When Your Dentist Says an Open Bite, What Does That Mean?
In a perfect world, your teeth align and match up perfectly, with the upper teeth resting slightly above your lower teeth. Unfortunately, this isn’t always the case and a malocclusion, or misalignment, occurs. An open bite is one form of malocclusion that occurs when the upper and lower teeth do not come together. In addition to affecting your smile, an open bite can cause complications with eating and speech. While open bite treatment can be more challenging than other malocclusions, orthodontic treatment can restore proper alignment and function.
What is an Open Bite?
An open bite is a condition where the upper and lower teeth do not align correctly. It is referred to as an open bite because, even when the mouth is closed, it appears to be open. An open bite can be anterior or posterior. An anterior open bite occurs when there is no overlapping between the front teeth when you bite down. In most cases, there is a clear and visible space between the upper and lower front teeth. A posterior open bite occurs when there is a space between the back teeth when the teeth bite down. The development of open bites can be attributed to genetics, body development, and environmental factors.
What are the Causes of an Open Bite?
An open bite is typically caused by variety of factors. While genetics can play a role, outside factors and behaviors can also contribute. The main causes of open bite include:
Thumb or pacifier sucking – While thumb-sucking and pacifier use is common with many children up to age 3, prolonged thumb-sucking can cause dental issues, including open bite. If thumb-sucking leads to an open bite with baby teeth, this will often correct on its own if thumb-sucking stops. If the habit continues into older years, when adult teeth are present, orthodontic care is often necessary to repair the open bite.
Tongue thrusting – While it may not seem like it, your tongue is a powerful part of your body. On average, you swallow 1200 to 2000 times a day, with up to 4 pounds of tongue pressure per swallow. The normal position of a tongue when swallowing is to have the tip of the tongue against the gum above the back of your upper front teeth. With tongue thrusting, the tongue pushes against the teeth themselves, pushing them out of alignment and resulting in open bite.
Temporomandibular Joint Disorders (TMD) – Your temporomandibular joints are the joints and muscles within the jaw that give you the ability to move your jaw and allow you to chew, speak and swallow. When problems arise with these joints, they result in a painful TMJ disorder, which can cause an open bite.
Skeletal problems – Some cases of open bite are due to improper skeletal development of the jaws themselves or uneven growth of the facial bones.
Macroglossia – Macroglossia refers to an unusually large tongue. In this case, the enlarged tongue puts pressure on the teeth, often resulting in an open bite.
Adenoid hypertrophy – Enlarged adenoids, or tonsils, can often place a forward pressure on the tongue, causing it to push the teeth forward, resulting in an open bite.
Airway obstruction – Airway obstruction or mouth-breathing can contribute to tongue placement abnormalities, resulting in open bite.
Why Should You Treat an Open Bite?
While an open bite definitely affects the look of a smile, treating an open bite is more necessary than just improving a smile. An open bite can affect how your mouth functions and, without treatment, can cause more severe complications. Eating with an open bite can be a difficult task. Biting into foods such as apples is often impossible, and general chewing can be difficult. Because, in most cases of open bite, the back teeth are the only ones to come together, with increased pressure those teeth can experience increased wear that can lead to pain and the weakening. This can lead to other dental problems, such as tooth fracture. An open bite can interfere with speech and pronunciation of words, often causing a lisp.
How are Open Bites Treated?
Treating an open bite depends on a variety of different factors, including age and the cause of the open bite. In children with baby teeth or a mix of baby and permanent teeth, an open bite can often resolve on its own if conditions, such as thumb-sucking, stop. Other treatment options, such as roller appliances, tongue spikes and tongue cribs are used in children that are still growing to help encourage proper tooth growth and alignment.
Roller appliances can help limit tongue thrusting if that is the cause. This is a small roller-type bead that is placed to a wire connected to back molars. This helps to keep the tongue from pushing onto the front upper teeth.
A high-pull headgear is an orthopedic appliance that is worn outside of the mouth and attached to the upper jaw. It is used to guide jaw growth and improve jaw alignment.
Once tooth growth is complete, orthodontic treatment is the main option. From an orthodontic standpoint, open bites can be one of the most challenging malocclusions to treat, often incurring a high incidence of relapse once treatment is complete. Treatment is most often traditional braces that work to move the front teeth down, the back teeth up, or a combination of these. In some cases, clear aligners such as Invisalign can also be a great option. A combination of orthodontic treatment and orthognathic surgery might be the only option in other cases.
Before braces are used, it is essential to treat any possible causes, such as tongue thrust, as this will continue to cause problems once braces are removed. After treatment with braces or aligners is complete, you will be fitted for a retainer which will help keep your new tooth position in place. It is essential to follow the directions of your orthodontist regarding the wear of your retainer in order to maintain your new teeth alignment and not have them return to an open bite.
If you believe you or your child has an open bite, talking to your orthodontist is essential and beneficial to breaking habits that can be the cause, as well as treatment options to return your smile and normal bite.
Have you ever had an open bite? Did you manage to correct that type of malocclusion? Comment Below!
This was very informative!
My Fiance’ has this and it really does bother him when it comes to smiling, hopefully one day we can get him a new smile :)
Wow, I did not know any of this. I can see why it would affect speech. Thanks for posting!
Thanks for sharing very informative information