Open bite: when the front teeth do not meet

What an open bite is

Close your back teeth together. If the upper and lower front teeth do not overlap at all and there is a visible space between them, that is an anterior open bite. Less commonly the gap is at the side or back, with the front teeth meeting and the molars apart; that is a posterior open bite. The gap can be a millimetre or two, or wide enough to affect eating and speech.

What causes it

• Tongue posture. The most common cause. A tongue that rests between the front teeth, or pushes against them when swallowing, gradually holds them apart. Because swallowing happens hundreds of times a day, the force is small but constant.
• Thumb or dummy sucking past the age of about four, which pushes the upper front teeth forwards and holds the lowers back.
• Jaw growth. In some people the back of the jaw grows more than the front, tipping the bite open. This skeletal pattern tends to run in families and often comes with a long lower face.
• Mouth breathing in childhood, which changes tongue position and jaw growth.
• Jaw joint changes in adulthood, which can open a bite that was previously closed.

Why it is worth treating

With an open bite you cannot bite through food with your front teeth, so the back teeth do all the work and wear faster. Speech can be affected, particularly "s" sounds. The lips may not close easily at rest, which dries the mouth and gums. And an open bite is visible when you smile. Closing it restores a bite that works as well as it looks.

How Invisalign treats an open bite

Aligners close an open bite in two ways, and the plan usually uses both. The front teeth are extruded, drawn gently down and up into contact, using attachments that give the aligners grip to pull as well as push. The back teeth are intruded, pushed slightly up into the bone, which lets the lower jaw rotate forwards and closes the bite at the front. Aligners are unusually good at this second movement because they cover the back teeth completely and the act of biting on them pushes those teeth in; fixed braces tend to do the opposite. That is why many open bites that once needed fixed braces or surgery are now treated with Invisalign. The animation on this page shows the front teeth coming into contact as the bite closes.

Keeping it closed

An open bite caused by the tongue will reopen if the tongue keeps doing what it did. Alongside treatment Louise will talk to you about tongue posture and swallowing, and simple exercises to retrain the habit; this is a normal part of the plan, not an afterthought. Retainers matter more than usual here, and your Vivera retainers are fitted the day treatment ends.

When more is needed

A large skeletal open bite in an adult, where the jaws themselves are shaped that way, can be improved but not fully closed with tooth movement alone; complete correction involves jaw surgery, and Louise will tell you honestly if that is the case for you and refer you to a specialist. In a child or young teenager, stopping the habit and guiding growth early often avoids anything more involved later.

What treatment looks like here

Open bites are almost always Comprehensive cases: twelve to eighteen months with unlimited aligners and refinements included, because the movements need to be staged carefully and often fine-tuned at the end. Milder cases can sometimes be treated in a Moderate plan over nine to twelve months. You see the planned result in 3D before you start.

At Clear Braces Solihull every Invisalign package includes your consultation, iTero scan, X-ray, Dental Monitoring, Vivera retainers, professional whitening and twelve months of aftercare, in one written price. Interest-free monthly payments are available.

Questions people ask

Can Invisalign close an open bite?

Many, yes. Aligners are particularly good at the movement that closes an open bite, pushing the back teeth slightly into the bone. A large skeletal open bite may need surgery for full correction, and Louise will tell you if that applies.

Why does my open bite keep coming back?

Almost always because of tongue posture or a swallowing habit. Treatment here includes retraining the habit, and retainers are worn carefully afterwards.

How long does open bite treatment take?

Usually twelve to eighteen months, as the movements need careful staging and often a set of refinement aligners to finish.

Can an open bite affect speech?

Yes, particularly sounds made with the tongue against the front teeth. Closing the bite often helps.

Is my child's open bite from thumb sucking?

Possibly. Thumb and dummy habits past about four are a common cause. Stopping the habit early allows the bite to improve on its own in many children.