A deep bite, also known as an excessive overbite, is a common dental misalignment where the upper front teeth cover too much of the lower front teeth when the jaw is closed. While a slight overlap is normal, a deep bite occurs when this vertical overlap is pronounced, often completely hiding the lower teeth. This structural issue requires orthodontic intervention to correct the vertical relationship between the upper and lower dental arches. Correcting a deep bite with braces involves specific techniques and specialized appliances designed to move teeth vertically, aiming for a healthy, stable, and functional bite.
Identifying and Assessing Deep Bite Severity
Failure to correct a deep bite can lead to significant oral health problems. A common issue is excessive wear on the chewing surfaces of the lower front teeth, which compromises tooth structure. In severe cases, the lower front teeth may repeatedly hit the gum tissue behind the upper teeth, causing irritation and soft tissue trauma.
This misalignment also contributes to strain on the jaw joints, potentially leading to temporomandibular joint disorders (TMD). Symptoms often include chronic jaw pain, headaches, and difficulty chewing. Correcting the deep bite removes this excessive pressure, mitigating the risk of long-term joint and tooth damage. Severity is assessed by measuring the vertical distance of the overlap to determine the required treatment mechanics.
Specialized Appliances Used with Braces
Correcting a deep bite requires auxiliary mechanisms that work alongside the standard brackets and wires of fixed braces to achieve vertical movement.
Bite Turbos
One of the most frequently used tools is the bite turbo, also known as a bite ramp or bite pad. These are small pads bonded to the back surface of the upper front teeth or sometimes placed on the back molars. The primary function of bite turbos is to immediately disengage the patient’s bite, preventing the upper and lower teeth from fully meeting. This “opens” the bite, allowing the teeth to move freely without the destructive force of normal chewing. When placed on the front teeth, the patient must chew primarily on the turbos, which encourages the back teeth to erupt slightly, helping to reduce the deep bite. Bite turbos are temporary and are removed once the bite has been adequately corrected.
Intrusion Arches
Another technique involves specialized archwires, such as intrusion arches or utility arches, which are used to actively push the front teeth upward. These wires are carefully shaped and engaged into the braces to apply a light, continuous force that drives the upper incisors into the jawbone, a process called intrusion. Intrusion of the front teeth is a highly effective way to reduce the vertical overlap, especially in cases where the front teeth have over-erupted.
Elastics
Elastics, or rubber bands, are often introduced in later stages of treatment to refine the final bite relationship. These small bands are typically worn between specific points on the upper and lower braces to apply gentle, directed forces. For deep bite cases, elastics help to precisely settle the back teeth into their final, interlocking position, ensuring the vertical correction is stable and the entire bite functions harmoniously.
The Phased Treatment Process
The correction of a deep bite with braces typically follows a structured sequence of phases.
Leveling and Alignment
Correction begins with the initial leveling and alignment of the teeth. Orthodontists use flexible, light wires to straighten crowded or rotated teeth. This initial phase prepares the dental arch for vertical correction movements and ensures teeth are properly aligned horizontally before complex vertical adjustments begin.
Active Correction (Intrusion Phase)
The next stage is the active deep bite correction, or intrusion phase, utilizing specialized appliances like bite turbos and intrusion arches. This is the period of most dramatic vertical change, requiring regular adjustment appointments. This correction phase often takes between six to twelve months to achieve the target vertical reduction. Patients may initially find chewing difficult with bite turbos, but this discomfort is temporary as they adapt.
Finishing and Settling
The final phase involves finishing and settling the bite once the deep bite has been corrected to a healthy overlap. Auxiliary devices are typically removed, and the orthodontist uses stiffer wires to make minor positional adjustments. This ensures the top and bottom teeth fit together perfectly, refining the overall outcome and stabilizing the teeth before the braces are removed completely.
Maintaining Correction After Braces
Retention is a mandatory, lifelong commitment following active treatment for deep bite correction. Teeth have a strong tendency to return to their original position, a phenomenon known as relapse. Because deep bite correction has a significant relapse rate, long-term retainer wear is non-negotiable for stability.
The retention protocol almost always includes both fixed and removable retainers. A fixed retainer is a thin wire custom-bonded to the back of the front teeth, providing continuous stabilization. Removable retainers are worn nightly and are particularly effective when designed with an anterior bite plane, which helps prevent the front teeth from re-erupting and the bite from deepening again.