Bite ramps are small orthodontic tools designed to modify how the upper and lower teeth meet during treatment. These appliances are added to a patient’s braces or clear aligner system, serving as tiny wedges to guide the bite. Their purpose is primarily mechanical, acting to separate the back teeth to allow for necessary tooth movement. This separation is a temporary, but important, step in correcting certain alignment issues.
Physical Structure and Placement
Bite ramps, also called bite turbos or bite blocks, are made from durable materials like composite resin or acrylic. For traditional braces, they are typically formed from tooth-colored composite and bonded directly to the back (lingual) surface of the upper front teeth. They are small, often triangular or L-shaped, and custom-sized to the patient’s needs.
In clear aligner therapy, the ramps are molded as small projections directly into the plastic of the top aligner tray, usually behind the upper central incisors or canines. While placement on the lingual side of the upper front teeth is most common, ramps can also be placed on the chewing surfaces of the lower molars or premolars. Regardless of the material or system, their function is to create space between the dental arches when the patient closes their mouth.
Clinical Function: Correcting Deep Bites
The primary purpose of bite ramps is to correct a deep bite, defined as an excessive vertical overlap of the upper front teeth over the lower front teeth. This condition can lead to premature tooth wear, jaw discomfort, and gum damage if left untreated. Bite ramps work by introducing a mechanical separation between the upper and lower dental arches.
This separation, known as disocclusion, prevents the back teeth from touching when the patient bites down. This removes heavy biting forces that would otherwise obstruct the movement of the back teeth. By keeping the back teeth apart, the ramps allow for the controlled eruption of the posterior teeth into their correct vertical position. The ramps also exert a gentle, intrusive force on the anterior teeth they contact, helping to push the front teeth slightly into the bone.
The combination of posterior tooth eruption and anterior tooth intrusion works to “open” the bite, effectively leveling the Curve of Spee. Correcting the deep bite is also necessary to protect the lower braces from being bitten off by the upper teeth during the early stages of treatment.
Patient Experience and Care
Patients should expect an initial adjustment period that typically lasts between one and two weeks after the ramps are placed. During this time, the separation of the back teeth means that chewing food will feel awkward and different, as only the front teeth or the ramps themselves make contact. Speech may also be temporarily affected, sometimes causing a slight lisp, particularly with ramps placed on the inside of the front teeth where they interact with the tongue.
Initial discomfort or soreness in the jaw and teeth is common as the muscles adapt to the new biting position, manageable with over-the-counter pain relievers. Patients must maintain diligent oral hygiene, as food particles can easily be trapped around the composite or plastic ramps. Regular brushing, especially focusing on the area around the ramps, helps prevent plaque buildup and irritation.
Dietary modifications are necessary, requiring patients to avoid hard, crunchy, or sticky foods that could dislodge or damage the ramps. The duration of wear varies, but ramps are kept in place only as long as required to achieve the necessary bite correction. Once treatment is complete, the removal of bonded composite ramps is a quick and non-painful process performed by the orthodontist.