What Is an Open Bite?
In a well-aligned bite, the upper and lower teeth come together with even contact when the mouth is closed. The front teeth slightly overlap, while the back teeth meet symmetrically to distribute chewing forces across the dental arches. An open bite disrupts this relationship — a visible gap remains between certain upper and lower teeth even when the jaw is fully closed.
An open bite differs from an overbite, in which the upper front teeth overlap the lower front teeth excessively, and from a crossbite, in which upper teeth sit inside the lower teeth laterally. While all three are forms of malocclusion, an open bite is specifically characterised by the absence of contact where contact would normally occur.
An anterior open bite is the most common type and involves a gap between the upper and lower front teeth. It is often visible when smiling and can make biting into foods difficult. A posterior open bite is less common and involves a gap between the upper and lower back teeth, which can affect chewing efficiency and place additional strain on the teeth that do make contact.
Common Causes of an Open Bite
An open bite can develop for a number of reasons, and the underlying cause varies between individuals. Contributing factors may include:
Childhood Habits
Prolonged thumb sucking, finger sucking, or extended dummy use beyond early childhood can exert pressure on the developing teeth and jaw, encouraging the front teeth to flare outward and preventing normal bite closure.
Tongue Thrust Patterns
A tongue thrust — where the tongue pushes forward against or between the front teeth during swallowing or at rest — can prevent the upper and lower teeth from meeting and may maintain or worsen an open bite over time.
Jaw Growth Differences
Uneven growth between the upper and lower jaws can result in a skeletal open bite, where the bone structure itself prevents the teeth from coming together properly. This type of open bite tends to be more complex than one caused by tooth position alone.
Genetic Factors
The shape and proportion of the jaws, facial height, and the angle at which the teeth erupt are all influenced by hereditary factors. A family history of open bite or long facial proportions may increase the likelihood of this condition developing.
Skeletal vs Dental Open Bite
A dental open bite is caused primarily by the position of the teeth, while a skeletal open bite involves a discrepancy in the jawbones themselves. Distinguishing between the two is important, as the treatment approach may differ significantly.
In many cases, an open bite results from a combination of factors. A professional assessment can help identify the contributing elements and distinguish between dental and skeletal causes.
Symptoms and Functional Effects
The impact of an open bite depends on its type, size, and the number of teeth affected. Common functional and aesthetic effects include:
Difficulty Biting Into Foods
Because the front teeth do not meet, biting into foods such as sandwiches, apples, or crusty bread can be difficult or impossible. Patients often compensate by using the side teeth to bite, which can lead to uneven wear.
Speech Differences
An anterior open bite may affect the clarity of certain sounds — particularly sibilant sounds such as "s" and "z" — as the tongue may protrude through the gap during speech. The degree of impact varies between individuals.
Jaw Strain
When the teeth do not come together evenly, the jaw muscles may need to work harder to achieve functional biting and chewing. This can contribute to muscle fatigue or discomfort, particularly around the temporomandibular joint.
Uneven Tooth Wear
Because biting forces are concentrated on the teeth that do make contact — typically the back teeth in an anterior open bite — those teeth may experience accelerated wear, increasing the risk of damage over time.
Cosmetic Concerns
A visible gap between the upper and lower front teeth when smiling or at rest may be a source of self-consciousness for some patients. This is a common reason for seeking professional assessment.
The severity of symptoms varies between individuals. Some patients with mild open bites experience minimal functional difficulties, while others may find everyday activities such as eating noticeably affected.
Why Professional Assessment Is Important
An open bite can place uneven strain on the teeth that do make contact, as these teeth bear a disproportionate share of the biting forces. Over time, this imbalanced loading may contribute to accelerated wear, tooth fractures, or discomfort in the jaw joints. A professional assessment allows the extent and impact of the open bite to be properly evaluated.
During an assessment, your dentist or orthodontist may use digital scans, clinical photography, or dental imaging to evaluate tooth positioning, jaw alignment, and the overall bite relationship. These investigations help determine whether the open bite is primarily dental — related to the position of the teeth — or skeletal, involving the jawbones themselves. This distinction is important because it influences the treatment approach.
Early evaluation — particularly in children and adolescents — may help identify open bites at a stage when intervention can take advantage of ongoing jaw development. In adults, timely assessment can help prevent progressive wear or functional complications. The severity of the open bite will determine whether active treatment is recommended or whether monitoring is more appropriate.
Orthodontic Treatment Options for Open Bite
The management of an open bite depends on its type, severity, and the patient's age. Treatment aims to create balanced tooth contact and may help improve bite function. Options may include:
Fixed Orthodontic Appliances
Traditional fixed braces use brackets and wires to move teeth into improved positions and may help close an open bite by intruding back teeth or repositioning front teeth. They are suitable for a wide range of open bite types and complexities.
Clear Aligners or Invisible Braces
For suitable cases — particularly milder dental open bites — clear aligner systems may help improve tooth positioning and bite closure. These removable appliances are often preferred by patients who value discretion during treatment.
Bite Correction Planning
Comprehensive treatment planning may involve detailed analysis of the bite relationship, jaw position, and facial proportions to determine the most effective strategy for achieving balanced tooth contact.
Retainers Following Treatment
After active orthodontic treatment, retainers are typically prescribed to help maintain the corrected tooth positions and prevent the open bite from returning. Open bites can have a higher tendency toward relapse, making retention particularly important.
Multidisciplinary Care
In complex cases — particularly skeletal open bites in adults — a combined approach involving orthodontics alongside other dental or surgical disciplines may be considered. Your orthodontist will discuss all appropriate options.
Treatment outcomes depend on individual circumstances, including the complexity of the open bite and patient compliance. Open bites can have a higher tendency toward relapse, making long-term retention an important part of treatment planning.
Orthodontic Assessment for Open Bite
If you notice gaps between your upper and lower teeth when biting, difficulty chewing certain foods, or changes in speech clarity, a dental assessment can determine whether orthodontic treatment may be appropriate. Your dentist or orthodontist can evaluate the type and severity of any open bite and discuss the most suitable management options for your individual situation.
Depending on the findings, your clinician may recommend invisible braces for suitable cases, a fixed retainer following correction, or TMJ treatment if jaw discomfort is present.
Orthodontic assessment and open bite treatment are available at our London clinics. You can attend our South Kensington dental clinic or our City of London clinic near St Paul's for a professional dental evaluation.
