Orthodontic assessment
Photographs, a digital scan and X-rays let us measure the open bite, judge how much is dental and how much is skeletal, and assess the tongue, the joints and the airway before proposing a plan.
About this treatmentDental condition · Wimpole Street, Marylebone
Open bite: when the front teeth never meet, and what can realistically be done
In a typical bite, the upper front teeth overlap the lower ones slightly when the back teeth are together. In an open bite there is a gap instead: close on your molars and you can still see daylight between the incisors, or slide your tongue tip through. It is less common than crowding or an overjet, and it behaves differently, because the cause is often the way the jaws have grown or the way the tongue rests rather than simply where the teeth sit. That matters for treatment. Teeth can be moved into contact with aligners or braces, but if the habit or the growth pattern that opened the bite is still there, they tend to drift apart again. A less frequent form is a posterior open bite, where the back teeth on one or both sides do not touch, and a lateral open bite that has appeared recently in an adult should always be checked, since it can signal a change in the jaw joint. At Wimpole Street we assess the whole picture, including the tongue, the airway and the joints, before recommending anything.
Recognising it
How it usually feels
Front teeth that do not touch when the back teeth are closed
The defining feature; the gap may be a millimetre or the height of a finger.
Difficulty biting through sandwiches, lettuce or spaghetti
Without incisor contact, food has to be torn with the side teeth or fingers.
A lisp or air escaping on “s” and “th” sounds
The tongue cannot seal against the front teeth to shape the consonant.
Lips that struggle to meet at rest
Often accompanies a long lower face and a mouth-breathing habit.
Heavy wear on the back teeth
They carry the whole load because the front teeth contribute nothing.
Back teeth on one side no longer meeting
A posterior open bite; if new, it warrants a look at the jaw joint.
Behind the symptoms
What's going on
- 01
Thumb or finger sucking beyond early childhood
A digit resting between the front teeth for hours a day stops them erupting fully and pushes the uppers forward. If the habit continues past six or seven, the open bite tends to persist into the adult teeth.
- 02
Tongue posture and tongue thrust
A tongue that sits low and forward, or pushes between the teeth on every swallow, exerts a constant gentle force that holds the incisors apart. It is the main reason open bites relapse after orthodontics unless the pattern is retrained.
- 03
Vertical jaw growth
Some faces grow more downwards than forwards, producing a long lower face, a steep jaw angle and back teeth that meet before the front teeth can. This skeletal pattern is inherited and is the hardest type to treat with tooth movement alone.
- 04
Mouth breathing and airway problems
Enlarged adenoids or tonsils, or a persistently blocked nose, encourage the mouth to hang open. The lowered tongue and altered muscle balance during growth are linked with the long-face pattern and open bite.
- 05
Changes in the jaw joint
In adults, a bite that opens on one side or at the front over months can result from the jaw joint remodelling or the condyle losing height, occasionally from arthritis. This is why a new open bite is examined differently from one you have always had.
Before your appointment
What you can do today
- Notice where your tongue rests during the day; the tip should sit just behind the upper front teeth, not between them or on the floor of the mouth.
- If you breathe through your mouth much of the time, ask your GP about nasal congestion or allergy, since a clear nose supports any orthodontic result.
- Cut food into pieces you can chew with the side teeth rather than straining to tear with the front.
- Photograph your bite from the front with the back teeth together every few months so that any change can be judged objectively.
- Avoid nail biting, pen chewing or resting the tongue between the teeth, all of which reinforce the open pattern.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Clear aligners
For mild to moderate open bites in adults, aligners can extrude the front teeth and, importantly, intrude the back teeth slightly so that the jaw closes further. Elastics are sometimes added to help.
About this treatmentFixed braces
Where more control is needed, or several teeth are impacted or rotated, brackets and wires remain the more predictable tool. Small anchorage screws can help intrude molars in adults.
About this treatmentTongue retraining
Exercises to change the resting position and the swallow pattern, sometimes with a referral to a speech and language therapist. Without this step, many open bites reopen after treatment.
About this treatmentLong-term retention
A bonded retainer behind the front teeth plus a night-time removable retainer, worn indefinitely, because the forces that created the open bite do not disappear once the teeth are aligned.
About this treatmentJoint assessment and surgical referral
A new open bite in an adult is imaged to check the joints. Severe skeletal open bites may need jaw surgery combined with orthodontics, and we refer to a maxillofacial team where that is the honest answer.
About this treatmentFees
Costs to expect
An orthodontic consultation at Wimpole Street with photographs and a digital scan is expected to be £95. Clear aligner treatment is indicative from £2,950 for straightforward cases, rising for complex open bites that require elastics, attachments and a longer treatment span. A fixed retainer is included in aligner plans and quoted separately if fitted alone.
Where an examination suggests a joint problem, a night splint is £795 and imaging is quoted individually. Cases needing combined surgery and orthodontics are referred, and the orthodontic component here is quoted after the surgical team has set out the plan.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Your bite has opened up over recent months, particularly on one side.
- You cannot bite through food with your front teeth and it is affecting what you eat.
- You have jaw pain, clicking or a change in your face alongside the open bite.
- Your back teeth are wearing down noticeably.
- Speech is being affected and you would like to know whether treatment would help.
- A child of six or older is still sucking a thumb and the front teeth are not meeting.
FAQ
Common questions
Aligners handle many mild and moderate open bites in adults well, partly because the plastic covering the back teeth tends to intrude them a little, which helps the front teeth come together. Larger gaps, skeletal patterns or impacted teeth are more predictably managed with fixed braces or, in severe cases, with surgery. We will tell you which category you fall into at the assessment.
Because the tongue and the growth pattern that produced the open bite are still present when the appliances come off. Retraining the tongue and wearing retainers for life are the two measures that most reduce relapse, and we build both into every open-bite plan.
Not necessarily. Many adults live with a small anterior open bite indefinitely. The concerns are extra wear on the back teeth, which carry the whole load, and difficulty incising food. If neither troubles you, monitoring is a reasonable choice, provided the bite is stable and not a recent change.
A bite that has changed within months, rather than being lifelong, needs the jaw joints examined. Remodelling of the condyle, arthritis or a displaced disc can alter how the jaw closes and create a gap at the front or on one side. It is important to identify this before any orthodontic treatment, since moving the teeth alone would not address the cause.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
