An overbite, often called a deep bite or Class II malocclusion, occurs when the upper front teeth excessively overlap the lower front teeth when biting down. While a slight overlap is normal, a pronounced one can cause issues like abnormal tooth wear and jaw pain. Age is not a barrier to correction; an overbite can definitively be fixed in adults. The approach to treatment differs from that for children because the jawbones are no longer growing, meaning methods focus on repositioning teeth or altering the jaw structure itself. Adult treatment plans are highly individualized, depending on the severity of the overlap and the underlying cause, which may involve solely tooth movement or a combination of orthodontic and surgical procedures.
Classifying the Overbite: Dental vs. Skeletal Causes
Appropriate treatment relies on diagnosing the origin of the overbite, which is categorized into two main types. A dental overbite means the problem lies exclusively with the position of the teeth, where the upper teeth protrude excessively despite the jawbones being correctly aligned. This misalignment often results from factors like teeth crowding or habits such as thumb-sucking during development.
A skeletal overbite, by contrast, is rooted in a structural discrepancy between the upper jaw (maxilla) and the lower jaw (mandible). This occurs when the upper jaw is positioned too far forward or the lower jaw is too small, creating a pronounced overlap that involves the facial bones, not just the teeth. Diagnosis involves a comprehensive examination, including clinical assessment and diagnostic imaging like cephalometric X-rays. This classification dictates whether a non-surgical or surgical approach will be necessary for a stable correction.
Non-Surgical Orthodontic Solutions
For overbites that are primarily dental or mild skeletal in nature, non-surgical orthodontic solutions are often highly effective. Traditional fixed appliances, commonly known as braces, use brackets and wires to apply continuous, gentle pressure, systematically moving the teeth into their corrected positions. The mechanism of tooth movement in adults is similar to that in adolescents, although the process can take longer due to the denser bone structure of a mature jaw.
Clear aligner systems, such as Invisalign, are a popular aesthetic alternative, utilizing custom-made, removable trays that gradually shift the teeth. To effectively address vertical overlap, these aligners often require the use of small, tooth-colored attachments bonded to the teeth, along with rubber bands (elastics) to apply the necessary force for bite correction. In complex cases, orthodontists may incorporate Temporary Anchorage Devices (TADs)—small, temporary implants placed in the bone—to provide a stable point for precise tooth movement, such as incisor intrusion. These non-surgical methods successfully correct the alignment of the teeth to reduce the deep bite, provided the underlying jaw structure is not severely misaligned.
Surgical Intervention for Complex Cases
When an adult’s overbite results from a severe skeletal discrepancy, orthodontics alone cannot achieve complete correction because the growth plates are closed and jawbones cannot be reshaped by tooth movement. In these instances, orthognathic surgery (corrective jaw surgery) is necessary to reposition the bones. This procedure is reserved for cases where the jaw misalignment is so pronounced that it compromises function, affecting the ability to chew, speak, or even breathe properly.
The surgical process involves an oral and maxillofacial surgeon carefully cutting and repositioning the upper jaw (maxilla), lower jaw (mandible), or both, to achieve a harmonious and functional alignment. This is typically performed under general anesthesia, with the goal of bringing the jawbones into their optimal functional and aesthetic position. Orthognathic surgery is not a standalone treatment; it is integrated into a comprehensive plan that includes pre- and post-surgical phases of orthodontic treatment to ensure the teeth are aligned perfectly to fit the newly positioned jaws.
Unique Considerations for Adult Treatment
Adult orthodontic treatment introduces specific factors that influence the experience and outcome. Due to the maturity and density of adult bone, tooth movement tends to be slower than in adolescents, often resulting in treatment timelines that can range from 18 to 36 months, depending on the severity of the case. This extended period requires careful planning to manage existing dental work, such as fillings, crowns, or compromised periodontal health, preventing complications during tooth movement.
The financial aspect is another unique consideration, as adult treatment is frequently considered elective and may not be covered by standard dental insurance, often leading to substantial out-of-pocket costs. The average cost for adult orthodontics can vary widely, with traditional braces generally ranging from $3,000 to $7,000 and clear aligners from $3,500 to $8,000, depending on the complexity and duration of the case. Long-term retention is necessary after the active phase of correction; fixed or removable retainers are required indefinitely to prevent relapse and protect the investment.