An overbite is a common dental alignment issue where the upper front teeth extend significantly over the lower front teeth. While a slight overlap is normal, a deep overbite can lead to functional problems, such as difficulty chewing, uneven wear on the teeth, and jaw discomfort. This misalignment often results from a discrepancy in the size or position of the upper and lower jaws. Fortunately, many people seeking correction can achieve a successful outcome through non-surgical methods that focus on repositioning the teeth and sometimes guiding jaw development.
Moving Teeth With Standard Orthodontics
The most common non-surgical approach for correcting an overbite, particularly in adults who are no longer growing, involves orthodontic treatments that focus on moving the teeth within the existing bone structure. Traditional braces utilize brackets bonded directly to the teeth, which are connected by a wire. The orthodontist adjusts the archwire periodically to apply continuous, gentle pressure, gradually pulling the upper teeth backward or the lower teeth forward.
Standard orthodontics often incorporate specialized components to achieve the necessary bite correction. Small elastic bands, called intermaxillary elastics, are frequently used, stretching between hooks on the upper and lower arches to apply force across the bite. This constant pulling motion works to physically shift the dental arches into a more harmonious relationship. In some cases, tiny springs or specialized appliances are built into the archwire to create space or facilitate the retraction of the upper arch.
Clear aligner systems offer a discreet alternative to braces for mild to moderate overbites. These custom-made, transparent trays apply precise, controlled forces to move the teeth incrementally, with a new set of aligners worn every one to two weeks. For overbite correction, the aligners are often designed with “power ridges” or are used in conjunction with small, tooth-colored attachments to help anchor the movements. Like braces, clear aligners can also use elastics attached to small buttons fixed to the teeth, providing the necessary gentle pressure to coordinate the alignment of the upper and lower jaws.
Guiding Jaw Growth in Younger Patients
For children and adolescents whose jaws are still developing, a unique non-surgical opportunity exists to address the overbite by modifying the growth of the jawbones themselves. This is known as interceptive or Phase I treatment and is typically performed before all permanent teeth have erupted, around age seven to ten. The goal is a skeletal correction, meaning the treatment guides the lower jaw (mandible) to grow into a more forward position.
Removable Functional Appliances
A variety of removable or fixed functional appliances are used to harness the patient’s own muscle movements to achieve this growth guidance. The Twin Block appliance, a two-piece removable device, uses inclined planes that force the lower jaw forward when the patient closes their mouth. This constant posturing encourages growth in the temporomandibular joint area, effectively closing the gap between the upper and lower teeth. Other appliances, like the Bionator, are removable but use acrylic shields and wire loops to influence the tongue and cheek muscles, guiding the lower jaw forward.
Fixed Functional Appliances
The Herbst appliance is fixed to the back teeth and uses telescopic rods to hold the lower jaw in an advanced position twenty-four hours a day. Because it is fixed, the Herbst appliance eliminates the need for patient compliance, ensuring consistent forward force on the mandible. These treatments are timed to coincide with a child’s pubertal growth spurt for maximum effect.
Identifying Cases Where Surgery Is Needed
While non-surgical treatments can successfully correct many overbites, their effectiveness is limited by the underlying cause and the patient’s age. A general distinction exists between a dental overbite, where only the teeth are misaligned, and a skeletal overbite, where the upper and lower jawbones are physically mismatched in size or position. Orthodontics alone can correct most dental overbites by moving the teeth.
However, if the jaw discrepancy is too severe—typically measured as an overjet, or horizontal overlap, exceeding approximately 8 to 10 millimeters—non-surgical methods may not provide a complete or stable correction. In these significant skeletal cases, the jawbones are too far apart for the teeth to be moved into a proper bite relationship. For adult patients, the window for non-surgical skeletal modification has closed, as bone growth is complete.
Once skeletal maturity is reached, the jaw structure is set, meaning growth-guiding appliances are no longer effective. Attempting to use only orthodontics to correct a severe skeletal issue in an adult can result in excessive tipping of the teeth, which may compromise tooth and gum health and often leads to an unstable result. In these situations, orthognathic surgery becomes the only way to physically realign the jawbones to achieve proper bite function and facial balance. Surgery is reserved for the most complex cases where the non-surgical limits of tooth movement have been reached.