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An open bite is a dental malformation where the front teeth on both the upper and lower jaw are pushed outward in such a way that neither the upper nor lower teeth meet, even with a closed mouth. When this occurs there is no vertical overlap of the front teeth, which is the normal development of the dental arches.
The open bite is also referred to as a malocclusion. “Occlusion” is the way in which opposite teeth align. The “mal” prefix then describes the improper alignment of opposing teeth. This term was created by the “Father of Modern Orthodontics,” American dentist Edward Angle in the 1890s.
An open bite condition is treated by an orthodontist. There are a number of ways to treat it, depending on the age of the patient and state of the malocclusion. Many cases are often not serious enough to warrant treatment. Those that are utilize treatment options that range from braces all the way up to orthodontic surgery.
The primary cause of an open bite is strain placed on the teeth. This often happens when the patient is young. Behaviors such as thumb sucking, finger sucking, tongue thrusting (when the tongue is pushed forward past the teeth) and chewing on various objects like pencils or toys can result in an open bite. Malocclusion can also develop from excessively prolonged use of feeding bottles and pacifiers (usually past the age of three).
All of these behaviors can cause the developing baby teeth to push outward. There are also certain natural features that may cause malocclusion during jaw development. These include extra, missing and/or misshapen teeth.
The shape of the face and skull face also has an impact on the development of the front dental arch. A hyperdivergent (meaning excessively tall) facial pattern, perhaps due to genetics or a birth defect, can be a factor in the growth of an open bite and possibly increase the severity of the condition.
The most obvious and visible effect of an open bite is the misalignment of the smile. Although a patient’s smile is merely aesthetic, malocclusion may possibly lead to low self-esteem. This can have long-lasting negative mental health effects. An Open bite can also cause the development of a lisp which lasts into adulthood. Correcting a malocclusion can help reduce speech problems that occur from the misalignment of teeth.
An open bite can also lead to problems during eating. After many years there can be excessive wear on teeth that are not aligned correctly on the upper and lower jaw. This can make the teeth sensitive and possibly cause eating to be difficult or painful. The risk of tooth decay is much higher for a patient with an open bite.
More severe cases of over bite can lead to excessive pressure in the jaw, resulting in frequent headaches and overall dental sensitivity.
In many individual cases, an open bite is not severe enough to warrant treatment. However, if the patient desires to treat it, there are many different options.
The most effective way to treat an open bite is to catch its development early on while the patient is still young. If this is done the primary way to treat the issues is to discourage the behaviors that lead to the development of misaligned teeth in the first place.
Although it is common for children to suck on their thumb or fingers, generally the child will cease the behavior on their own. If a child continues to suck his/her thumb as they approach the age of four, parents should encourage them to stop the behavior. Developing teeth will still be able to move back to their original placement. This can be accomplished with frequent communication about the behavior and the utilization of positive reinforcement. The same applies for consistent use of a pacifier, which can also push the teeth outward with excessive and prolonged use.
Tongue thrusting is also a common cause of open bite in very young children. There are devices available that can be used to treat the incorrect tongue posture and movement, called myofunctional appliances. There is also myofunctional therapy. This includes tongue exercises to fix the resting behavior of the tongue.
Some examples of devices to fix tongue posture are the Frankel functional regulator, bionators and twin blocks. The purpose of the Frankel appliance is to help create additional room for teeth to grow. A bionator is specifically used to correct overbite. A twin block appliance is composed of two parts that move the lower jaw forward and look like plastic blocks.
If the patient is older, orthodontists may recommend the use of other orthodontics for treatment. Dental braces or clear Invisalign braces can help re-align crowded teeth and push them back until the dental arch is correctly positioned.
This may also be coupled with tooth extraction to create more room in the jaw.
In more extreme cases where the patient is older and dental braces did not have a lasting effect, jaw surgery may be suggested. Alignment correction obtained via braces and myofunctional appliances may not always be permanent if formation problems still exist. Orthognathic surgery involves surgically reshaping the jaw to reposition the bone, possibly making use of wires, plates or screws. The process of jaw surgery can take many years to complete and is reserved for more severe cases.
Open Bite Wrap Up
Having an open bite isn’t fun at all, but in most cases it’s not the biggest of health concerns. Only those with the most extreme malocclusions even need to worry about treatment in the first place. If you’ve young one at home (or more than one!) make sure you’re monitoring their behavior to ensure they don’t have issues with misaligned teeth or an open bite in the future. As always, if you have any concerns contact your local dentist for their professional advice.