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Open bite

An open bite is a malocclusion where the upper and lower teeth do not meet when biting down. It often occurs during the transition from milk teeth to permanent teeth. Open bite often corrects itself and doesn't remain in adulthood. However, if a child develops an open bite as they get older and the anterior open bite remains, treatment will be necessary to avoid problems in the future.

If you have an open bite, it is important to know what it is, its symptoms, the problems resulting from an open bite and your treatment options.

What is an open bite?

An open bite is when some of the upper and bottom teeth do not meet when the teeth are closed. Usually, the upper front teeth are slightly in front of the bottom teeth, and the molars at the back fit into each other.

With an open bite, your teeth don't come together properly, leaving a gap between the top and lower jaws. You can have an open bite with other types of malocclusion, like an overbite, crossbite, or underbite.

Anterior open bite  

An anterior open bite is when the front teeth don't connect properly, but the back teeth make contact. About 1.5 – 11% of people may have some degree of open bite, depending on the country.  

Posterior open bite

The back teeth do not meet in a posterior open bite, but the front teeth connect. This type of open bite isn't common but may require treatment with braces.

What are the symptoms of an open bite?

An open bite is easily identifiable by looking at your teeth when you bite down. You will notice space between the top and bottom teeth in the front or on one or both sides. If the underbite results from any problem with the jawbone, it is likely from excess bone growth at the back of the upper jaw. This growth pushes the teeth out of alignment, resulting in protrusion of the front teeth.

What happens if you don't correct an open bite?

An open may result from an inherited pattern in jaw growth. It may also result from behavioural factors like thumb sucking or injury. An untreated open bite may lead to an out-of-normal appearance and other concerns such as:

  • Altered saliva flow
  • Lisping or other speech difficulties
  • Trouble with chewing food and biting down
  • Excess forces on the back teeth may lead to the wearing down or cracking of the back teeth
  • Issues with swallowing

You can treat an open bite at any age, but correcting it in childhood or adolescence is easier.

What causes open bite?

An open bite can result from several causes. They include:

  • Tongue thrusting
  • Temporomandibular joint problems
  • Milk and permanent teeth are coming through
  • Jawbone problem
  • Genetics
  • Dummy, pen, pencil or thumb sucking

The genetic causes of open bite aren't fully understood, but if you have a family history of problems with jaw development, you and your child will likely have this problem.

If an open bite occurs from bone issues, it is known as a skeletal open bite, but if it results from habits like dummy sucking or tongue thrusting, it is a dental open bite.

What are the problems with an open bite?

An open bite can cause certain noticeable problems, such as:

  • Increased wear on the back teeth
  • Lisping and other speck difficulties
  • Difficulty eating some foods
  • Self-consciousness if you aren't comfortable with how your smile looks

Open bite problems in children

Open bite is common in infants and young children but usually corrects itself around age four. An open bite is likely to occur when the milk teeth fall out, and the adult teeth erupt.

When a few adult teeth have come through, the dentist can check the new teeth' alignment and advise on the correction options if there are any problems. If a child uses a dummy often or sucks their thumb, this may affect bite development.

Problems from tongue thrusting

Tongue thrusting, which means when the tongue thrusts forward when you talk or swallow, is a major cause of open bite. This makes the front teeth gradually move forward into an open bite.

Tongue thrusting is quite common in children, but they usually outgrow it by age four. If it persists, you may get a recommendation for treatment options.

Jaw problems

The temporomandibular joint, or TMJ, is the hinge allowing the mouth to open. Some people who have problems with this joint move their tongue and mouth around to feel comfortable. They usually get comfortable by resting their tongue between the teeth or forward in the mouth, but this can push the teeth forward, resulting in an open bite.

The underlying cause of the jaw problem requires treatment and the treatment for an open bite.

Treatment options

Several treatment options for an open bite are available, but identifying the problem in early childhood increases the chances of correcting the open bite without surgery. Open bite treatment for adults is usually surgery.

Your dentist will recommend the right treatment option. If you are below 18 years and the open bite treatment is medically necessary, you can get free dental treatment from the public healthcare service.

Below is a summary of treatment options for different age groups.

Age Treatment or intervention options

0 – 4

No need for intervention

Open bite and tongue thrusting are normal

Restrict dummies and thumb sucking

7 – 10

Speech therapy for tongue thrusting

A dentist can identify if the adult teeth are coming through in an open bite 

Wear a tongue crib if the tongue thrusting persists

11 – 17

Tongue thrusting therapy and treatment may still be successful

Braces to correct an open bite


Invisalign and braces are still options

An untreated open bite in adulthood will likely need surgery

Jaw surgery since the jaw has finished growing

Veneers are also an option

Braces for open bite

Open bite treatment with braces is common. The orthodontic braces will help pull the teeth pack if they sit forward and into proper alignment. The treatment can last six months to two years, followed by wearing retainers. Retainers are important to ensure the teeth remain in their new position.

Treatment for tongue thrusting

If the open bite occurs from tongue thrusting, treating the cause of this problem is important, including the dental issue. The common treatments include:

  • Tongue exercise
  • Tongue therapy
  • Appliances like a tongue crib

A tongue crib or cradle is similar to a retainer that attaches to the molars. It places a barrier across the mouth, which prevents forward tongue movement. A speech therapist can offer therapy and exercises. Your GP can refer you to a therapist for treatment.

Stopping tongue thrusting will not correct tooth misalignment, but it ensures the bite problem doesn't worsen and prevent relapse after braces treatment.

Can clear aligners correct an open bite?

At-home clear aligners like NewSmile and SmileDirectClub may be effective for some open bite cases, but the treatment option is tailor-made. Clear aligners are usually for crowding and spacing conditions but can give good results for minor bite issues.

At-home aligners are more affordable than metal braces. They cost about £1600, and monthly payment options are available in most dental practices, making payment easy and convenient.

Can Invisalign correct an open bite?

Invisalign can correct an open bite, including other malocclusions. The treatment requires clear, plastic aligners that fit snugly over the teeth. You need an appointment with an Invisalign provider to discuss your treatment options.

Can you correct an open bite with veneers?

If the open bite is minor, veneers may be a treatment option. Veneers are thin coverings made of composite or ceramic material. Fitting a veneer requires scraping a small amount of the enamel.

Although correcting an open bite with veneers is possible, it may only cover the problem. Some downsides of using veneers include:

  • The teeth will look bigger – The veneer will need to be longer than the natural teeth to close the gap
  • More alignment issues may occur because of the new force in the mouth
  • Any future jaw surgery or braces treatment will be harder because the brackets can't adhere to veneers
  • It may not correct the underlying issue like increased wear on the back teeth or tongue thrusting

Your dentist will advise you about using veneers to correct your open bite, and you have much to consider about your long-term oral health. If the open bite is small and doesn't cause eating or speech problems, veneers may be the right option to improve your smile.

Open bite surgery

Depending on the open bite's severity, surgery may be necessary. Adults are more likely to require surgery because bone fusion is complete, and the bones are less likely to move. Surgery for an open bite may be free for those under 18 if the procedure is medically necessary. Open bite surgery can cost between £2000 - £6000 in private dental practices.

You may need braces for about one year before the jaw surgery and six months afterwards. This surgery doesn't leave scars because the incisions are inside the mouth, but you will be on a liquid diet for a couple of days and may experience swelling.

Risks of open bite surgery

Like any surgery, open bite surgery has some risks. However, jaw surgery is common and dental professionals fully understand the healing process.

The doctor can use computer modelling to map the adjustments to be made. This process which involves breaking bones and plates and fitting screws, may sound scary, but the benefits include eating well and improved speech.

If your upper and bottom teeth do not come together properly, visit McKennell Dental Practice for open bite treatment. You can contact our dental clinic on 020 7834 8802 to book an appointment.

Frequently asked questions

Yes, you can. However, it depends on the severity of the open bite. The orthodontist can assess your case and discuss your treatment options. You may need clear aligners or braces to realign your teeth.

An open bite in children can correct itself as the jaw develops. Close monitoring by a dentist is important in case surgery or orthodontic treatment is necessary. However, an open bite in adults with a fully developed jaw doesn't correct itself.

An open bite treatment usually involves an orthodontic treatment, but clear aligners are an alternative to fixed metal braces if you don't want a conspicuous treatment option.