Correcting an open bite with braces aims to achieve proper vertical overlap between the upper and lower teeth when the jaw is closed. Treatment time varies significantly, ranging from 12 months for mild cases to over three years for complex situations, not including the retention phase. This duration depends heavily on the severity of the malocclusion, the patient’s biological response to treatment, and their dedication to the prescribed regimen.
Defining Open Bite and Correction Methods
An open bite is a type of malocclusion where a vertical gap remains between the upper and lower teeth when the mouth is fully closed. This condition manifests primarily as an anterior open bite (AOB), where the front teeth do not meet, or a posterior open bite (POB), where the back teeth fail to make contact. The anterior form is the most common and is often associated with habits like prolonged thumb-sucking or tongue thrusting.
Traditional metal or ceramic braces are effective for managing most open bite cases by applying consistent pressure to realign the teeth. For mild to moderate open bites, clear aligners may also be used as a discreet alternative. Both methods facilitate controlled tooth movement, but they often require specialized adjuncts to achieve the necessary vertical correction.
To close the vertical gap, orthodontists frequently use elastic rubber bands worn between the upper and lower arches. For complex dental movements, such as the intrusion of posterior teeth, Temporary Anchorage Devices (TADs) or mini-screws may be utilized to provide stable leverage. In the most severe cases involving a significant skeletal discrepancy, orthognathic surgery to reposition the jawbones is combined with the orthodontic treatment.
Key Variables Affecting Treatment Duration
The primary factor influencing treatment duration is the underlying cause and severity of the malocclusion, specifically whether it is dental or skeletal in origin. A dental open bite, caused only by tooth positioning, is easier and faster to correct than a skeletal open bite, which involves a mismatch in jaw size or position. Skeletal cases often require complex mechanics or surgery, leading to longer treatment times.
The patient’s age is another determinant, as treatment is faster for children and adolescents whose jaws are still growing. Growth modification appliances can be used in younger patients to influence jaw development, potentially shortening the time needed for fixed appliances later. In adults, corrections must rely solely on tooth movement or surgical intervention, which extends the overall timeline.
The complexity of the required tooth movement also plays a role, as closing an open bite involves either extruding the front teeth or intruding the back teeth. Posterior intrusion, often achieved with TADs, is a biomechanically challenging movement that contributes to a longer active treatment phase. Poor patient compliance, such as inconsistent wear of elastics or removable appliances, can significantly delay progress.
Patient Compliance and Habits
Persistent oral habits, such as tongue thrusting or mouth breathing, must be mitigated, as these forces actively work against the braces. If these habits are not corrected, often with myofunctional therapy or habit-breaking appliances, treatment is prolonged and the risk of relapse is higher. Missed appointments or frequent bracket breakages also lead to delays in the overall treatment timeline.
The Stages of Open Bite Correction
The correction process is divided into stages, with the active phase typically ranging from 18 to 36 months. The initial phase focuses on leveling and aligning the teeth, creating a stable arch form before vertical correction begins. This establishes a foundation for the bite closure mechanics by straightening crowded or rotated teeth.
The active mechanics phase addresses the vertical gap, often using elastics and specialized wires to achieve vertical movement. For non-surgical correction, this phase involves controlling the forces to either extrude the incisors or intrude the molars, which takes a substantial portion of the overall time. Regular adjustments, typically every four to six weeks, are necessary to maintain proper force levels and monitor the vertical tooth movement.
Once the open bite is closed and the teeth are in their final positions, the finishing and detailing stage begins to refine the occlusion. This stage is followed by the retention phase, which starts immediately after the braces are removed. Retention is important for open bite cases due to the high tendency for the bite to relapse or reopen.
Retainers, which may be fixed or removable, hold the corrected bite in place while the surrounding bone and soft tissues stabilize. Because the muscles and tongue have adapted to the former open bite position, retainers may need to be worn long-term or permanently to ensure stability. While the active phase may end in two or three years, the retention phase represents a lifelong commitment to maintaining the result.