An open bite, where your front teeth don’t touch when your back teeth are fully closed, can be corrected through several approaches depending on its cause and severity. Options range from habit changes and orthodontics for mild cases to jaw surgery for severe skeletal misalignment. The right fix depends on whether the problem is in your teeth, your jaw bones, or both.
What Type of Open Bite You Have Matters
Not all open bites are the same, and the distinction shapes your entire treatment plan. A dental open bite is limited to the teeth themselves. Your jaw structure is normal, but the teeth have shifted out of alignment, often from habits like thumb sucking or tongue thrusting. On an X-ray, nothing looks wrong with the bones.
A skeletal open bite involves the jaw bones themselves. The upper and lower jaws grew at different rates or in different directions, creating a vertical gap that can’t be closed by moving teeth alone. Skeletal open bites show up clearly on a cephalometric X-ray (a side-view skull image) as a measurable disharmony between the upper and lower jaw angles. This type is harder to treat and more likely to need surgery in adults.
There’s also a pseudo open bite, where the front teeth simply stick out far enough that they can’t overlap, even though the jaw and tooth positions are otherwise normal. This is generally the easiest type to correct.
Breaking Habits in Children
In kids, open bites frequently develop from prolonged thumb sucking, pacifier use, or tongue thrusting (pushing the tongue forward against or between the front teeth during swallowing). If the habit stops early enough, the bite often self-corrects as the child grows. When it doesn’t stop on its own, dentists can place a small appliance inside the mouth to help.
A tongue crib is a metal framework attached to the back teeth with small bars behind the front teeth. It physically blocks the tongue from pushing forward and reminds the child not to suck their thumb. These appliances are extremely effective as both reminders and physical restrainers. A variation called the Bluegrass appliance uses a small roller on the palate to give the tongue something to play with, redirecting the habit rather than just blocking it. In one documented case, a hybrid habit-correcting appliance resolved a tongue thrust in just six months.
Early intervention matters. Phase one treatment in children typically takes 16 to 24 months and can prevent the need for more invasive correction later.
Braces and Anchorage Devices
For older teens and adults with a dental open bite, traditional braces are the most common starting point. But standard braces have a limitation: when you push teeth in one direction, other teeth tend to move as a reaction. That’s where temporary anchorage devices, or TADs, have changed the game.
TADs are tiny titanium screws placed directly into the jawbone during a quick office procedure. They act as fixed anchor points, letting your orthodontist push back teeth upward (intrusion) without unwanted movement elsewhere. When the back teeth are pushed up into the jawbone, the lower jaw naturally rotates forward and upward, closing the open bite in front.
A systematic review and meta-analysis found that TAD-assisted molar intrusion achieves an average of 1.7 mm of tooth movement. That might sound small, but each millimeter of molar intrusion produces roughly 0.86 mm of bite closure in the front. One study documented 2.67 mm of intrusion resulting in 3.6 mm of bite closure. For many patients, that’s enough to fully resolve the problem without surgery.
Clear Aligners for Mild to Moderate Cases
Clear aligners like Invisalign can correct open bites, though they work best for milder cases. In a clinical study of patients with open bites averaging negative 3.5 mm (meaning their front teeth were 3.5 mm apart when biting down), aligner treatment improved overbite to a positive 1.6 mm on average. That’s a swing of over 5 mm, which represents a fully corrected bite.
Treatment required an average of about 25 sets of aligners, with a range of 20 to 30 sets. Since you typically change aligners every one to two weeks, expect roughly 10 to 15 months of active wear for the aligner phase alone. Aligners work through a combination of small, staged movements: tipping teeth, adjusting their roots, and selectively intruding certain teeth while extruding others. The tradeoff is that aligners give the orthodontist less control over complex vertical movements compared to braces with TADs, so they’re not ideal for severe or skeletal open bites.
When Surgery Is the Best Option
If your open bite stems from a skeletal problem, particularly significant vertical excess in the upper jaw or a jaw that grew too far downward, orthodontics alone may not get the job done. Orthognathic surgery repositions the jaw bones themselves.
The most common procedure for open bite is a LeFort I osteotomy, which separates the entire upper jaw from the rest of the skull so the surgeon can reposition it. The surgery is done through an incision inside your mouth (no visible scars) from one first molar to the other. The surgeon uses a small saw and specialized instruments to carefully free the upper jaw, then moves it into the planned position and secures it with titanium plates and screws.
The jaw can be moved in all three dimensions: up, down, forward, backward, or tilted to correct asymmetry. For open bite, the typical movement is impacting (pushing up) the back of the upper jaw, which rotates the lower jaw closed.
Recovery is faster than most people expect. You’ll spend one night in the hospital. A feeding tube stays in for 24 hours to manage nausea. Most patients are back to desk work within two weeks, though you’ll eat soft foods for six to eight weeks while the bones heal. Orthodontic braces are worn before and after surgery to fine-tune the tooth positions around the new jaw alignment.
Tongue Exercises to Support Treatment
Regardless of which correction method you choose, myofunctional therapy (a fancy term for tongue and lip exercises) plays an important supporting role. Here’s why: if a tongue thrust caused or contributed to your open bite, moving the teeth without retraining the tongue is like straightening a fence while the wind keeps blowing it over. The habit will push the teeth back apart.
Common exercises include:
- Tongue spot hold: Place the tip of your tongue on the ridge just behind your upper front teeth. Hold for 10 seconds, repeat 10 times. This trains the tongue to rest in the correct position.
- The 4S exercise: Touch the spot, salivate, squeeze the tongue against the palate, and swallow while keeping your teeth together. This retrains your swallowing pattern.
- Button pull: Thread a string through a large button, hold the button between your lips and teeth, and try to pull it out while resisting with your lips. This strengthens the lip seal.
- Lip stretching: Stretch your upper lip downward and outward to its maximum, hold, and repeat 10 times. Builds the muscle tone needed to keep your lips closed at rest.
These exercises work best when done consistently over months. They don’t replace orthodontic treatment, but they significantly reduce the chance of relapse after treatment ends.
What Treatment Costs
Cost varies widely depending on the approach. Metal braces typically run $3,000 to $7,500. Ceramic (tooth-colored) braces cost $4,000 to $8,000. Clear aligners range from $3,000 to $9,000, with most patients paying $5,000 to $7,000. Lingual braces, which sit behind the teeth, are the priciest orthodontic option at $8,000 to $13,000. TADs add a few hundred to a few thousand dollars on top of orthodontic fees, depending on how many are placed.
Orthognathic surgery is a separate and much larger expense, often $20,000 to $40,000 before insurance. However, because jaw surgery corrects a functional problem (not just cosmetics), medical insurance frequently covers a significant portion. Dental insurance typically covers part of the orthodontic component. Many orthodontists offer payment plans that spread the cost over the treatment period.
Relapse Is the Biggest Long-Term Risk
Open bite has the highest relapse rate of any orthodontic correction. About 30% of patients experience some degree of relapse within 10 years. Most of the change happens early: roughly 80% of relapse occurs in the first year after treatment ends. One-year relapse rates across studies range from 12% to 18%.
Certain factors affect your odds. Treatment plans that included tooth extractions had a relapse rate of about 26%, compared to 38% for non-extraction cases. TAD-assisted molar intrusion using zygomatic mini-plates showed much better stability, with only 8% relapse at one year and 11% at four years. Patients under 18 who had skeletal anchorage combined with orthodontics showed particularly good long-term results.
Retention is critical. Fixed retainers (thin wires bonded behind your front teeth) are more effective than removable retainers for preventing open bite relapse, especially in severe cases. However, fixed retainers alone aren’t foolproof. The combination of proper retention, resolved habits, and myofunctional therapy gives you the best chance of keeping your results. Your orthodontist will likely recommend wearing retainers indefinitely, with the most vigilant use during the first two years after treatment.