Open bite: when the teeth do not meet when biting down
You bite down – and a gap remains at the front. The cause usually does not lie with the teeth.
In an open bite, the rows of teeth do not touch everywhere when biting down. Usually a gap remains at the front: you cannot bite off food without helping along. Less often the gap remains at the side.
The cause rarely lies with the teeth
An open bite is almost always the result of a habit or a functional pattern. Prolonged thumb sucking mechanically keeps the teeth apart. Tongue thrusting when swallowing – the tongue settles between the rows of teeth instead of against the palate – acts hundreds of times a day. Constant mouth breathing also changes the position of the tongue.
Why it is treated
Biting off food no longer works properly; the load shifts to the back teeth, which become overloaded as a result. Speech also suffers, especially with s and z sounds. And as long as the cause persists, every correction relapses.
First the cause, then the teeth
That is why treatment does not begin with the brace but with stopping the habit: weaning off sucking, myofunctional exercises for tongue and lips, and in the case of mouth breathing an assessment by an ENT specialist. Only then is the position of the teeth corrected – otherwise it will not hold.
The key facts at a glance
- In an open bite, the rows of teeth do not touch when biting down – usually at the front, less often at the side.
- The cause almost always lies in a habit: thumb sucking, tongue thrusting when swallowing, constant mouth breathing.
- Biting off food no longer works, the back teeth become overloaded, and speech suffers with s and z sounds.
- Without eliminating the cause, every correction relapses. That is why functional treatment comes before tooth movement.
Answered briefly
Frequently asked questions
If the cause disappears early – for instance thumb sucking ends at age four – a mild open bite in the primary dentition can still close. If the habit continues or there is tongue thrusting, this does not happen.
An exercise programme for the tongue, lips and cheeks, usually guided by speech therapists. The aim is for the tongue to rest against the palate when swallowing and at rest, instead of between the teeth. It does not replace a brace, but without it the result often does not last.
Biting off is difficult – many cut or tear their food instead. Chewing works via the back teeth, which as a result carry more load than they should.
The part that removes the cause takes months and depends on cooperation. The subsequent tooth correction is within the usual range of one to three years. The open bite is considered one of the malocclusions with the highest risk of relapse.