Short answer: An open bite is when the upper and lower teeth, most often the front teeth, do not touch when the mouth is closed, leaving a vertical gap between them. Thumb or pacifier sucking, pushing the tongue against the teeth when swallowing, mouth breathing and the growth direction of the jawbones are the main causes. Treatment is planned according to age and cause, using habit control, an orthodontic appliance, braces, clear aligners or jaw surgery.
If your back teeth touch when you close your mouth but a gap remains between your front teeth, this is called an open bite in orthodontics. Also referred to in the literature as open bite, this bite problem is not only an aesthetic issue; it can also affect biting, speech and the pattern of tooth wear. Upper and lower teeth that do not meet are sometimes the result of childhood habits and sometimes of the direction in which the jaw grows.
In this article we cover the types of open bite, its causes, its effects on daily life and treatment approaches by age. We also look separately at the role of clear aligners in this problem.
What is an open bite?
An open bite is when opposing teeth cannot reach each other vertically while the jaw is closed. Normally, the upper front teeth slightly overlap part of the lower front teeth. In an open bite, this overlap is missing and a visible gap remains between the teeth.
Clinically, two types are usually described:
- Anterior open bite: The most common type. The back teeth close, but a gap remains between the incisors.
- Lateral (posterior) open bite: The front teeth touch, but the back teeth on one or both sides do not meet. It is rarer and is sometimes related to teeth not erupting enough.
A distinction is also made by origin: if the problem comes only from the position of the teeth, it is called a dental open bite; if it comes from the structure of the jawbones, it is called a skeletal open bite. This is the distinction that most shapes the treatment plan.
Causes: habits and skeletal structure
An open bite usually develops from several factors together; habits mainly shape the dental picture, while heredity and growth direction mainly shape the skeletal picture.
Habit-related causes
- Thumb, pacifier or bottle sucking: Short-term sucking habits are common during the baby-tooth stage and often cause no problems. However, if they continue after the permanent teeth start to erupt, they can affect the position of the front teeth.
- Tongue thrusting: Pushing the tongue between the front teeth when swallowing or speaking creates a constant force that keeps the teeth from closing.
- Mouth breathing: If the mouth stays open all the time because of enlarged adenoids or allergic nasal congestion, the position of the tongue changes and the vertical growth of the jaw can be affected.
- Lip or pencil biting: These habits, repeated over a long period, can also disturb the position of the front teeth.
Skeletal causes
In some people, the lower jaw grows too much vertically, downward and backward. In this case the lower part of the face looks long, and the front teeth cannot reach each other even if their own positions are correct. Family history is important in this type. Rarely, jaw joint diseases or trauma can also lead to an open bite later in life.
What are the signs, and how does it affect daily life?
The most obvious sign is a gap between the front teeth when the teeth are closed; in addition, there may be difficulties with biting and speech.
- Difficulty biting into foods such as apples, sandwiches or pasta with the front teeth
- A lisp or whistling sound with sounds such as "s," "z" and "sh"
- Chewing load concentrating on the back teeth, which wear down over time
- Lips that do not close comfortably, with the mouth resting slightly open
- In some people, concerns about their smile and self-confidence issues
These signs alone do not establish a diagnosis. The type and origin of an open bite are assessed with an orthodontic examination and records such as photographs and a cephalometric X-ray.
How does treatment differ for children and adults?
In children, the focus of treatment is removing the cause and guiding growth; in adults, since growth is complete, the position of the teeth and, if needed, jaw surgery come to the fore.
In children
During the baby-tooth stage, mild open bites often tend to correct themselves once the sucking habit stops. If the habit continues, behavioral methods and, if needed, habit-breaking appliances can be used. For children with tongue thrusting, appliances that guide tongue position and swallowing exercises with the support of a speech therapist contribute to treatment. If there is mouth breathing, an ear, nose and throat (ENT) assessment is recommended.
In teenagers and adults
Once all the permanent teeth are in, dental open bites can be treated with braces or clear aligners. In cases where the back teeth need vertical control, mini-screws can provide support. In marked skeletal open bites, orthodontic treatment is planned together with orthognathic surgery.
One important point applies at every age: if habits such as tongue thrusting are not brought under control, the risk of relapse after treatment increases. That is why the retention (retainer) phase receives particular attention in open bite treatment.
Can an open bite be treated with clear aligners?
Yes, in suitable cases an open bite can be treated with Invisalign clear aligners; this method is often preferred especially for anterior open bites of dental origin. Because the aligners cover the back teeth, they apply light pressure to them and help move the front teeth up and down in a controlled way.
Some of the advantages clear aligners offer in this treatment are:
- Simulating the vertical movement of the front teeth in advance with digital planning
- Keeping the back teeth under vertical control thanks to the thickness of the aligners
- Guiding movement with small attachments bonded to the teeth
- Easier oral hygiene, since they can be taken out and put back in
However, in marked skeletal open bites, clear aligners alone may not be enough. The success of treatment also depends on wearing the aligners consistently for 20–22 hours a day and giving up the habits. For more details, see our open bite treatment with clear aligners page, and to learn who the method suits, read our who are clear aligners suitable for article.
What can families watch for at home?
With a few simple observations, families can notice the risk of an open bite early, and this information guides the dentist during the examination. The aim is not to make a diagnosis at home but to note the signs that stand out.
- Is there a gap between the front teeth when your child closes their mouth?
- Does the mouth stay open during sleep or while watching TV, and is there snoring?
- Is the tip of the tongue visible between the teeth when swallowing?
- Does thumb sucking or pacifier use continue after age 4?
- Is there a noticeable lisp with some sounds?
When it comes to breaking a sucking habit, a patient and positive approach usually works better than punitive methods. Noticing the moments in the day when the child turns to the habit, suggesting activities that keep their hands busy and praising small successes can help in this process. If the habit continues, making a plan together with the dentist and orthodontist is the healthiest path.
When should you have an examination in Ankara?
If your child's thumb sucking continues after the permanent teeth come in, or their front teeth do not close, having an orthodontic assessment rather than waiting helps you catch the right timing. For adults, too, an examination clarifies the options if there are difficulties biting or speech problems. At our clinic in Oran, Çankaya, we use records to determine whether an open bite is dental or skeletal and discuss treatment options with the patient.
Frequently asked questions
Does an open bite correct itself?
During the baby-tooth stage, mild open bites can often correct themselves once the sucking habit stops. In the permanent dentition or in cases of skeletal origin, self-correction is not expected and orthodontic treatment is needed.
Can a tongue thrust habit cause an open bite?
Yes, constantly pushing the tongue between the front teeth when swallowing or speaking can lead to an open bite or prevent an existing one from correcting. For this reason, exercises targeting the tongue habit and, if needed, appliances are also used in treatment.
How long does open bite treatment take?
The duration varies with the type and severity of the open bite and the person's age. Cases of dental origin are usually completed in one to two years, while cases requiring surgery can take longer. The exact duration is determined after the examination and planning.
Can an open bite come back after treatment?
An open bite is one of the bite problems with a relatively high tendency to relapse. Wearing retainers consistently and keeping habits such as tongue thrusting under control reduce this risk.
