Open Bite

OPEN BITE

When we hear about dental malocclusion, we understand that it means a disproportion in the arrangement of the teeth- they may have spacing or crowding issues.One particularly common type is having an “open bite”.

Open bite is an improper alignment of the teeth, in whichsome do not align properly when you are biting down. This often happens when the baby teeth are being replaced with permanent teeth. It usually rectifies itself before a child becomes an adult, but if it doesn’t, you may need your dentist’s help to correct it.

In this guide, we will address the details of having an open bite, and the different options to treat it.

TABLE OF CONTENTS

THE MEANING OF OPEN BITE:

Open bite is an improper arrangement of the upper and lower teeth, where they do not touch when they bite against each other.

Normally, the upper frontteeth bite down slightly lower and in front of the lower front teeth, while the back teeth touch each other. In an open bite, there is a recognisable gap between both the upper and lower jaws as the teeth do not join together.

TYPES OF OPEN BITE:

  • Anterior open bite
  • Posterior open bite.

ANTERIOR OPEN BITE:  This is where the front top and bottom teeth do not touch each other (even when the back teeth do) when the mouth is closed because they are outwardly slanted.

POSTERIOR OPEN BITE:

This is less common, and usually occurs as a result of treatment using braces. It is a condition in which the back top and bottom teeth don’t meet when the mouth is shut, even when the front ones do. This can impede your ability to chew properly.

CAUSES AND SYMPTOMS OF OPEN BITE

Symptoms of an open bite can be noted just by observing the arrangement of the teeth when they’re biting down on each other. If the open bite is caused by a jawbone issue, the front teeth usually extend outwards noticeably.

In more common cases, there is a visible space between the upper and lower teeth at the front or by the sides.

Here are some common causes of open bite:

  • Genetics- where the jaws develop away from each other instead of converging, as is normal.
  • Sucking dummies, thumbs and other objects can lead to irregularities in the arrangement of the teeth as they develop.
  • Issues with the temporomandibular joint can affect the positioning of the teeth. This joint connects the bottom jaw and skull together, so a defect in the joint can lead to asymmetrical teeth and an over bite.
  • Thrusting the tongue against the teeth during speech. This is more common in young children, and usually rectifies itself before the age of four. If not, however, continued force from the tongue can alter the alignment of teeth and cause over bite.
  • Defects in the structure of the jaw bone.
  • Transitioning between baby and adult teeth.

Generally, if the defect results from bone disorders, it is referred to as a “skeletal open bite”. However, where it results from factors such as thumb-sucking and thrusting of the tongue, it is called a “dental open bite”.

DIFFICULTIES RESULTING FROM OPEN BITE:

  • It can cause you to lose confidence and lower your self-esteem, which can have other psychological and social effects.
  • Difficulty eating some kinds of food.
  • It can lead to speech problems, and a lisp can develop.
  • Wear or fracture of the back teeth, due toimproper contact with each other.

Other problems associated with open bite include:

1) Problems with the jaw: The joint which moves your lower jaw, letting your mouth open, iscalled the “Temporomandibular Joint”. People with adisorder of this joint may tend to place their tongue in a certain place, or move their mouth in a certain way. This changes the position of the teeth as they are jutted forward, leading to an open bite. The issue causing the defect in the jaw has to be rectified and treated to reverse the misaligned bite.

2) Thrusting of the tongue: This is the most common cause of open bite. Tongue thrusting is a condition where the tongue pushes forward against the front teeth when you speak, eat and drink. This forcefully pushes the mouth forwards, and results in open bite. Commonly, children under the age of four are most susceptible to develop this, although it usually resolves itself with time.

TREATMENTS

Treatment for open bite usually depends on the age of the individual affected, and whether they have baby or permanent teeth. This is why it is important to seek advice from your dentist, who will be best able to advise on the appropriate steps.

In children, there is rarely any need for actual treatment, as the condition is a result of childish habits like tongue thrusting and thumb- sucking. This usually clears up on its own when the child grows out of these habits. It is best to just monitor your child to see if they persist in these habits.

In individuals whose adult teeth are coming through, or where the adult teeth haven’t completely developed, therapy can be used to modify behaviour.Where the adult teeth are developing with an open bite, braces may be usually recommended.

In fully formed adult teeth, multiple methods may be recommended simultaneously; such as using braces and behavioural modification therapy.In some extreme cases, surgery of the jaw may be needed to correct abnormalities.

The following are the different remedies used for various ages:

Age REmedies
<  Age 4 -Try to stop tongue thrusting and dummy sucking.

-No additional attention is required; the condition tends to to rectify itself at this age.

5 -10years  As above
10- 17 years -At this age, braces may be suggested.
18 and above -Braces may be used.

-At this age, veneers may be recommended for

aesthetic purposes.

– In rare cases, surgery may be advised to correct

jaw abnormalities

 
 

TREATMENT METHODS

  • Braces

This is the most common method to correct an open bite. Braces will help re-adjust teeth that jut out forward by pulling them back into their normal positions.

Treatment with braces can take between six months- 2 years. After that, it is important to begin wearing a retainer. Retainers are devices that help maintain straightened teeth. They can be permanently worn or temporarily. They can be made out of metal wires or transparent plastic. Either way, they help maintain the new position that the braces have moved your teeth to. Without them, after removing braces, the teeth will begin shifting again.

  • Thrusting of tongue treatment

Usually, treatment of tongue thrusting is achieved with the aid of speech therapy, tongue exercises and orthodontic rectifiers such as a tongue crib.A tongue crib is used to restrict forward pushing of the tongue. Combined with therapy and exercises, the habit of tongue thrusting can be discontinued. This ensures no relapses after the braces have come off, and prevents the issue re- occuring.

  • The use of Invisalign

These popular new invisible braces can be used to re-arrange the teeth to a desired position. TheNHS only funds braces with metal materials, but many people opt for Invisalign because it is a very discreet alternative. These are transparent plastic braces that are replaced every fortnight, and they re-arrange the teeth to a different position over time.

These invisible braces can treat over 90% of misalignment disorders.An appointment with anInvisalign- certified dentist should be booked to discuss your treatment options.

  • Using veneers

Veneers are a type of thin tooth coating or covering made from composite materials or Ceramic. They can be used in minor open bites cases, as they aid in filling up space in the teeth and the arrangement of disproportional teeth. This is generally a cheap option to fix the issue but does have some drawbacks:

  • Veneers alter the natural size of your teeth, making them appear larger to fill up the gaps.
  • Secondly, they can be counterproductive as the addition of more forces in the mouth can cause more issues with tooth arrangement.
  • Inherent issues like the wear on the back teeth and tongue thrusting will not be resolved by using veneers.
  • The surface of veneers makes it hard for braces to stick on to in the future. They also make jaw surgery harder to perform.
  • Some of your enamel has to be permanently scraped off when applying veneers- this enamel cannot be replaced or regenerated..

This is why it is important to seek professional advice from a dentist before deciding to rectify anopen bite using veneers.

Deespite this, veneers are the fastest way to rectify a minor open bite without additional chronic factors, such as a jaw disorder.

OPEN BITE SURGERY

In extreme cases, surgery may be recommended; especially in cases involving adults where the teeth have finished developing and as such are harder to move. Before surgery, braces will have to be worn for around one year; and up to a year afterwards too.

After the surgery, you won’t be able to eat solid food for some days because of the work on your mouth, though you won’t have any surgical scars as the surgery is internal. The NHS covers all open bite surgeries for individuals below 18 years of age for free, and if there is a medical emergency requiring open bite surgery in adults, theNHS covers the charges. Open bite corrective surgeries performed privately cost between £2,000 and £6,000.

Open bite as a defect can result in certain practical problems, and as such, it is advisable – even as adults – to seek advice from a dentist.

ARE THERE ANY RISKS INVOLVED WITH THE SURGERY?

Any surgical procedure carries some level of risk. The type of risk is all dependent on the complexity of the issue and surgical operation. In dental jaw surgeries, the risks are generally not extensive; there is a small theoretical risk of bones breaking and the need for additional plates and screws. Oral and maxillofacial surgeons, however, are dual-qualified in both medicine and dentistry so are highly skilled and experienced in their work. You may be assured you are in very capable hands if you undergo this type of procedure.

Before the surgery, your doctors will first map out all the repairs they will make, using a computer or virtual model of your mouth.

SUMMARY:

There are a huge variety of ways to correct an open bite, and give you a smile which will make you more confident and feel good about yourself. At Chatfield, our team will listen to your concerns and endeavour to give you the very best treatment, in order to give you your dream smile. So don’t hesitate, and call us for a consultation today!