Open bite: types, causes and how to fix it

Among the types of tooth malocclusion, one of the most common is an open bite. This type of bite is identifiable because a person with this malocclusion cannot close their mouth properly. This is because the position of their teeth prevents them from doing so.

Beyond the aesthetic difference that an open bite can produce, there can be other implications. These include challenges with speech, breathing, chewing and even muscular pain. This article explores this bite and the problems that keep it open. We also discuss side effects on the patient and corrective treatments for children and adults.

What is an open bite?

If you're wondering what an open bite is, it's a type of malocclusion that makes it impossible for the front or back sets of teeth to close properly. As a result, it leaves some areas with no contact between the teeth of the upper and lower arches.

Types of open bite

There are different types of open bite depending on which teeth are not in contact with those of the opposing arch.

Below we will review the four types of open bite that can be found depending on which part of the occlusion cannot be performed correctly:

Posterior open bite

Posterior open bite is a malocclusion in which the upper back teeth (molars) do not make contact with the lower back teeth, preventing occlusion at the back of the mouth. This type of open bite may not be visible to the naked eye, as the malocclusion occurs on the inside of the mouth.

Anterior open bite

The anterior open bite is the most common of the existing types of open bite. An anterior open bite occurs when the upper and lower front teeth do not occlude properly, leaving a gap between the teeth at the front of the mouth. It is the easiest type of open bite to identify, as it is the most visible.

Lateral open bite

A lateral open bite is when the occlusion occurs on only one side of the mouth, either the left or the right.

Complete open bite

A complete dental open bite is a combination of a posterior and anterior issue. In this type of bite, the last molars of the dentition are the only ones that touch, so there is no occlusion between some molars and all the front teeth.

What causes an open bite?

The causes of this bite complexity can vary significantly and, in some cases, are unavoidable, such as those which are a result of genetics.

Below we will look at the most common causes of open bite and how they can be avoided when it comes to the bad habits that can trigger it.

Genetic skeletal bite complexity

Genetic inheritance or developmental problems are the causes of a skeletal open bite, which cannot be avoided. In cases where the cause is genetic, parents and other relatives should undergo tests to find out the source of the problem. On the other hand, if it is due to developmental issues, it cannot be avoided by changing habits, as the open bite is a result of a lack of development in the teeth or bone structures. An example of this could be a narrow dental arch.

Habits acquired during childhood

Habits can be acquired during childhood that contribute to the development of an open bite and other issues with bite. Parental involvement in the developmental phase is important to avoid any type of malocclusion surfacing that may have consequences for the child's oral development.

Below, we look at the habits that can lead to this type of bite forming:

Open bite from a dummy or bottle

One of the main causes of an open bite is often the prolonged use of a dummy or baby’s bottle. Overuse of these during a child’s developmental phase can affect the alignment of the teeth, which can lead to an open bite.

Open bite from thumb sucking

A baby, young child, or adult that sucks their thumb can cause problems with their permanent teeth and create issues with jaw development. If the habit hasn't stopped by the time a person's baby teeth fall out, patients can experience dental problems. This usually impacts alignment with their upper and lower teeth.

Open bite from tongue thrust

In many cases, the habit of tongue thrusting (placing the tongue in incorrect positions in the mouth) can be a cause for open bite. When speaking or swallowing, poor tongue positioning can cause the arches to separate and an open bite to develop.

Open bite from mouth breathing

Another trigger for an open bite is breathing through the mouth instead of the nose. Mouth breathing can alter the natural position of the teeth and muscles, affecting the way they develop, an the overall oral health of a person.

Side effects of an open bite

Having an bite that doesn't close correctly can lead to a series of problems and health issues, beyond the aesthetic issues it can cause the patient.

Below we will look at the main side effects of having an open bite and the problems it can cause for our health:

• Speech problems

An open bite means that the mouth cannot close properly, which makes the pronunciation of some phonemes complicated. Having an open bite prevents the tongue from being positioned as it should, thus causing speech difficulties.

• Issues with biting and chewing

As this type of bite prevents proper occlusion, it can be difficult to chew certain foods correctly. The impact can lead to digestive problems.

• Respiratory problems

Mouth breathing is both a cause and a side effect of having an open bite. Malocclusion can encourage mouth breathing, which in turn can further aggravate the problem.

• Temporomandibular disorders (TMD)

This type of bite creates more tension and stress on the jaw muscles and joints, which can lead to headaches, neck pain or bruxism.

How to fix an open bite: treatments and solutions

There are different treatments for the correction of an open bite, but depending on the age of the patient and the degree of malocclusion, one or the other will be chosen. Below, we will discuss the most appropriate solutions to fix an open bite for each age group.

Treatments for open bite correction in children

Being in the developmental phase, childhood is the perfect time to consider how to fix an open bite with a treatment that would prevent problems in adulthood.

The most suitable treatment for correcting this bite complexity in children is interceptive orthodontics, as we will explain further.

Interceptive orthodontics

The most common treatment for correcting open bite in children is interceptive orthodontics with different devices. In many cases, appliances such as grids are often incorporated to stop the habit that causes the open bite. These devices can also help to reposition the tongue in cases where the open bite has been caused by problems with swallowing.

This type of treatment as a solution for an open bite malocclusion is only effective in children, as once the bones are fully developed, it is not possible to further intervene.

Correcting an open bite in adults

In cases of open bite in adults, interceptive orthodontics is not effective because bone development is complete at this stage. There are other solutions for correcting an open bite in adults, with and without surgery, as we will see below.

Orthognathic surgery to correct open bite in adults

Orthognathic surgery, or jaw surgery, is used in cases of severe open bite. Surgery is normally combined with a phase of orthodontic treatment before and after the operation.

Stages of corrective jaw surgery

1. Prior to surgery, an orthodontic phase is carried out in which each tooth is placed in the correct position.
2. Next, orthognathic surgery is performed, which fixes the open bite by altering the size and position of the upper and lower jaws.
3. After surgery, orthodontics is applied again to successfully complete the treatment, correct the bite and achieve an aligned smile.

Orthodontic treatments for non-surgical open bite correction

Non-surgical methods of correction can be used in adults for mild to moderate cases of a bite that is open. For example, orthodontics with aligners or braces can be used to modify the malocclusion and fix the open bite.

Orthodontics with aligners and braces combine intrusive or extrusive movements on anterior or posterior teeth, depending on the type of bite. In some cases, it needs to be accompanied by auxiliary elements such as micro-screws.

Impress treatments for you

At Impress we can help you fix your bite with orthodontics regardless of your age, as we offer treatments for kids, teens and adults.

Children with a suspected bite issue require a thorough assessment of the case. Only then can the best course of action be agreed upon. We design a personalised treatment plan with interceptive orthodontics to correct the bite, whether open, crossed or any other type of treatable malocclusion.

If the case to be treated is in teens or adults, we offer various orthodontic treatments. Those with Impress clear aligners are suitable for correcting an open bite efficiently and discreetly.

If you would like us to assess your case, our team of orthodontic specialists is here to assist. Check out our clinic locations to find your nearest Impress clinic, make an appointment online, by phone on 020 3808 1072, or via WhatsApp.