An overbite is a common malocclusion where the upper front teeth vertically overlap the lower front teeth when the back teeth are closed. While 1 to 2 millimeters of overlap is normal, an excessive overlap of four millimeters or more is classified as a deep bite, which can cause abnormal tooth wear and jaw discomfort. Causes range from genetic factors influencing jaw size to dental alignment issues. Fortunately, modern orthodontic technology offers effective alternatives that do not rely on traditional metal braces, addressing both dental issues and underlying skeletal discrepancies.
Clear Aligner Systems
Clear aligner systems offer a modern, discreet approach to correcting mild to moderate overbites by focusing primarily on tooth movement. These systems use a series of custom-made, transparent plastic trays to apply gentle, continuous pressure. Each tray is worn sequentially, typically for one to two weeks, moving the teeth incrementally toward the desired final position.
Successful correction often involves small, tooth-colored composite attachments bonded temporarily to the teeth. These attachments provide the necessary grip for complex movements, such as the vertical intrusion or extrusion required to reduce the overlap. Elastics may also connect the upper and lower trays to guide the bite when slight jaw alignment issues exist.
Aligners are most effective for dental overbites, not underlying jaw structure issues. Treatment success relies heavily on patient compliance, requiring the trays to be worn for at least 20 to 22 hours per day. Duration varies based on misalignment severity, often ranging from nine to eighteen months.
Functional and Orthopedic Appliances
When an overbite is caused by a structural or skeletal imbalance, functional and orthopedic appliances modify jaw growth. These devices are primarily used in growing patients, typically adolescents, to harness natural growth spurts. They work by posturing the lower jaw (mandible) forward, stimulating growth in the jaw joints and surrounding bone structure.
Appliances like the Twin Block or the Herbst utilize specialized acrylic blocks or telescoping arms to hold the jaw in a corrected, forward position. For example, the Twin Block consists of two separate plates that interlock at an angle, forcing the patient to close their mouth with the lower jaw advanced. This continuous pressure encourages desired skeletal changes over time.
Removable retainers with a built-in bite plane prevent the back teeth from fully contacting, allowing the lower front teeth to move out of the deep bite. Timing is important for these orthopedic methods, as they capitalize on the patient’s remaining growth potential.
Addressing Overbite Through Oral Exercises
Targeted oral exercises and myofunctional therapy (MFT) focus on correcting detrimental muscle habits. This approach recognizes that the resting posture of the tongue, improper swallowing patterns, or other oral habits can contribute to or exacerbate a malocclusion. MFT is a program designed to retrain the muscles of the tongue, face, and mouth to establish a proper resting position and function.
Exercises may include tongue push-ups, where the tongue is pressed firmly against the roof of the mouth behind the front teeth, or specific drills to improve lip seal and nasal breathing. Correcting a low-resting tongue posture helps create a more favorable environment for dental and skeletal stability. While rarely a standalone cure for a significant deep bite, MFT is highly effective in preventing orthodontic relapse after other treatments have been completed.
Surgical Correction for Severe Skeletal Issues
For the most severe overbites where jawbones are significantly misaligned and the patient is no longer growing, orthognathic surgery is the definitive non-braces solution. This procedure is reserved for adults whose skeletal discrepancy is too large to be corrected by tooth movement or functional appliances alone. The goal is to physically reposition the maxilla (upper jaw), the mandible (lower jaw), or both, to achieve a proper, functional bite.
The surgical process involves the oral surgeon making precise cuts in the jawbones and moving the segments into ideal alignment, securing them with small metal plates and screws. This procedure corrects the bite and often improves facial symmetry and profile.
While surgery corrects the underlying skeletal problem, it is typically performed in conjunction with a short course of pre-surgical and post-surgical orthodontics, often using clear aligners. This orthodontic phase fine-tunes the final position of the teeth over the newly aligned jaws, improving functions such as chewing, speech, and breathing.