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MosdentISTANBUL 1992
// Orthodontics

Understanding Open Bite: Causes, Types, Treatment, and Long-Term Solutions

Open bite can be closed without surgery in the right case: in a meta-analysis of 14 studies, clear aligner therapy closed adult anterior open bite by a mean 2.76 mm (95% CI 2.23-3.28), driven by incisor extrusion rather than molar intrusion. Which types respond, and which need more.

Dr Ahmet Murat Artuç, PhDWritten by
Published
7 minread
Close-up mouth with visible gap between front teeth; dentist holds jaw model near X-ray screen
Orthodontics·7 min
// Quick answer

An open bite is a malocclusion in which the upper and lower teeth fail to contact when the mouth is closed, leaving a vertical gap that is anterior in most cases and posterior in a minority. Cause and treatment follow the same split: dental open bites follow oral habits or eruption problems, skeletal ones follow jaw growth. In a meta-analysis of 14 studies, clear aligner therapy closed adult anterior open bite by a mean 2.76 mm (95% CI 2.23-3.28), an effect driven by incisor extrusion rather than molar intrusion (PubMed 39445659). Relapse is the recurring limit rather than the exception.

// Key takeaways
  • 01Anterior open bite means the front teeth do not meet while the back teeth occlude; posterior open bite is the reverse, and the two carry different treatment paths.
  • 02Clear aligner therapy corrected adult anterior open bite by a mean 2.76 mm (95% CI 2.23-3.28), achieved mainly through maxillary and mandibular incisor extrusion of about 0.85 mm each, with no significant molar intrusion across 12 pooled studies (PubMed 39445659).
  • 03Molar intrusion with skeletal anchorage leaves measurable relapse: pooled overbite relapse of 1.23 mm (95% CI 0.81-1.64) at a mean 2.5 years, with about 12% relapse of maxillary and 27.2% of mandibular molar intrusion (PubMed 32888097).
  • 04Habit duration is the modifiable risk factor: across 33 pooled studies, daily pacifier use carried an odds ratio of 10.22 (95% CI 5.36-19.49) for anterior open bite in children (PubMed 40619361).
  • 05Treatment durations reported in this article run 12-24 months for mild to moderate aligner cases, 18-30 months with braces and elastics, and 12-18 months for surgical cases including recovery.

/ Introduction

A perfect bite ensures optimal chewing, speaking, and facial aesthetics. However, some individuals experience a misalignment known as an open bite, where the upper and lower teeth do not meet when the mouth is closed. This malocclusion can cause functional, aesthetic, and even emotional challenges if not addressed.

In this comprehensive guide, we’ll explore everything you need to know about open bite teeth, including the types of open bite, causes, symptoms, treatment options, and answers to common questions like “How to fix an open bite?” or “Can Invisalign fix open bite?” Whether you’re dealing with a mild misalignment or a more complex case, this article is your go-to resource.

/ What Is an Open Bite?

Definition of Open Bite

An open bite is a type of dental malocclusion where the upper and lower teeth do not touch when the mouth is fully closed. Instead of overlapping as they should, a gap is visible between the upper and lower front or back teeth.

What Does an Open Bite Look Like?

People with an open bite often display the following traits:

  • Visible space between front teeth when biting down
  • Difficulty with pronunciation (especially with “s” or “th” sounds)
  • Challenges with chewing or biting into food
  • Aesthetic concerns due to improper smile line

Clinical Insight: Dentists often notice a flattening of the smile arc and asymmetry in lip posture in patients with open bite.

/ Types of Open Bite

1. Anterior Open Bite

An anterior open bite occurs when the front upper and lower teeth do not make contact when the back teeth are closed together. It’s the most common type and is often caused by habits like thumb-sucking or tongue thrusting.

Tip: Anterior open bite can severely affect speech development in children, especially when not addressed before the age of 7.

2. Posterior Open Bite

A posterior open bite is less common and occurs when the back teeth do not touch, while the front teeth may close normally. This can lead to chewing difficulties and uneven jaw stress.

3. Skeletal vs. Dental Open Bite

  • Skeletal Open Bite : Caused by abnormal jaw growth and usually requires orthognathic (jaw) surgery. These cases are often genetically driven and may be diagnosed during adolescence.
  • Dental Open Bite : Caused by habits or tooth misalignment and is typically treatable with orthodontics, especially if caught early.

/ What Causes an Open Bite?

Several factors may contribute to the development of an open bite:

1. Thumb-Sucking and Pacifier Use

Prolonged thumb-sucking or pacifier use beyond age 3–4 can apply pressure on developing teeth, pushing them out of alignment and causing an anterior open bite.

Parent Alert: Even “orthodontic pacifiers” can cause open bite if used for extended periods.

2. Tongue Thrusting

When a person pushes the tongue against the front teeth during swallowing or speaking, it can interfere with proper tooth eruption and alignment.

Tongue posture is controlled by both neuromuscular coordination and habit, making behavioral therapy essential in some cases.

3. Genetics

Open bite can run in families and be the result of inherited jawbone structures or dental arch shapes. If parents or siblings have open bite issues, early evaluation in children is recommended.

4. Temporomandibular Joint (TMJ) Disorders

Some TMJ issues can affect bite alignment, leading to posterior open bite in certain cases. Patients often experience jaw clicking, facial pain, or difficulty opening the mouth fully.

5. Abnormal Eruption of Teeth

When teeth do not erupt properly, gaps may appear between upper and lower arches, especially in mixed dentition stages in children.

/ Open Bite Symptoms and Complications

Common Symptoms

  • Incomplete closure of the mouth
  • Lisping or speech difficulties
  • Inability to bite into sandwiches, apples, or similar foods
  • Mouth breathing
  • Jaw discomfort or strain
  • Narrow smile or asymmetric facial appearance

Long-Term Complications

If left untreated, an open bite can lead to:

  • Excessive wear on certain teeth
  • Gum recession or periodontal issues
  • Poor oral function and digestion
  • Self-esteem or psychological distress
  • Risk of worsening misalignment over time
  • Chronic jaw pain or TMJ dysfunction

Important: An untreated open bite can also alter muscle tone in the cheeks and lips, leading to aesthetic imbalances in facial symmetry.

/ How to Fix an Open Bite

1. Orthodontic Treatment (Braces)

Traditional braces are highly effective in treating most cases of dental open bite. They gradually reposition the teeth using brackets and wires. Rubber bands may also be used to help pull the teeth into proper alignment.

Success Rate: Orthodontic treatment alone can correct over 80% of dental-origin open bites when started before adulthood.

2. Clear Aligners (Invisalign)

Yes, Invisalign can fix open bite in many cases. Clear aligners use customized trays to shift teeth over time. Invisalign is most effective for mild to moderate open bites and is a popular choice for adults due to its discreet appearance.

Aligners also help retrain tongue posture when paired with myofunctional exercises.

3. Orthognathic (Jaw) Surgery

For skeletal open bites, surgery is often required to reposition the upper or lower jaw. This is usually combined with orthodontic treatment and is recommended in severe cases or when orthodontics alone is insufficient.

4. Myofunctional Therapy

This therapy focuses on correcting tongue posture and breathing patterns. It may help prevent the recurrence of open bite after orthodontic treatment, especially in cases caused by tongue thrusting or mouth breathing.

5. Habit-Breaking Appliances

Appliances like tongue cribs or thumb-sucking guards can be used in children to break harmful oral habits before they affect bite development.

These are especially effective between ages 4–8 when the dental arches are still developing.

/ How to Fix Open Bite Naturally

Many people wonder how to fix open bite naturally without braces or surgery. While it’s not always possible, mild cases caused by habits may respond to:

  • Eliminating oral habits (thumb-sucking, pacifiers)
  • Myofunctional therapy
  • Tongue exercises and breathing correction
  • Avoiding soft diets that don’t stimulate proper jaw function
  • Posture awareness to ensure proper head and neck alignment

Caution: "Natural" methods may help prevent progression but are unlikely to correct moderate-to-severe open bites without professional intervention.

/ Open Bite in Children vs. Adults

Children

In children, open bites are often temporary and related to habits. Early intervention can prevent the need for complex treatment later. Pediatric dentists monitor bite development closely and may refer to orthodontists around age 7.

Adults

In adults, treatment may take longer and sometimes require more invasive methods, such as surgery or long-term orthodontics. However, options like Invisalign have made treatment more appealing and accessible.

/ How Long Does Open Bite Treatment Take?

Treatment duration varies depending on severity, age, and the chosen method:

  • Mild to moderate cases with Invisalign : 12–24 months
  • Braces with rubber bands : 18–30 months
  • Surgical cases : 12–18 months (includes recovery and follow-up orthodontics)

Note: Treatment times may extend if relapse prevention (e.g. retainers, exercises) is not followed post-treatment.

/ Open Bite vs. Other Malocclusions

Understanding the differences between bite issues is crucial for proper diagnosis and treatment.

MalocclusionDescriptionTreatment
Open BiteUpper and lower teeth do not touchBraces, Invisalign, surgery
OverbiteUpper teeth excessively overlap lowerBraces or aligners
UnderbiteLower teeth extend past upperBraces, surgery
CrossbiteUpper teeth bite inside lower teethExpanders, braces

/ Frequently Asked Questions (FAQs)

What is an open bite?

An open bite is a dental condition where the upper and lower teeth do not make contact when the mouth is closed.

Can Invisalign fix open bite?

Yes, Invisalign can correct many cases of anterior open bite, particularly those not caused by skeletal abnormalities.

How to fix an open bite?

Treatment options include braces, clear aligners (like Invisalign), jaw surgery, and myofunctional therapy.

How to fix open bite naturally?

While it may not be suitable for all cases, stopping harmful habits, practicing tongue posture correction, and early intervention may help.

What causes an open bite?

Causes include thumb-sucking, tongue thrusting, genetics, improper tooth eruption, and skeletal growth patterns.

/ Conclusion

An open bite is more than just a cosmetic issue. It can affect speech, nutrition, and confidence. Fortunately, with advances in orthodontics and behavioral therapies, most open bites are fully correctable.

Whether you're exploring how to fix an open bite or wondering if Invisalign can fix open bite, the first step is professional evaluation. Your dentist or orthodontist can tailor a personalized treatment plan to restore your bite, function, and smile aesthetics.

Pro Tip: Don’t wait for symptoms to worsen. Early treatment is more effective, less invasive, and often more affordable.

Let’s plan the right treatment together.

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// Frequently Asked

Frequently asked questions

What is an open bite?+

An open bite is a malocclusion in which some upper and lower teeth do not contact when the mouth is closed, leaving a visible vertical gap. When the gap sits between the front teeth and the posterior teeth are in occlusion, it is an anterior open bite, the most common form. When the posterior teeth fail to meet while the front teeth close normally, it is a posterior open bite.

Can Invisalign fix an open bite?+

Clear aligner therapy corrects many adult anterior open bites. In a meta-analysis of 14 studies, aligner treatment closed the open bite by a mean 2.76 mm (95% CI 2.23-3.28), an effect driven by maxillary and mandibular incisor extrusion of roughly 0.85 mm each, with no significant molar intrusion or change in mandibular plane angle (PubMed 39445659). Skeletal open bites driven by jaw growth are a different problem.

How to fix an open bite?+

Treatment follows the cause. Dental open bites are addressed with fixed appliances, clear aligners, habit-breaking appliances in children, and myofunctional therapy where tongue posture or mouth breathing is involved. Skeletal open bites usually need orthognathic surgery combined with orthodontics, or molar intrusion with skeletal anchorage as a less invasive alternative in carefully selected adults (PubMed 32888097). Timing changes the odds: orthodontic treatment alone can correct over 80% of dental-origin open bites when it starts before adulthood.

How to fix open bite naturally?+

Mild, habit-driven cases can improve once the habit stops. Across 33 pooled studies, daily pacifier use carried an odds ratio of 10.22 (95% CI 5.36-19.49) for anterior open bite, and longer habit duration raised the risk further (PubMed 40619361). Stopping the habit removes the force, but it does not reposition teeth that have already erupted out of alignment, so an established open bite still needs orthodontic treatment.

What causes an open bite?+

This article lists thumb-sucking and prolonged pacifier use, tongue thrusting, inherited jaw and arch patterns, temporomandibular joint disorders and abnormal tooth eruption. The non-nutritive sucking route is the best quantified of these: 33 pooled studies show a dose relationship, with daily pacifier users reaching an odds ratio of 10.22 for anterior open bite (PubMed 40619361).

Does an open bite come back after treatment?+

Relapse is measurable rather than rare. After molar intrusion with skeletal anchorage, pooled overbite relapse was 1.23 mm (95% CI 0.81-1.64) at a mean 2.5 years of follow-up, with roughly 12% relapse of maxillary and 27.2% of mandibular molar intrusion across six studies (PubMed 32888097). Retention and, where a habit was involved, myofunctional follow-up are part of the treatment rather than an optional extra.

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