What Is an Open Bite?
An open bite occurs when the upper and lower teeth do not overlap when you close your mouth. An anterior open bite affects the front teeth, leaving a visible gap even when the back teeth come together. A posterior open bite affects the back teeth, where the front teeth meet but the sides do not. Both types can make it difficult to bite into food, affect speech, and cause uneven wear.
Open bites fall into two categories. A dental open bite is caused by tooth position. Treatment options for a dental open bite usually include traditional braces or metal braces, which fix open bite problems by moving teeth into alignment. A skeletal open bite is caused by abnormal growth of the upper jaw, lower jaw, or both, and often requires braces and jaw surgery for a lasting correction.
Common Causes of Open Bite
- Thumb sucking or pacifier use beyond age 3 to 4, which pushes the front teeth outward and prevents them from meeting.
- Tongue thrusting, a habit where the tongue pushes forward against or between the front teeth during swallowing or at rest.
- Skeletal growth patterns where the lower jaw grows downward and backward more than normal (sometimes called long face syndrome).
- Genetics. Some patients inherit jaw proportions that predispose them to an open bite.
- Temporomandibular joint (TMJ) conditions that alter how the jaw closes.
How Braces Correct an Open Bite
Traditional braces and metal braces close an open bite by moving teeth vertically. The goal is to push the back teeth up (intrusion) or pull the front teeth down (extrusion) so the upper and lower teeth meet properly. Orthodontics fix open bites through a combination of both approaches. Your orthodontist will design a plan based on whether you have an anterior open bite, posterior open bite, or both.
Elastics (Rubber Bands)
Elastics are small rubber bands that connect upper and lower braces to apply force in specific directions. For open bite treatment, vertical elastics pull the upper and lower teeth toward each other. Whether you wear metal braces or clear braces, you wear these elastics 20 to 22 hours per day, removing them only to eat and brush.
Consistent elastic wear is critical for treating open bites. Skipping elastics even for a few hours a day slows progress. Orthodontists consider compliance one of the biggest factors in open bite treatment success.
Temporary Anchorage Devices (TADs)
TADs are small titanium screws (about the size of an earring post) temporarily placed into the jawbone through the gum tissue. They act as fixed anchor points that allow the orthodontist to apply forces that would be difficult or impossible with braces and elastics alone.
For open bite treatment, TADs are commonly used to intrude (push up) the back teeth. By moving the back teeth upward, the lower jaw rotates forward, which helps fix open bite gaps. This works for both anterior open bite and posterior open bite cases. TAD placement is a minor in-office procedure under local anesthesia. The screws are removed once treatment is complete.
Extrusion of Front Teeth
In some cases, the orthodontist will use archwire mechanics or elastics to extrude (pull down) the front teeth so they close the gap. This approach works well when the back teeth are already in a good position and the front teeth simply need to be brought together.
Extrusion tends to be less stable long-term than intrusion, which is why many orthodontists prefer TAD-assisted intrusion. With traditional braces or metal braces, your orthodontist will determine which mechanics produce the most stable result for your bite.
Can Invisalign Fix an Open Bite?
Clear aligners like Invisalign can correct mild to moderate dental open bites, particularly anterior open bite cases in adults where the gap is small and the underlying jaw relationship is normal. Clear aligners can extrude front teeth and, to a limited degree, intrude back teeth.
However, moderate to severe open bites typically require mechanics that clear aligners cannot deliver. Vertical tooth movement is one of the most challenging movements for aligners. Among treatment options for significant open bite treatment, traditional braces with elastics and TADs provide the most predictable control. Some orthodontists use a hybrid approach: metal braces or clear braces for the main correction phase, then clear aligners for finishing.
If you are interested in clear aligners for an open bite, an orthodontist can evaluate whether your specific case falls within the mild to moderate range that aligners can predictably treat. Many patients with anterior open bite concerns find that treatment options beyond aligners produce more reliable results.
When Is Jaw Surgery Needed for an Open Bite?
Skeletal open bites in adults, where the jaw prevents the upper and lower teeth from meeting, cannot be corrected with traditional braces alone. Treatment options for skeletal cases include orthognathic (jaw) surgery combined with braces. Can orthodontics fix open bites that are skeletal? Only when surgery repositions the jaw first.
The orthodontist first aligns the teeth with metal braces (typically 12 to 18 months of pre-surgical orthodontics). A surgeon then repositions the jaw to fix open bite problems caused by the skeletal structure. After surgery, braces remain for several more months to finalize the bite.
Surgery is typically recommended when the open bite is large (more than a few millimeters), when the cause is clearly skeletal, or when previous treatment has relapsed. Treating open bites surgically can cost $20,000 to $40,000 total. Medical and dental insurance may cover portions when deemed medically necessary. Costs vary by location and provider.
Why Stopping Habits Is Essential
If thumb sucking or tongue thrusting caused the open bite, that habit must stop for the correction to be stable. Can orthodontics fix open bites caused by habits? Metal braces or traditional braces move teeth into position, but if the tongue keeps pushing against the front teeth after treatment, the open bite will return.
For children, a habit appliance (such as a tongue crib or rake) can be built into braces to help break the habit. For older patients, myofunctional therapy, a series of exercises that retrain the tongue to rest in the correct position and swallow properly, is often recommended. An orthodontist can refer you to a myofunctional therapist if this applies to your case.
Relapse rates for open bite correction are higher than most other orthodontic problems. Whether orthodontics fix open bites with metal braces, clear braces, or clear aligners, habit control and retainer wear are the two most important factors in keeping results.
Treatment Timeline and Cost
Open bite treatment is among the more complex orthodontic procedures. Treatment options like traditional braces, metal braces, and clear braces all require a longer timeline compared to straightforward crowding or spacing cases.
How Long Does Treatment Take?
Braces for open bite correction typically take 18 to 30 months. Mild to moderate dental open bites may be corrected in as few as 12 to 18 months. Severe or skeletal cases that include surgery may take 24 to 36 months total, including pre-surgical and post-surgical orthodontic phases.
Consistent elastic wear and habit cessation can significantly affect the timeline. Patients who are diligent with their elastics and address underlying habits tend to finish open bite treatment faster.
How Much Do Braces for Open Bite Cost?
The cost of braces for open bite correction typically ranges from $5,000 to $8,000 for non-surgical cases. If TADs are needed, they may add $300 to $600 per screw. Surgical cases that include orthognathic surgery can cost $20,000 to $40,000 total for orthodontics and surgery combined. Costs vary by location, provider, and case complexity.
Most orthodontic practices offer payment plans. Dental insurance typically covers a portion of orthodontic treatment (often up to a lifetime maximum of $1,500 to $2,500). Medical insurance may cover jaw surgery when it is deemed medically necessary.
When to See an Orthodontist
If you or your child has a visible gap between the upper and lower front teeth when the mouth is closed, an orthodontic evaluation is the first step. The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7, which is early enough to detect open bite tendencies and intervene with habit appliances if needed.
For adults, it is never too late to address an open bite. An orthodontist can determine whether braces alone, braces with TADs, or braces combined with surgery will produce the best result. Because open bite treatment is more complex than many other orthodontic corrections, seeing a specialist rather than relying solely on a general dentist's assessment is particularly important.
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