Fixing an open bite: are braces the only answer?

Medically Reviewed by a
Licensed DDS

Table of Contents

  1. Causes
  2. Treatment
  3. Treatment Costs
  4. Resources

Close a healthy mouth, and back teeth will fit together perfectly. Top incisors drop down in front of their lower counterparts. The teeth touch like one perfect unit.

Someone with an open bite has teeth that don't fit this model. Two forms exist.

  • Anterior open bite: Front teeth slant outward and don't connect at all, even when the back molars do. Most people with an open bite have this version.
  • Posterior open bite: Front teeth fit together as they should, but back teeth never do.

Genetics, injuries, and habits all cause open bites. Surgery, orthodontics, or some combination of the two are common treatment approaches. Experts may also use aligners or palate expanders.

Open bites are complex, and lengthy treatment times are common. This is one of the most expensive dental problems to solve, but insurance may cover some of the costs.

What causes an open bite?

Open bites can stem from genetic factors. If one jaw grows faster than another, and this same issue appears throughout your family tree, genetics could be to blame. But some decisions made both in childhood and adulthood could spark an open bite.

Experts say open bites can develop due to:

Childhood Choices
Kids who suck on pacifiers, bottles, or thumbs place enormous pressure on their teeth. They can change growth trajectories without even realizing it.
Tongue Movement
The tongue is the strongest muscle in the body, and it pushes on teeth when you speak or swallow. Unusual tongue position, both in motion and at rest, strains teeth.
Tooth Grinding
People with temporomandibular joint disorder (TMD) push their teeth together all night long, and they experience popping and grinding throughout the day. Tongue movements to reposition the jaw can cause an open bite.

Very young kids can develop open bites. If they stop the behaviors that lead to the issue, their teeth can adjust to their proper positions. But adults with open bites can't expect spontaneous recovery. They will need help.

People with braces can also develop open bites, researchers said back in 1997. It's hard to find comfortable positions for your teeth when they're covered in metal. You may use your mouth muscles and tongue to swallow food, and that can contribute to tongue thrust and tooth movement. Your orthodontist must catch this and fix it if it happens.

People with an open bite have teeth that don't fit together, even when their mouth is closed, typically surgery, braces, and aligners are suggested treatment options.

How is an open bite treated?

Open bites are serious. It's difficult to clean your teeth when they don't fit together. And open jaws strain muscles and tendons, causing headaches. Plenty of open bite treatments exist to ease discomfort and encourage your teeth to connect.

Dentists, orthodontists, and other dental health professionals treat open bites with:

Screws
Bits of metal drilled into the jaw give rubber bands something to attach to. The other end of the elastics wrap around braces. Those bands slowly pull teeth back and down to close the open bite.
Self-Ligating Bands
Braces brackets connect with loops of elastics. The teeth pull on one another, and in time, the open bite closes.
Surgery
Traditional treatment takes months or even years to complete. Surgery is different. Patients head in for one appointment. Some teeth are pulled, others are twisted into place, and long jaws are shaved down.
Aligners
Teeth attempt to take up their former positions when braces, bands, and elastics come off. Some clear aligners can push the teeth back to their proper positions, without the wires and brackets and pain braces patients may be so tired of. The severity of your case will determine whether you can use an aligner, and what type is a fit for you.
Palate Expanders

Teeth roll forward or back when they don't have enough room to line up along the jaw. Palate expanders sit behind the teeth and push on the jaw. Bone slowly grows, and teeth get the room they need.

Braces or aligners complete the treatment process, as they encourage teeth to take up their proper spots.

Tongue Spurs
Treatment won't work unless the tongue stops pressing on teeth to nudge them out of the way. Devices with spurs can hurt for about 10 days, researchers say. But after this training period, people learn how to use the tongue helpfully, and that can protect teeth.

These solutions are dramatically different. Some patients need multiple therapy types to close an open bite. You may need tongue help, screws, elastics, and braces, for example. You may then use aligners to secure your teeth in place.

But mild cases of open bite don't need intense interventions. A few months in aligners or braces could be all you need to perfect your smile.

You can talk with an orthodontist to determine the best path forward. After an exam, your team can tell you what should happen next and how long your treatment plan might last.

You can also consult an at-home aligner company. You’ll take impressions of your teeth and send those in to the company. They’ll assess your teeth’s alignment, including your open bite, to determine if they can straighten your smile and correct your bite with aligners.

What does treatment cost?

An open bite changes your smile. When your teeth don't meet, it's hard to show off a row of pearly whites. But the issue isn't just cosmetic.

Often, it interferes with your quality of life. It's common for insurance companies to chip in and pay for part of your care. But even with some insurance coverage, the bills can still be high.

People who opt for surgery will see the biggest bills. Experts say orthognathic surgery (which involves amending an open bite) can cost up to $40,000 for people without insurance. With coverage, you can knock that bill down to $5,000 or so.

Choose braces, and you will pay less. Experts say braces cost, on average, about $5,000. But difficult open bites come with higher prices. Expect to pay more for interventions like:

  • Headgear.
  • Jaw screws.
  • Rubber bands.

You'll also pay more if you modify your braces. Choose tooth-colored ceramic brackets, for example, and your bill can jump to about $8,500.

Dental insurance can offset some of the costs of braces, but this is usually only the case when braces are medically necessary rather than purely for aesthetic reasons.

Clear aligners offer both efficacy and value. You don’t have to visit an orthodontist regularly since the aligners are mailed right to your home. For mild cases, doctor-supervised, at-home aligners can be yours for about $2,000.

These tools aren't right for all open bite problems. Significant cases may need more help than aligners can deliver. But for some, they offer the perfect way to straighten a smile while saving money and time.

Resources.

Open Bite. (May 2018). Healthline.

Treating the Open Bite. (March 1997). Journal of General Orthodontics.

Nonsurgical Treatment and Stability of an Adult With Severe Anterior Open-Bite Malocclusion. (2018). Journal of Orthodontic Science.

Rapid, Nonsurgical Open-Bite Closure With a Passive Self-ligating Bracket System Using a Differential Bonding Technique. (October 2017). Orthodontic Practice U.S.

Open Bite Malocclusion: An Overview. (January 2018). Journal of Oral Health and Craniofacial Science.

A New Approach to Open Bite Treatment. (September 2010). Oral Health.

Two-Phase Treatment of Anterior Open Bite. (December 2017). Journal of Clinical Orthodontics.

Perception of Discomfort During Orthodontic Treatment with Tongue Spurs. (2011). Orthodontics.

Orthognathic Surgery Cost. CostHelper.

Braces Cost. CostHelper.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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