If you’ve been told you have an open bite, or if you’ve noticed that your front teeth don’t touch when you close your mouth, you’re probably wondering what this means and whether it’s something that needs to be fixed. Open bites can affect how you chew, speak, and even how your jaw feels, and understanding your treatment options is the first step toward a healthier, more functional smile.
Here’s the direct answer upfront: an open bite can be fixed through orthodontic treatment, often using braces or Invisalign combined with elastics, habit correction, or in severe cases, orthognathic surgery. Treatment typically takes 18 to 36 months depending on the severity of the open bite and the patient’s age.
At Freedman & Haas Orthodontics, we treat open bites regularly for patients of all ages in West Palm Beach, Wellington, and Indiantown. Let’s dive deeper into what an open bite is, what causes it, how we fix it, and what you can expect from treatment.
What Is an Open Bite?
An open bite is a type of malocclusion, or bad bite, where the upper and lower front teeth don’t come together when the mouth is closed. If you bite down on your back teeth and there’s still a gap between your front teeth, that’s an open bite.
Open bites can vary in severity. Some patients have a small gap of just a few millimeters, while others have a significant opening that’s very noticeable when they try to bite into food or speak. The gap can involve just the front teeth or can extend to the side teeth as well, though front open bites are more common.
There are two main types of open bites: anterior open bite and posterior open bite. An anterior open bite is when the front teeth don’t touch, which is the most common type. A posterior open bite is when the back teeth don’t touch, which is less common but can still cause functional problems.
Open bites aren’t just a cosmetic issue, though many patients do feel self-conscious about the appearance. More importantly, open bites can make it difficult to bite into foods like sandwiches, pizza, or apples. They can affect speech, causing a lisp or making certain sounds harder to pronounce. They can also put extra strain on the back teeth, which have to do all the work of chewing, leading to excessive wear and potential jaw problems over time.
Furthermore, open bites can contribute to TMJ disorders. When the front teeth don’t come together, the jaw has to work harder to compensate, which can cause muscle tension, clicking, or pain in the temporomandibular joint.
You should know it’s never too late to correct an open bite. While treatment may be slightly more complex in adults than in growing children, open bites can be successfully treated at any age. The key is getting a professional evaluation to determine the best approach for your specific case.
What Causes an Open Bite?
Understanding what caused your open bite helps determine the best way to fix it. Open bites can develop for several reasons, and sometimes multiple factors are involved.
Prolonged Thumb Sucking or Pacifier Use
This is one of the most common causes of open bites in children. When a child sucks their thumb or uses a pacifier for extended periods, especially past age 3 or 4, it can push the front teeth outward and prevent them from erupting properly. The constant pressure from the thumb or pacifier creates an opening between the upper and lower front teeth.
Most orthodontists recommend breaking thumb sucking or pacifier habits by age 3 to prevent open bite development. If the habit stops early enough, the open bite may self-correct as the child grows. If the habit continues into the school-age years, orthodontic intervention is often needed.
Tongue Thrusting
Tongue thrusting is a swallowing pattern where the tongue pushes forward against or between the teeth instead of pushing upward against the roof of the mouth. This constant forward pressure can prevent the front teeth from coming together and can even push teeth that have been aligned back into an open bite.
Tongue thrust often develops as a compensation for an existing open bite, but it can also cause or worsen the problem. Correcting a tongue thrust habit usually requires working with a speech therapist or myofunctional therapist in addition to orthodontic treatment.
Genetics and Jaw Growth Patterns
Some open bites are skeletal, meaning they’re caused by the way the jaw bones grow rather than by habits. Skeletal open bites tend to run in families and are often more challenging to treat because they involve the underlying bone structure, not just the teeth.
In skeletal open bites, the lower jaw may grow more vertically than horizontally, or the upper jaw may be positioned too far forward. These growth patterns can create a gap between the upper and lower front teeth even when the back teeth come together.
Mouth Breathing and Airway Issues
Chronic mouth breathing, often caused by enlarged tonsils, adenoids, or nasal obstructions, can contribute to open bite development. When a child breathes through their mouth instead of their nose, the tongue rests lower in the mouth, which can affect jaw growth and tooth positioning.
Addressing airway issues is an important part of treating some open bites. If the underlying cause isn’t addressed, the open bite may relapse after orthodontic treatment.
Temporomandibular Joint Disorders
In some cases, TMJ problems can contribute to open bite development or make treatment more complex. If the jaw joint isn’t functioning properly, it can affect how the teeth come together.
Orthodontic Treatments to Fix an Open Bite
Most open bites can be successfully treated with orthodontic intervention. The specific approach depends on the severity of the open bite, the patient’s age, and whether the open bite is dental or skeletal in nature.
Braces with Elastics
Traditional braces are one of the most effective treatments for open bites. Brackets and wires control tooth movement precisely, and elastics provide the additional force needed to bring the front teeth together.
Elastics, also called rubber bands, are stretched between hooks on the upper and lower braces. When worn consistently, they create a pulling force that helps close the open bite by moving the front teeth toward each other and sometimes by intruding the back teeth slightly to allow the front teeth to come together.
The key to success with elastics is compliance. Elastics only work when they’re worn as instructed, typically 20 to 22 hours a day. If a patient forgets to wear elastics or only wears them part-time, treatment takes longer and results may be compromised.
If you keep forgetting to wear your elastics, and you’re worried treatment will never finish here’s the solution: build elastic wear into your routine. Put new elastics in after brushing your teeth, keep extras in multiple places like your backpack, car, and bathroom, and set phone reminders if needed. Once it becomes automatic, compliance gets much easier.
Invisalign for Open Bite Correction
Invisalign can be an effective option for mild to moderate open bites, especially in adults. Aligners apply controlled forces to move teeth, and precision cuts in the aligner material can create intrusion forces on back teeth to help close the bite.
Invisalign for open bite correction often requires the use of elastics, just like braces. Small buttons are bonded to the teeth, and elastics are stretched between them to provide the additional force needed. Furthermore, aligners must be worn 20 to 22 hours a day for treatment to work, and compliance is critical.
Invisalign may not be appropriate for very severe open bites or for cases where skeletal correction is needed. Your orthodontist will evaluate whether Invisalign is a good option for your specific open bite.
Temporary Anchorage Devices
In some cases, small titanium screws called temporary anchorage devices, or TADs, are placed in the jaw bone to provide stable anchor points for moving teeth. TADs can be especially helpful in open bite treatment because they allow orthodontists to intrude back teeth without unwanted side effects.
TAD placement is a quick, minimally invasive procedure done in the orthodontic office. The screw is placed under local anesthesia and removed once it’s no longer needed. TADs have revolutionized open bite treatment by making it possible to achieve results that previously required surgery.
Habit Correction and Myofunctional Therapy
If an open bite is caused or maintained by thumb sucking, tongue thrusting, or other oral habits, those habits need to be addressed for treatment to succeed. For younger children, a habit-breaking appliance may be placed in the mouth to remind them not to suck their thumb or thrust their tongue.
Myofunctional therapy involves exercises and retraining to correct tongue posture and swallowing patterns. A myofunctional therapist works with the patient to develop healthier oral habits that support orthodontic treatment and prevent relapse.
Combining orthodontic treatment with habit correction often produces the most stable, long-term results.
Surgical Options for Severe Open Bite
In cases where the open bite is primarily skeletal and caused by jaw growth patterns, orthodontics alone may not be enough to fully correct the problem. For severe open bites, especially in adults whose jaws are no longer growing, orthognathic surgery may be recommended.
Orthognathic surgery, also called jaw surgery, involves repositioning the upper jaw, lower jaw, or both to correct the skeletal discrepancy. The surgery is performed by an oral and maxillofacial surgeon in a hospital setting under general anesthesia.
Here’s how it typically works: before surgery, the patient undergoes orthodontic treatment to align the teeth within each jaw. This pre-surgical phase usually lasts 12 to 18 months. Once the teeth are aligned, the surgeon repositions the jaws to correct the bite. After surgery, orthodontic treatment continues for several more months to fine-tune the bite and ensure everything fits together properly.
Orthognathic surgery sounds intimidating, and recovery does require several weeks of rest and a modified diet, but the results can be life-changing. Patients who undergo jaw surgery for open bite correction often experience dramatic improvements in function, facial balance, and confidence.
Surgery is typically reserved for the most severe cases where orthodontics alone cannot achieve a stable, functional result. Your orthodontist will work closely with a surgeon to plan treatment and determine whether surgery is necessary.
If you’re afraid of surgery, ask questions and make sure you understand why surgery is being recommended. If orthodontics alone could achieve a stable result, we’d recommend that first. When surgery is necessary, it’s because it provides the best long-term outcome. Modern surgical techniques have improved significantly, and most patients recover well with proper care.
How Long Does It Take to Fix an Open Bite?
The timeline for correcting an open bite depends on several factors, including the severity of the bite, the patient’s age, the treatment approach, and compliance with wearing elastics or aligners.
For mild to moderate open bites treated with braces or Invisalign, treatment typically takes 18 to 24 months. If the open bite is more severe or if skeletal issues are involved, treatment may take 24 to 36 months or longer.
Cases that include orthognathic surgery have a longer timeline because of the pre-surgical orthodontics, the surgery itself, and the post-surgical orthodontic finishing phase. The total treatment time for surgical cases is often 24 to 36 months or more.
Age also plays a role. Children and teens who are still growing often respond more quickly to treatment because their jaws are more adaptable. Adults can achieve excellent results as well, but tooth movement and jaw repositioning may take slightly longer.
Furthermore, compliance significantly affects treatment length. Wearing elastics as instructed, attending all appointments on time, and following care instructions all help keep treatment on schedule. Poor compliance can extend treatment by months or even years.
If treatment seems to be taking forever, and you’re not seeing much progress you should know that open bite correction is a gradual process, and changes aren’t always visible immediately. Trust that every adjustment and every day of elastic wear is moving you closer to the goal. If you’re concerned about progress, ask your orthodontist to show you comparison photos from the start of treatment so you can see how far you’ve come.
Preventing Open Bite Relapse After Treatment
One of the biggest challenges with open bite treatment is preventing relapse. Open bites have a higher tendency to relapse compared to other types of malocclusions, especially if the underlying cause wasn’t fully addressed.
Retention is absolutely critical after open bite correction. Most patients will need to wear retainers full-time initially and then transition to nighttime wear indefinitely. Some patients may need bonded retainers on the back of their front teeth to provide extra stability.
If tongue thrusting or other oral habits contributed to the open bite, those habits must be corrected and not allowed to return. Continued myofunctional therapy or periodic check-ins with a therapist can help maintain good oral habits.
Furthermore, if airway issues or TMJ problems were part of the original cause, those need to be managed long-term to prevent the bite from reopening. Addressing the root cause is just as important as correcting the teeth.
Regular retainer checkups with your orthodontist help catch any early signs of relapse before they become significant. If teeth start to shift, adjustments can be made quickly to get things back on track.
If your open bite came back after braces, and you’re feeling devastated, don’t panic, and don’t give up. Relapse can often be corrected with a shorter round of treatment or with retainer adjustments. The key is addressing it early. Contact your orthodontist as soon as you notice any changes, and we’ll create a plan to stabilize your bite.
Conclusion
An open bite is more than just a cosmetic concern, it affects how you chew, speak, and even how your jaw functions over time. The good news is that open bites can be successfully treated with orthodontic care, often using braces or Invisalign combined with elastics, habit correction, and in some cases, temporary anchorage devices. Severe skeletal open bites may require orthognathic surgery, but even these complex cases can achieve excellent, life-changing results.
Treatment timelines typically range from 18 to 36 months depending on severity, and retention is critical for preventing relapse. Addressing underlying causes like tongue thrust, thumb sucking, or airway issues is just as important as moving the teeth.
At Freedman & Haas Orthodontics in West Palm Beach, Wellington, and Indiantown, we have extensive experience treating open bites for patients of all ages. If you or your child has an open bite, the first step is a professional evaluation to determine the cause and the best treatment approach.
Ready to learn more about your options for fixing an open bite? Schedule a complimentary consultation with us at Freedman & Haas Orthodontics. We’ll evaluate your bite, explain your treatment options, and create a personalized plan that addresses both the symptoms and the underlying cause. Your healthier, more functional smile is closer than you think.