An overbite, or deep bite, occurs when the upper front teeth excessively overlap the lower front teeth vertically, a condition also known as a Class II malocclusion. While traditional fixed metal braces have historically been the primary treatment, modern orthodontics offers several effective alternatives. For many individuals with mild to moderate issues, an overbite can be corrected without relying on fixed braces, though the specific method depends entirely on the underlying cause and severity of the misalignment.
Determining the Type of Overbite
The success of any non-braces treatment hinges on correctly identifying the origin of the overbite, which is broadly categorized as either dental or skeletal. A dental overbite is primarily caused by the positioning and angle of the teeth themselves. This type is the least complex to correct, as the underlying jaw structure is properly aligned.
A skeletal overbite, conversely, stems from a mismatch in the size or position of the upper and lower jaws. This discrepancy might involve an upper jaw that is too far forward, or a lower jaw that is positioned too far back. Skeletal issues are more challenging to treat, especially in adults whose jaw growth is complete, and may require more invasive interventions.
Appliance-Based Solutions for Mild to Moderate Cases
For overbites caused mainly by tooth position, or for patients still undergoing jaw growth, discreet appliances offer an alternative to fixed braces. Clear aligners, such as those made by Invisalign, are custom-made, transparent trays that move teeth incrementally into their correct positions. They are effective for mild to moderate dental overbites by applying controlled pressure to vertically intrude the upper teeth and extrude the lower teeth.
To enhance the effectiveness of clear aligners, orthodontists often use attachments—small, tooth-colored bumps temporarily bonded to the teeth. These attachments give the aligners the necessary grip to execute the vertical movements required to reduce the overlap. Patient compliance is necessary for success, as aligners must be worn for approximately 22 hours per day.
For children and adolescents whose facial skeletons are still developing, functional appliances are used to modify and guide jaw growth. These devices, which can be fixed or removable, utilize the natural muscle movements of the mouth to reposition the lower jaw forward. Appliances like the Twin Block or Herbst appliance encourage the lower jaw to catch up to the upper jaw, correcting the skeletal imbalance during a growth spurt.
Functional appliances are often used in a first phase of treatment to create a harmonious foundation, reducing the complexity of future tooth movement. Palatal expanders can also be used when the overbite is compounded by a narrow upper jaw. This device gently widens the upper jaw structure, allowing the upper and lower teeth to fit together properly, often preventing the need for more extensive treatment later.
Active retainers, generally used after major orthodontic treatment to maintain alignment, can sometimes be used alone to correct minor dental overbites. These devices apply slight, continuous pressure to achieve subtle tooth movements, particularly for cases of relapse or minimal overlap. An anterior bite plane, incorporated into certain removable appliances, can also help by preventing the lower incisors from erupting further while allowing the back teeth to move into a better relationship.
Advanced and Surgical Corrections
When an overbite is severe and originates from a significant skeletal discrepancy that cannot be corrected by growth modification, especially in adults, the solution often involves surgery. Orthognathic surgery, or corrective jaw surgery, is required to physically reposition the jawbones—the maxilla (upper jaw) or mandible (lower jaw), or both—to establish a correct bite. This procedure is reserved for the most pronounced cases where non-surgical methods are insufficient to achieve proper function.
Orthognathic surgery is necessary to alleviate functional issues such as difficulty chewing, jaw pain, and excessive tooth wear caused by the severe misalignment. While the surgery corrects the bone structure, it is often performed in conjunction with a period of orthodontic treatment, which prepares the teeth for the new jaw position.
In some adult cases, dental crowding contributes to the overbite, and tooth extraction may be required to create space for the remaining teeth to align properly. This extraction can be done without full fixed braces, allowing subsequent treatment with clear aligners or other appliances to move the teeth into the newly created space. For minor aesthetic concerns, dental restorations like veneers or crowns can sometimes be used to cosmetically mask a small overbite by altering the appearance of the front teeth. However, this approach does not correct the underlying bite structure. A consultation with an orthodontist is necessary to determine the most appropriate pathway based on the specific type and severity of the overbite.