorrect tongue posture, placement, and movement can lead to an open bite. When children push their tongue between their teeth while speaking or swallowing, it can cause an open bite, as well as gaps between the teeth.
If you have children, you must teach them good hygiene habits and have ongoing discussions about health. Many of the behavioral causes of an open bite may not seem alarming in and of themselves, but they can have lifelong impacts for your child.
Finally, an open bite can be caused by external factors, such as an injury to the head, jaw, or teeth. Certain health conditions may also contribute to the development of an open bite, like temporomandibular joint disorder (TMJ). TMJ causes chronic jaw pain; as a way to find comfort, people 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.
Can an Open Bite Be Corrected?
Depending on the cause, you can correct an open bite without formal treatment or dental work. If behaviors like thumb-sucking or mouth breathing are addressed early enough in childhood, an open bite may correct itself after the mixed definition stage (or when children lose their baby teeth and their adult teeth start to grow in). If the problem persists after adult teeth come in or it’s caused by an external issue, you will need to find a local orthodontist to correct your open bite.
Open Bite Treatment Options
There are a variety of different ways to treat either an anterior or posterior open bite. Experts consider open bite to be one of the most challenging malocclusions to treat effectively, as many patients continue engaging in the behaviors that first caused their open bite, encouraging its development once again.
In addition to breaking these habits, it’s important to find the best treatment plan and orthodontist for your specific needs in order to permanently correct an open bite. It can be costly and intimidating, but the right orthodontist will help you find a treatment and financing plan that suits your needs.
Common orthodontic treatments for an open bite include:
High-pull headgear is used to control the growth of your jaw and properly align your 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 for children, whose jaws are not fully-formed, than for adults. High-pull headgear often must be worn for 12 to 16 hours per day, though that time can be broken up to suit your schedule.
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. Like high-pull headgear, it must be worn for many hours of the day and it is best for children whose jaws and mouths are still developing.
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, making it a great treatment option for children who frequently thrust their tongues. Because the 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 if they still maintain that habit.
Bite blocks are two pieces of plastic or wire that can be used to treat anterior open 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 do not yet have all of their adult teeth.
Braces and Clear Aligners
Braces and clear aligners like Invisalign can be used to treat an open bite for children and adults. Both must be worn for most, if not all, hours of the day as they work to slowly realign the teeth; sometimes this process can take up to several years. For adults, braces are often used in conjunction with behavior modifications (such as avoiding tongue thrusting) to ensure their effectiveness. Further, braces and clear aligners are likely best suited for older children who have all of their permanent teeth.
Surgery on your jaw can be used to treat severe or persistent open bites, including those caused by an injury or genetics. During the surgery, an orthodontist will reposition your jaw and secure it in place using metal plates and screws. Generally, surgery is best for adults with an open bite or children with their adult teeth.
Before making any decisions, it’s always best to schedule a consultation with an orthodontist to evaluate all of your options and find the best one for you and your child. An open bite can be hard to handle, but if you select the right approach to treatment, you can permanently correct the issue and enjoy a brighter smile for years to come.