What is Open Bite? Overview, Symptoms, Causes & Treatments

What is Open Bite? Overview, Symptoms, Causes & Treatments

What is an open bite?

Open bite finds its roots in the widely understood malocclusion issues of teeth. If we look at malocclusion’s definition, it is the misalignment or distance in two teeth arches, which is visible once the jaws are closed. Among all of such deformities, an open bite is the most difficult to treat. These deformities occur in three planes namely, sagittal, transverse, and vertical plane. An open bite is the one that occurs in the vertical plane. It is thoroughly characterized by the failure of proper overlap between the maxillary and mandibular sections. 


Open bite is alluded to as no contact between front or back teeth. The multifaceted nature of open bites is credited to a mix of skeletal, dental, and constant variables. It traces back to hereditary qualities, anatomic and ecological elements. Be that as it may, the inclination toward backsliding after customary or careful orthodontic treatment has been demonstrated. Till date, an open bite is the most challenging and tedious dentofacial problems to treat. 

Failure of tongue adjustment resulting in orthodontic or potentially careful treatment may be the essential explanation behind backslide of an open nibble. Delayed maintenance with fixed or removable retainers is fitting and fundamental by and large open bite treatment. With so many advancements, it still stands as a test for clinicians’ stays; cautious determination and ideal mediation with appropriate treatment modalities and apparatus choice will improve the treatment results and long haul steadiness.

Classification of an open bite

Open bites are classified based on region as

  • Anterior open bite: it is known as the traditional one and occurs to the majority of patients. No overlap takes place between upper incisors and lower incisors. It means that the frontal teeth are not able to touch each other. It is necessary to undergo treatment to save yourself from the problem of tearing food with front teeth. Problems in speaking can also be faced.
  • Posterior open bite: In the posterior open bite the posterior teeth and not able to touch each other which is basically because of the hinging action of the jaw. It hinders the process of chewing.

Based on etiological factors, it is classified as

  • Skeletal open bite
  • Dental open bite

In a skeletal open bite, there is an increase in the plane angle of maxillary and mandibular. You also face an increase in the lowering of your facial height. In a dental open bite, there is a continuous and increased eruption of posterior teeth. This may result in irregular development of molars or jawbones with huge spaces between them.

On the basis of the molar relationship, it is classified as

    • Class 1 open bite
    • Class 2 bite


  • Class 3 occlusion


In the first class, bite patterns are normal which means the distance or gap created between the teeth is balanced. In the second class, the first lower molar teeth are positioned a little backward than normal. In this case, the upper teeth protrude more than the lower ones and may be called an open bite. Lastly, in the class 3 bite, the patterns are totally opposite to the former abnormal patterns. Here the lower molar is positioned towards the front of the mouth. The upper molar is pushed back and resultantly, an underbite is formed where the lower teeth and jaws protrude more than the upper ones.

Types of open bites

Open bites come in many forms and shapes. These are:

  • Simple open bite: This refers to the condition when some teeth are unable to meet the line of occlusion and no other abnormal measures are observed according to the cephalometric analysis.
  • Complex or skeletal open bite: This refers to the type where a revelation about the disharmonies of the anterior face height in skeletal components is discovered through cephalometric analysis.
  • Compound open bite: In this type of open bite, all parts of teeth are completely open including the molars. This type is also known as an infantile open bite.
  • Iatrogenic open bite: This type of open bites takes place as a result of orthodontic or surgical therapy.
  • Anterior open bite
  • Posterior open bite

Causes of an open bite

Many genetic and environmental factors lead to the formation of open bites. Some of these are:


  • Sucking of objects – you may have notices people around you who like to suck their thumb or other things like pencils. In doing so, they unintentionally create a gap between their teeth, which may result in open bites. During sucking, the jaws are joined but the object between the anterior teeth prevents them from occlusion.


  • Thrusting – another factor that serves as both cause and symptoms of the open bite is the tongue thrusting. People who push their tongue between their teeth a lot during swallowing, talking, etc are prone to develop an open bite. This is because they disturb the alignment of occlusion.
  • TMD – known as the temporomandibular joint disorder may result in an open bite. Severe and chronic jaw pain is associated with this disorder and patients, in the effort to get rid of the pain uses their tongue to push the upper and lower teeth apart. This helps them to relieve the pain.
  • Skeletal disposition – an abnormality in the skeleton also leads to open bites and it is the hardest to treat. Often controlled by genetics and influenced by the environmental factors, your jaws oppose each other instead of growing in a parallel manner. This leads to the formation of an open bite.
  • Other factors – abnormal growth patterns, tongue, and other muscle activities, genetics, orofacial subjects, and posture imbalance.



Some innate behaviors contribute to open bites like abnormal swallowing and getting your tongue in between the top and bottom teeth when you speak. It is, however, not as significant a factor as the others are. Mouth breathing is another important etiologic factor that accounts for open bites’ formation. It may result from anatomic conditions, nasal obstructions, or simple habits. In this type of breathing, your tongue is lowered that increases the inter-maxillary space, and hence an open bite.

  • Iatrogenic factors – these are the factors that are the results of other medical treatments and advice. Extrusion of molar teeth may lead to an open bite formation.

Treatment of open bites

Before we proceed to the treatment options of an open bite, first we need to address the need for a therapy. Many patients and families ask that an open bite isn’t painful so why is it important to get it treated. Others, however, look through the problem and understands the abnormality. Open bites have effects both aesthetic and clinical and even if you don’t realize it now, you will want to get rid of it one day. Some common side effects of open bites are:

Your apparel – just imagine how would you look when your front teeth cannot join together? People with open bites don’t like to smile properly because they are not comfortable with the way their teeth appear and to be honest, no one likes an open bite smile

Talking style – open bites patients usually develop abnormal speech habits. It interferes with the pronunciation and speech patterns of a patient. This condition’s severity depends on the epigenetics and behavioral genetics of the patient. One such example is the development of a lisp because of the openbite

Eating problem – if your teeth don’t join properly, you may develop an eating disorder. This can be clinical or psychological. Patients of open bites often think that they can’t chew properly because of the space between the upper and lower teeth. This feeling, be it psychological, makes you sick and you will eventually develop an eating problem.

Dental issues – open bites result in the protrusion of back teeth and they start coming together, which results in discomfort. This may also lead to tooth fracture or other serious dental issues and for which you may have to undergo surgery.

Treating the bites

Anterior open bites are the most primary sorts of dentitions resulting from malocclusions and, therefore, many treatments exist to get over this problem. Any treatment depends on the age of the patient primarily. Similarly, treatment for open bites is also different for babies and adults, essentially, as teeth sets are different. Most common treatment options are:


  • Behavioral treatmentsmostly applicable to the kids. In this treatment, the doctor manages to prevent activities like sucking and thrusting
  • Invisalign open bite or braces this is called mechanical treatment and pushes the teeth together. It is quite painful and is not recommended for children under 12 years of age. To answer the question can Invisalign fix an open bite? Yes it can, but requires special attention
  • Surgery


For children, the treatment of an open bite is easy and requires training in the majority of the cases. It is the adults, which bring in complexities. Braces and behavioral modifications are the essentials of adult open bite treatment. If none of it works, jaw surgery is recommended.

  1. Other potential treatment options include the utilization of a roller; to help get rid of thrusting, and headgear; which are based on pressure appliance to get the correct position and alignment.

Management of open bite

Management of Open Bite is based on the diagnosis and position of malocclusion. It can be managed by controlling the normal habits and eliminating irregular perioral muscle function. There are different types of open bite on to which management is dependent.

During the active growth period, it can be managed by redirecting the growth, and after active growth; it can be treated by orthognathic surgery. The period and growth pattern determination is really important. Management of open bite can be done as Orthodontic correction, surgical correction, or by combining these two.

Myofunctional therapy

The open bites can be caught by development adjustment. The point is to accomplish counterclockwise mandibular turn for the conclusion of an open bite, particularly if there is remaining development of the mandibular ramus, to control the expansion in foremost face stature and accomplish improved occlusal results and a decent profile. The treatment approach is aimed at vertical control of facial development or potentially ‘genuine’ or relative interruption of the posterior teeth.

Orthodontic therapy

If someone asks you which type of doctor specializes in teeth and jaw alignment, they are orthodontists. Mild dental open bites can be effectively overseen utilizing fixed mechanical machines related to boxing elastics. This type of versatile application comprises of a flexible elastic that is extended to stretch out between the upper and lower foremost regions. This achieves the expulsion of the upper and lower foremost regions. This type of treatment may not give good outcomes in serious skeletal bites.

Openbite surgery cost

Open bite surgery can also help to improve jaws and teeth misalignment which may result in an open bite, underbite, or overbite. Open bite surgery costs nearly $20,000-$40,000 or may be higher or lower than this amount because it depends on the patient’s specific variability. The cost also depends on the area where you live and which doctor you visit. It includes

  • Anesthesia fee
  • Orthodontic costs
  • Surgery fee
  • Hospital dues 
  • And medication costs.

All the above-mentioned fees account for the total cost of open bite surgery and it may vary from place to place or surgeon to surgeon.

Some FAQs

What is an open bite?

It is a condition in which there is a visible space between the upper and lower teeth when the jaws are joined together.

Can on open bite occur due to genetics?

Yes, genetics may result in skeletal deformities that are the precursor of open bites. Furthermore, environmental factors also play an important role in the onset of a bite.

Is open bite linked to other dental or facial problems?

Yes, it is linked to a few problems like long face syndrome. The problem is a potential cause of an open bite.

Should open bite braces be applied to children?

If an open bite can be treated with behavioral modification, there is no need for braces. If not, the child needs to come to age for the application of the braces. The cost for braces is also impotant to consider.

Should I go for surgery for an open bite?

Surgery is never the ideal option so you don’t need to go for it unless they open bite poses serious problems to dental health

How much does open bite surgery cost?

It depends on several factors like the severity of the bite, the preference of doctor, etc. however, the general range is 20-40,000$



Author Since:  September 18, 2018


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