An overbite, or deep bite, is a common dental misalignment where the upper front teeth vertically overlap the lower front teeth excessively. While a slight overlap of two to four millimeters is normal, an excessive overlap leads to various functional and health issues. Correcting a deep bite in adulthood is a frequent and highly successful application of modern orthodontics. This process moves teeth and sometimes modifies jaw position, but it always begins with a professional consultation to determine the underlying cause and severity of the misalignment.
Functional and Aesthetic Impacts of Untreated Overbites
Correction of a deep bite is sought for reasons beyond aesthetics. A severe overbite causes excessive and uneven wear on the lower front teeth, potentially resulting in chipping, cracking, or premature enamel loss. This pressure can cause tooth sensitivity and necessitate extensive restorative dental work later in life.
When the overlap is deep, the lower incisors can bite directly into the gum tissue or the roof of the mouth behind the upper teeth. This constant impingement causes chronic gum irritation, painful sores, and tissue damage, increasing the risk of periodontal issues.
Furthermore, an uncorrected bite places strain on the temporomandibular joints (TMJ), potentially leading to chronic headaches, jaw pain, and difficulty chewing. Addressing the misalignment prevents cumulative long-term damage and improves the ability to chew food efficiently and enhance speech clarity.
Standard Non-Surgical Orthodontic Solutions
Most adult deep bites are successfully treated using non-surgical orthodontic methods focused on repositioning the teeth, known as dental compensation. Traditional fixed braces use brackets and archwires to apply continuous force for vertical correction. This correction involves two movements: intrusion of the front teeth and extrusion of the back teeth to open the bite.
Specialized components manage this vertical movement. Intrusion arches are shaped wires that push the incisor teeth gently upward into the jawbone. Bite turbos are small, temporary composite pads placed on the back of the teeth. These pads separate the back teeth, preventing the patient from biting off lower braces and allowing posterior teeth to naturally erupt, which helps open the deep bite.
Clear aligner systems, such as Invisalign, are also effective for correcting mild to moderate deep bites. The transparent aligners are customized with auxiliary features to facilitate the required vertical movements. These features include bite ramps, which are built-in ledges located behind the upper front teeth within the aligner itself.
When the patient bites down, the lower front teeth contact these ramps, momentarily separating the back teeth and mimicking bite turbos. This disarticulation allows the back teeth to extrude while promoting intrusion of the lower incisors. For intricate adjustments, aligners may include cutouts for elastics that stretch between the arches to apply necessary force.
Adult orthodontic treatment for overbites generally requires 18 to 36 months. The exact timeline depends on the severity of the initial misalignment and the biological response of the adult bone structure to the sustained forces.
Complex and Surgical Correction Methods
Severe deep bites are often rooted in a skeletal discrepancy, where the upper and lower jaws are mismatched in size or position. If the overbite is too severe for dental movement alone, or if jaw correction is needed for a balanced facial profile, orthognathic surgery (jaw surgery) is recommended. This approach requires collaboration between the orthodontist and an oral and maxillofacial surgeon.
Surgical correction is a phased treatment. It begins with pre-surgical orthodontics to align the teeth within their respective jaws, known as decompensation. This process often temporarily worsens the bite’s appearance. Following surgery, which repositions one or both jaws, a final phase of post-surgical orthodontics fine-tunes the bite.
For patients with moderate skeletal discrepancies who decline surgery, or those needing localized tooth movement, Temporary Anchorage Devices (TADs) offer an alternative. These small titanium screws are temporarily placed into the bone as fixed anchor points. TADs allow the orthodontist to apply precise forces to move teeth segments without relying on other teeth for anchorage, enhancing non-surgical treatment capability.
The use of TADs to mask a minor skeletal issue is called camouflage treatment. In this method, the skeletal imbalance is not corrected, but the teeth are moved to achieve a functional and aesthetically acceptable bite. This approach is only suitable for specific mild to moderate discrepancies where the facial profile will not be compromised.
Retention and Long-Term Maintenance
The active phase of correction must be immediately followed by the critical phase of retention. Teeth naturally tend to shift back toward their original positions, a phenomenon known as relapse, which is common with vertical corrections like deep bites. Inadequate retention can lead to a significant percentage of deep bite corrections relapsing.
To counteract relapse, patients are prescribed retainers, worn full-time initially and then transitioning to nightly wear, often indefinitely. Retention appliances come in two primary forms: fixed retainers and removable retainers. Fixed retainers consist of a thin wire bonded directly to the back surface of the front teeth, providing continuous support.
Removable retainers are typically a clear plastic shell (Essix or Vivera type) or a wire and acrylic appliance (Hawley type). For deep bite patients, the Hawley design may include a built-in anterior bite plane. This small acrylic ledge behind the front teeth helps maintain the vertical space created during treatment and prevents the bite from deepening again.