An open bite is a type of malocclusion, or “bad bite,” where some teeth do not meet when the jaws are closed. This condition prevents the upper and lower teeth from coming into proper contact, leading to a gap. While open bites can affect different parts of the mouth, this article will focus specifically on the posterior open bite, exploring its characteristics, underlying causes, daily impacts, and available treatment options.
Understanding Posterior Open Bite
A posterior open bite occurs when the back teeth, specifically the molars and premolars, do not make contact when a person bites down. This creates a noticeable vertical gap between the chewing surfaces of the upper and lower back teeth. Unlike an anterior open bite, where the front teeth fail to meet, the issue in a posterior open bite is situated further back in the mouth.
Identifying a posterior open bite often involves a visual assessment of the dental arch. The lack of occlusion in the posterior segments means that the upper and lower posterior teeth do not overlap or touch, preventing efficient chewing. This distinct separation can be observed by looking into the mouth while the individual attempts to bring their teeth together.
Common Causes
The development of a posterior open bite can stem from a variety of factors, including genetic predispositions and specific patterns of skeletal growth. An individual’s inherited craniofacial structure can sometimes lead to a vertical growth pattern of the jawbones, contributing to the back teeth not meeting properly.
Certain habits maintained over extended periods can also contribute to the formation of a posterior open bite. Prolonged thumb sucking, pacifier use beyond early childhood, or persistent tongue thrusting can exert pressure that prevents the eruption of posterior teeth or pushes them out of alignment.
Temporomandibular joint (TMJ) disorders represent another potential cause, as issues within the jaw joint can alter the way the teeth come together. Inflammation or displacement within the TMJ can lead to changes in the bite, sometimes resulting in a posterior open bite. Furthermore, specific dental procedures may inadvertently contribute to this condition. Poorly fitted dental restorations, such as crowns or fillings that are too high, can prevent natural tooth contact in the back of the mouth.
Impact on Daily Life
A posterior open bite can significantly affect an individual’s ability to perform routine oral functions. One primary consequence is difficulty with chewing and biting food effectively. The absence of contact between the back teeth means food cannot be properly ground, which can lead to inefficient digestion and discomfort during meals.
Speech impediments, such as lisps, can also arise due to the altered oral environment. The tongue’s positioning and movement during speech may be affected by the gap between the posterior teeth, leading to articulation challenges.
The lack of posterior support can place excessive stress on the anterior teeth, forcing them to bear more biting force than they are designed for. This increased load can result in accelerated wear on the front teeth, potentially leading to chipping, fractures, or sensitivity. Aesthetic concerns may also arise, as the misalignment can affect the facial profile and overall appearance of the smile. The continuous strain on jaw muscles from an improper bite can lead to chronic discomfort or pain in the jaw region.
Treatment Approaches
Correcting a posterior open bite often involves a range of orthodontic interventions designed to bring the back teeth into proper contact. Traditional braces, utilizing brackets and wires, can gradually move teeth into their correct positions, closing the posterior gap. Clear aligners offer a less visible option for tooth movement through a series of custom-made, removable trays. Specific orthodontic appliances, such as palatal expanders, might be used to widen the upper jaw, creating more space and allowing for better tooth alignment.
For cases involving significant skeletal discrepancies, orthognathic surgery, or jaw surgery, may be recommended to reposition the jawbones. This surgical approach is typically reserved for severe malocclusions where orthodontic treatment alone is insufficient. Addressing underlying habits is also a crucial component of effective treatment; myofunctional therapy, for instance, can help retrain the tongue and facial muscles to correct habits like tongue thrusting. Early intervention in children is particularly beneficial, as addressing the issue while the jaw is still developing can prevent the condition from worsening and simplify future treatment.
References
1. Temporomandibular Joint and Occlusion. ScienceDirect. [https://www.sciencedirect.com/science/article/abs/pii/B9780323673377000030]
2. Anterior open bite: Etiology, diagnosis, and treatment. PubMed. [https://pubmed.ncbi.nlm.nih.gov/30043818/]
3. Anterior open bite: Etiology, diagnosis, and treatment. PubMed. [https://pubmed.ncbi.nlm.nih.gov/30043818/]
4. Etiology and management of anterior open bite. PubMed. [https://pubmed.ncbi.nlm.nih.gov/22168925/]