top of page

Open bite and its significance for orthodontics: challenges and solutions

  • Sep 10
  • 30 min read
ree

Learning objectives

  • Understanding Open Bite: Recognize what an anterior open bite (AOB) is and the impact this malocclusion can have on aesthetics, speech, and chewing function.

  • Causes & risk factors: Learn about the multifactorial causes (habits such as thumb sucking, tongue thrusting, genetic predisposition, etc.) and risk factors (e.g. mouth breathing, iatrogenic factors) for the development of an open bite.

  • Understanding treatment options: Overview of treatment options for AOB (orthodontic vs. surgical, aligner vs. conventional appliances) and their limitations, including evidence on success and long-term stability pubmed.ncbi.nlm.nih.gov .

  • Assess evidence & bias: Ability to critically evaluate studies on AOB treatment (evidence level according to traffic light system 🟢🟡🔴) and to recognize possible biases (conflicts of interest, author clusters, publication bias) in order to make informed treatment decisions.



Key messages (take-home)

  • Prevalence: Anterior open bite occurs in approximately 5% of the general population, with prevalence rates of up to 17% observed in orthodontic patients with skeletal malocclusion. Therefore, anterior open bite is not a rare anomaly—early detection is important.

  • Multifactorial etiology: The development of an open bite is usually multifactorial. Habits (pacifier use, thumb sucking), incorrect tongue position/thrusting, and unfavorable growth patterns (genetic predisposition to a "long face") often play a role. Enlarged adenoids (mouth breathing) or an enlarged tongue body (macroglossia) can also contribute. The consequences are significant: Open bites impair speech formation, chewing ability, and aesthetics, and have been proven to reduce quality of life.

  • Therapy is demanding: Correcting an open bite is considered particularly challenging in orthodontics and is prone to recurrence pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov . Nevertheless, long-term studies show that both surgical and non-surgical therapies achieve a success rate of approximately 75–82% (i.e., this is how many patients maintain a positive overbite ≥12 months after treatment) pubmed.ncbi.nlm.nih.gov . Surgical treatments tend to have slightly higher stability rates (up to ~82–100%) than purely orthodontic approaches (~62–97%) pmc.ncbi.nlm.nih.gov , but overall, with careful planning, permanent overbite correction is possible in ~3 out of 4 patients even without surgery.

  • Aligners vs. fixed braces: Current studies show that transparent aligners (e.g., Invisalign) can successfully correct mild to moderate open bites – however, the virtually planned tooth movements are often not fully achieved clinically. In a recent study, for example, only ~66% of the bite closure programmed in ClinCheck® was actually achieved on average. Conventional fixed appliances (brackets) achieve comparable correction results, sometimes even slightly greater overbite improvements. Important: Both methods close the open bite primarily through anterior tooth extrusion; actual controlled influence on the posterior teeth (molar intrusion) is limited and often requires additional measures.

                        Want to read more?

                        Subscribe to dailydentaljournal.com to keep reading this exclusive post.

                        bottom of page