An open bite is a dental condition where the upper and lower teeth do not meet when the mouth is closed. This results in a vertical gap between the dental arches. It is a common orthodontic issue that can affect various aspects of oral health and function. While often associated with aesthetic concerns, an open bite can also impact basic daily activities. Fortunately, this condition is correctable through various treatment methods.
Understanding Open Bite
This misalignment can manifest in different forms. An anterior open bite, the most prevalent type, involves a visible gap between the front upper and lower teeth. Conversely, a posterior open bite occurs when the back teeth, such as molars or premolars, fail to make contact.
Correcting an open bite is important due to its potential impacts on daily life. Individuals with this condition may experience difficulties with biting and chewing certain foods efficiently. Speech impediments, particularly with sounds requiring precise tooth contact, can also arise. Additionally, an open bite can lead to excessive wear on the teeth that do make contact, and in some instances, jaw pain or temporomandibular joint (TMJ) disorders.
Orthodontic Approaches to Correction
Orthodontic treatment is a non-surgical method for correcting open bites, aiming to realign teeth and jaws. Traditional braces utilize brackets, wires, and bands to exert controlled pressure on the teeth. Brackets are bonded to the tooth surface, acting as anchors for arch wires that guide tooth movement. Elastics, often used in conjunction with braces, apply additional force to improve jaw positioning and close the bite.
Clear aligners, such as Invisalign, offer another orthodontic option. These custom-made, removable plastic trays gradually shift teeth into their correct positions. Aligners can achieve bite correction through mechanisms like the extrusion of anterior teeth or the intrusion of posterior teeth, sometimes aided by attachments.
Specialized orthodontic appliances may also be employed, especially during growth or to address specific habits. Palatal expanders can widen the upper jaw, creating more space and improving overall bite alignment. Habit appliances, such as tongue cribs or spurs, help modify habits like thumb-sucking or tongue thrusting that contribute to an open bite.
Bite blocks, small raised platforms on back teeth, can help intrude posterior teeth, allowing the jaw to rotate and the open bite to close. Temporary anchorage devices (TADs), which are small mini-screws, can be placed to provide stable anchorage for precise tooth movements, such as molar intrusion.
Surgical Interventions for Severe Cases
In cases where open bites are severe and involve significant skeletal discrepancies, surgical intervention is a necessary part of the treatment plan. Orthognathic surgery, commonly known as jaw surgery, aims to reposition the jaws to achieve proper alignment and bite closure. This procedure is typically recommended when orthodontic treatment alone cannot effectively address the underlying jaw structure issues.
During orthognathic surgery for an open bite, the oral and maxillofacial surgeon may remove excess bone from either the upper or lower jaw to improve the fit between the maxilla and mandible. This process, known as osteotomies, involves controlled surgical cuts to reshape the bone structure, allowing for optimal jaw realignment. The goal is to correct the vertical dimension, enabling the teeth to meet properly.
Jaw surgery is often part of a comprehensive approach, combined with orthodontic treatment both before and after the surgical procedure. Orthodontics prepares the teeth for the new jaw position and then fine-tunes their alignment post-surgery. This collaborative effort between an orthodontist and an oral surgeon ensures that both the dental and skeletal components of the open bite are addressed for functional and aesthetic improvements.
Long-Term Stability After Correction
Maintaining the results of open bite correction is an important aspect of treatment, requiring diligent post-treatment care. Retention protocols are implemented to prevent the treated bite from relapsing, meaning the teeth shifting back towards their original misaligned positions. Relapse is a concern with open bite corrections, with some studies indicating a potential for opening of the bite in a percentage of patients years after treatment.
Retainers are the main tools used for long-term stability. These can be either fixed or removable. Fixed retainers are typically bonded to the back of the teeth, providing continuous support. Removable retainers, such as Hawley retainers or clear vacuum-formed retainers, are worn for specific periods each day, as directed by the orthodontist. The choice of retainer type and wear schedule depends on the individual case and the orthodontist’s assessment.
Patient compliance with wearing retainers as prescribed is important for the longevity of the treatment outcome. Regular follow-up appointments with the orthodontist are also part of the long-term care. These visits allow for monitoring the bite’s stability and making any necessary adjustments to the retention plan, helping to ensure the corrected bite remains stable over many years.