An open bite is a type of malocclusion in which certain upper and lower teeth do not come into contact when the mouth is closed. It can affect the way you bite, chew, speak or swallow, although it does not always cause pain.
A gap that looks similar at first glance can have very different causes, and that difference can completely change the treatment approach.
What exactly is an open bite?
The most common form is an anterior open bite: the back teeth meet, but the upper and lower incisors remain apart. There is also a posterior open bite, where the side or back teeth do not come into contact.
The gap may be small and localised or form part of a more complex problem involving the position of the teeth and jaws. This is why simply seeing a gap between the teeth is not enough to determine which treatment will be most suitable.
Common symptoms and signs
The most common signs include difficulty biting into food with the incisors, less efficient chewing, changes in the pronunciation of certain sounds and the tongue resting between the teeth when speaking, swallowing or keeping the mouth at rest.
The impact depends on the location and severity. A mild open bite may cause little discomfort, while a more pronounced one can clearly affect oral function.
What causes an open bite?
Oral habits and tongue function
Prolonged thumb sucking, extended use of a dummy and other sucking habits can contribute to the development of an anterior open bite. The effect depends on factors such as the frequency, intensity and duration of the habit.
The position and function of the tongue should also be assessed. Persistent tongue thrusting can help maintain the gap or make the result less stable after treatment. However, it is not always the initial cause: sometimes the tongue simply adapts to an open bite that was already present.
Mouth breathing can coexist with changes in the position of the lips and tongue. If nasal obstruction or an airway problem is suspected, the underlying cause should be investigated rather than treating it as a simple habit.
Dental development and growth pattern
In some cases, the cause is mainly dentoalveolar: the teeth have erupted or become positioned in a way that creates a vertical gap. In others, there is a skeletal component related to facial growth or the relationship between the jaws.
This distinction is essential because an open bite of mainly dental origin is not treated in the same way as one associated with a skeletal discrepancy.
Can an open bite correct itself?
In some children, an open bite associated with a sucking habit may improve once the habit stops while the teeth and jaws are still developing. This does not happen in every case, so progress should be assessed individually.
If the gap persists, affects eating or speech, or is linked to a habit that is difficult to stop, an assessment is advisable. In adolescents and adults, diagnosis helps determine whether the problem is mainly dental, functional or skeletal.
How is it diagnosed?
The dental professional assesses which teeth come into contact, how the tongue and lips function, whether any oral habits are present and the relationship between the jaws. Depending on the case, the assessment may include photographs, X-rays, digital records or dental models.
Two patients with a similar anterior gap may require very different treatment approaches. This is why choosing a treatment based solely on the external appearance of the bite can lead to an unsuitable solution. The cause and severity are key factors when planning treatment.
Treatment options for an open bite
Habit control and treatment during growth
In children, the priority may be to stop the habit contributing to the problem and monitor how the bite develops. In certain cases, interceptive orthodontic appliances or dentofacial orthopaedics may be used.
When functional issues involving the tongue or swallowing are present, these factors may also need to be assessed. The aim is to prevent abnormal function from maintaining the problem or compromising the stability of the result.
Braces or clear aligners
Many open bites of dental origin can be treated with orthodontics. Braces allow the teeth to be moved and can be combined with elastics or other techniques.
Clear aligners may also be used in certain cases. Their suitability depends on the movement required, the complexity of the malocclusion and patient compliance, which means that not all open bites can be treated in the same way.
Miniscrews and skeletal anchorage
Orthognathic surgery in severe cases
When there is a significant discrepancy between the jaws and growth has finished, orthodontics alone may not be sufficient. In some adults with a severe skeletal open bite, a combined treatment involving orthodontics and orthognathic surgery may be considered.
Surgery is reserved for specific situations in which the underlying skeletal relationship cannot be adequately corrected by moving the teeth alone.
When should you seek professional advice?
An open bite should be assessed when it makes biting or chewing difficult, affects speech, persists after a sucking habit has stopped or becomes more noticeable over time. During growth, an examination allows us to assess whether it is better to monitor how the bite develops or to intervene.
As we also explain in our article about the most common reasons for having orthodontic treatment, these treatments are not limited to straightening the teeth; they can also help correct problems related to the bite and oral function.
At Quality Dent, we are a dental clinic located in Sabinillas and provide orthodontic treatments under the care of a specialist in orthodontics and dentofacial orthopaedics.
During an individual assessment, we examine the position of the teeth and the bite before recommending the most suitable option for each case. For us, the key is to identify the cause of the problem, not simply to close the gap between the teeth.
