An open bite is when the upper and lower front teeth don’t touch at all when the back teeth are biting together, leaving a visible gap. It’s usually caused by a combination of genetics and childhood oral habits — things like prolonged thumb sucking, tongue thrusting, or chronic mouth breathing — and it’s corrected with anything from a habit-breaking appliance in a young child to braces, clear aligners, or temporary anchorage devices in older patients, depending on how the case developed.
What Causes an Open Bite?
Open bites generally fall into two overlapping categories, and most real cases involve a bit of both:
- Dental open bites, where the jaw bones themselves are positioned normally, but a habit — thumb sucking, prolonged pacifier use, or tongue thrusting — has physically pushed the front teeth out of alignment over years of repeated pressure.
- Skeletal open bites, where the upper and lower jaws themselves grew in a way that doesn’t let the front teeth meet, often related to a longer, more downward-tilted facial growth pattern. This type is frequently linked to chronic mouth breathing during childhood.
Genetics plays a real role in which growth pattern a child inherits, but ongoing habits during the years teeth and jaws are developing can meaningfully worsen — or in some cases largely cause — an open bite that wouldn’t otherwise have developed.
Why Does an Open Bite Matter Beyond Appearance?
Because the front teeth aren’t meeting, an open bite can make it harder to bite into food cleanly, sometimes shifts more of the chewing workload onto the back teeth, and can affect certain speech sounds, particularly ones like “s” and “th” that rely on the tongue meeting the front teeth in a specific way. Left untreated into adulthood, it can also contribute to excess wear on the back teeth over time.
How Is an Open Bite Corrected?
Treatment depends heavily on the patient’s age and what’s driving the open bite:
In Younger, Growing Children
If a habit like thumb sucking or tongue thrusting is still active, breaking that habit is often the first priority — sometimes with a simple habit-reminder appliance. If the jaw itself is contributing, early treatment with a palatal expander or other growth-guiding appliance can help redirect development while there’s still growth to work with.
In Older Children and Teens
Braces or clear aligners can close a dental open bite directly, sometimes with the help of temporary anchorage devices (TADs) to pull the front teeth down into contact with more precision than braces alone allow.
In Adults With Significant Skeletal Open Bites
Severe skeletal cases that didn’t get early intervention may need a combination of orthodontic treatment and, in some cases, jaw surgery to fully close the bite — which is exactly why catching the skeletal pattern early, in childhood, is so valuable.
At Davis & Goldberg Orthodontics, we determine which category a given open bite falls into with digital scans and X-rays, since that distinction — habit-driven versus jaw-growth-driven — changes the entire treatment approach.
How TADs Help With Open Bite Correction
One of the more precise tools for closing a dental open bite is a temporary anchorage device, or TAD — a small titanium screw placed in the bone that gives your orthodontist a fixed point to pull against. Because a TAD doesn’t move the way a tooth does, it can apply a very targeted downward or intrusive force on the back teeth, or a controlled pull on the front teeth, without disturbing the rest of the bite the way relying on tooth-to-tooth anchorage sometimes does. This has made TADs an increasingly common part of open bite treatment plans that would once have leaned more heavily on headgear or, in severe cases, surgery.
Can an Open Bite Be Prevented?
Not entirely, since genetics plays a real role in facial growth pattern, but the habit-related contributors are worth addressing early: helping a child transition away from thumb sucking or pacifier use around the age it’s typically outgrown, watching for chronic mouth breathing and bringing it up with a pediatrician, and keeping that first orthodontic evaluation around age 7 so any emerging open bite pattern gets caught while there’s still time to guide jaw growth rather than wait for a more involved correction later.
How We Diagnose the Type of Open Bite You Have
Telling a dental open bite apart from a skeletal one takes more than a visual exam, which is why our orthodontists at Davis & Goldberg Orthodontics rely on digital X-rays and 3D scans to measure the actual jaw relationship, not just where the teeth currently sit. These images let us see whether the upper and lower jaw bones themselves are positioned and growing normally, or whether there’s a genuine skeletal component contributing to the gap between the front teeth. That distinction is often the single biggest factor in how confidently we can predict which treatment approach — habit correction, braces, TADs, or in rare adult cases surgery — will get the best result.
Living With an Untreated Open Bite
Some adults have lived with a mild open bite for years without major issues and wonder whether treatment is really necessary at this point. It often still is worth considering: beyond the cosmetic aspect, an open bite that’s gone untreated for decades has usually had time to concentrate more wear on the back teeth and can make certain foods harder to bite through cleanly. Correcting it as an adult is entirely possible, though the approach and timeline will look different than treating the same open bite in a still-growing child.
Frequently Asked Questions
Can an open bite close on its own without treatment?
Occasionally a mild, habit-related open bite improves once the underlying habit stops, especially in younger children, but most open bites — particularly skeletal ones — need active orthodontic treatment to fully close.
Is an open bite the same as an overbite?
No, they’re opposite problems. An overbite is when the upper front teeth cover too much of the lower front teeth; an open bite is when the front teeth don’t touch at all.
Can adults get an open bite corrected without surgery?
Many adult cases, especially milder or primarily dental (rather than skeletal) open bites, can be corrected with braces, clear aligners, and sometimes TADs. Surgery is generally reserved for more severe skeletal discrepancies.
How long does open bite treatment usually take?
It varies significantly based on severity and the patient’s age, ranging from under a year for a mild dental case in a cooperative young patient to two years or more for complex cases.
Does an open bite affect chewing function, not just appearance?
Yes — when the front teeth don’t meet, biting into food cleanly becomes harder and more of the chewing workload shifts to the back teeth, which is part of why treatment is generally recommended even when a patient isn’t bothered by the appearance alone.
Can an open bite come back after treatment?
If the original habit — thumb sucking, tongue thrusting, or mouth breathing — isn’t fully resolved, or if a retainer isn’t worn as directed afterward, an open bite can partially relapse, which is why addressing the underlying cause is such an important part of treatment.
Is jaw surgery always needed for a severe skeletal open bite in adults?
Not always — some adult skeletal open bites can be managed with braces or aligners combined with TADs, though the most severe cases may still benefit from a combined surgical and orthodontic approach for the most stable, complete correction.
Can a dentist treat an open bite, or does it require an orthodontist?
Diagnosing and treating an open bite’s underlying cause — whether habit-related or skeletal — is squarely within an orthodontist’s specialty training, so it’s the right specialist to see for this kind of bite correction.
At what age should an open bite first be evaluated?
Age 7 is the general benchmark for a first orthodontic evaluation, but an open bite tied to an active habit like thumb sucking or prolonged pacifier use is worth mentioning sooner if it’s noticeable, since addressing the habit early can sometimes prevent the bite problem from becoming more established.
Disclaimer: The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.