Open Bite Braces: The Straightforward Guide to Treatment and Results
An open bite is one of those problems that looks obvious once you know what you are looking at. When the back teeth are touching and the front teeth are not — there is a visible gap when the mouth is closed — that is an open bite.
It is not as common as overcrowding or a mild overbite, but it is more common than most people realize. And it can cause real problems: difficulty biting through food, speech issues, uneven wear on the back teeth, and in some cases, jaw discomfort over time.
Braces can fix most open bites. The approach depends on what is causing it, how severe it is, and whether the jaw is still growing. Dr. Patel evaluates and treats open bites regularly at Tooth By Tooth Orthodontics in Cary.
In this article:
- What is an open bite and what causes it?
- How braces fix an open bite
- When is early treatment the right move?
- Can braces always fix an open bite without surgery?
- Frequently asked questions
What Is an Open Bite — and What Causes It?
An open bite means there is a gap between the upper and lower teeth when the jaw is fully closed. The most common form is an anterior open bite — a gap between the upper and lower front teeth. Posterior open bites (a gap in the back teeth while front teeth touch) are less common.
Thumb sucking or prolonged pacifier use: The most common cause in children. Consistent pressure from a thumb or pacifier pushes front teeth outward and apart. If this habit continues past age 4 or 5, an open bite can develop.
Tongue thrust: When the tongue pushes forward against the teeth during swallowing or at rest, it applies constant pressure that holds teeth apart. Open bites caused or maintained by tongue thrust are more likely to relapse after treatment unless the habit is addressed.
Skeletal growth patterns: Some patients develop an open bite due to vertical jaw growth patterns — the lower jaw grows downward and back rather than forward, creating a natural opening between upper and lower teeth. These cases often have a genetic component.
Mouth breathing: Chronic mouth breathing changes tongue posture and can contribute to vertical jaw development patterns over time.
Understanding the cause matters for treatment planning. A habit-related open bite in a 9-year-old is a very different treatment challenge than a skeletal open bite in an adult.
How Braces Fix an Open Bite
Braces correct open bites by moving teeth — specifically by intruding (pushing up) the back teeth and extruding (pulling down) the front teeth to close the gap.
Full braces: Standard brackets and wires on all teeth provide the foundation. Specific wire bends and bracket positioning help guide teeth into a closed position.
Vertical elastics: Rubber bands worn vertically between upper and lower front teeth apply a constant closing force. Patient compliance with these matters a great deal.
Temporary anchorage devices (TADs): For more significant open bites, Dr. Patel may use TADs — small titanium mini-screws placed in the bone — to provide stable anchor points for applying vertical force. They are more comfortable than they sound, and they allow movements that would otherwise require surgery.
Habit appliances: If tongue thrust is involved, a tongue crib or similar appliance can block the tongue from pushing against the teeth during treatment, improving results and reducing relapse risk.
| Open Bite Type | Treatment Approach | Typical Timeline |
|---|---|---|
| Mild, habit-related (child) | Habit correction plus braces | 12-18 months |
| Moderate dental open bite | Braces plus vertical elastics | 18-24 months |
| Significant, with tongue thrust | Braces plus TADs plus habit appliance | 24-30 months |
| Severe skeletal (adult) | Pre-surgical ortho plus jaw surgery | 24-36 months total |
When Is Early Treatment the Right Move?
For children, catching an open bite early — especially a habit-related one — produces the best results with the least treatment.
If thumb sucking is still happening at age 7 or 8, stopping the habit at that stage can allow the teeth to drift back into better position naturally, especially if the front teeth are only mildly separated. Full braces may not even be necessary.
Dr. Patel looks at open bites during Phase 1 evaluations. For growing patients with moderate to severe open bites, addressing the issue before the jaw finishes growing allows the jaw structure itself to adapt, not just the teeth. After growth is complete, the teeth-only correction window is the only option short of surgery.
The practical message: if your child’s pediatric dentist mentions an open bite or a persistent thumb-sucking habit, schedule an orthodontic evaluation. Even if treatment is not needed right away, knowing where things stand is worth the visit.
Can Braces Always Fix an Open Bite Without Surgery?
For most patients, yes. Dental open bites — where the jaw structure itself is normal but teeth are in the wrong position — respond well to braces, often with excellent long-term results.
Skeletal open bites in adults are different. When the vertical jaw relationship is the root cause, braces can improve things meaningfully but may not close the bite completely without surgical repositioning of the jaw. Dr. Patel is direct about this in consultations. If a case warrants a surgical evaluation, he refers to a trusted oral and maxillofacial surgeon and works collaboratively.
One thing worth noting: open bites have a higher relapse rate than other bite issues. Retainer compliance after treatment is especially important. Dr. Patel typically recommends long-term retainer wear for open bite cases, and when tongue thrust was a factor, some patients benefit from working with a myofunctional therapist alongside orthodontic treatment.
Frequently Asked Questions
How long does it take to fix an open bite with braces?
Most open bite cases take 18 to 30 months with braces. Severe skeletal cases that require surgery run 24 to 36 months total. Habit-related cases in young children can sometimes be addressed in 12 to 18 months, especially if the habit is stopped early.
Will an open bite come back after braces?
It can. Open bites have a higher relapse rate than overcrowding because the forces that caused the bite do not disappear when braces come off. Consistent retainer wear and, where applicable, addressing tongue posture reduces relapse risk significantly.
Can clear aligners fix an open bite?
Mild to moderate dental open bites can be treated with clear aligners. Significant skeletal open bites or cases requiring complex vertical movement are generally more predictable with traditional braces. Dr. Patel evaluates each case individually.
Have questions about your child’s bite? Dr. Patel is happy to take a look — no commitment, no runaround. Schedule a free consultation at Tooth By Tooth Orthodontics.
Related reading: Overbite braces before and after results | Braces at age 7
About the Author: Dr. Nishant Patel, DDS, MS is the founder and sole orthodontist at Tooth By Tooth Orthodontics in Cary, NC. He earned his DDS from the University of Illinois at Chicago (top of his class) and his MS with orthodontic certificate from the University of Minnesota. His research has been published in the American Journal of Orthodontics and Dentofacial Orthopedics. Over 12 years of clinical experience treating patients in the Chicago suburbs before founding Tooth By Tooth in Cary.
