An overbite is a common bite issue requiring orthodontic correction. This condition is characterized by an excessive vertical overlap of the upper front teeth over the lower front teeth when the mouth is closed. The appropriate treatment is highly customized, depending on the severity of the bite discrepancy, the patient’s age, and skeletal maturity. Understanding the precise nature of the overbite is the first step toward determining which type of appliance, whether fixed braces, functional devices, or clear aligners, will be most effective.
Understanding the Overbite Condition
An overbite refers specifically to the vertical dimension of the bite, measuring how much the upper incisors cover the lower incisors. A slight overlap (about one to three millimeters) is normal, but anything beyond this range constitutes a deep bite. An excessive overbite can cause issues like abnormal tooth wear, soft tissue trauma to the palate, and temporomandibular joint discomfort.
The cause of the overbite determines the necessary hardware and treatment approach. A dental overbite is primarily a problem of tooth position, often resulting from the overeruption of the front teeth or under-eruption of the back teeth. Conversely, a skeletal overbite involves a discrepancy in the size or position of the jawbones, most commonly a lower jaw (mandible) that is underdeveloped or positioned too far back relative to the upper jaw (maxilla). Orthodontic correction must address the underlying dental or skeletal factor to achieve a stable result.
Fixed Braces and Specific Functional Devices
Traditional fixed braces are highly effective for correcting the dental components of an overbite. These systems apply continuous, precise forces to align the teeth and can intrude the upper or lower incisors to reduce the vertical overlap. Fixed braces are often the preferred choice for moderate to severe cases due to the superior control they offer over individual tooth movement.
However, fixed braces alone cannot correct a significant skeletal jaw discrepancy, which requires specific functional devices to modify bone growth. These functional appliances are typically fixed to the teeth and are used most effectively in growing patients to guide the lower jaw forward. The Herbst appliance is one such device, which uses telescoping rods connected to the upper and lower back teeth to hold the mandible in a forward position. The Herbst appliance encourages mandibular growth and simultaneously restrains maxillary growth over an average treatment period of six to twelve months.
Another common fixed functional device is the Forsus Fatigue Resistant Device. The Forsus spring uses a spring module that attaches to the molar band on the upper arch and the archwire on the lower arch. This system provides a non-stop, gentle pushing force to move the lower jaw forward and the upper teeth backward. Because these appliances are fixed in place, they do not require patient compliance for wear time, ensuring the consistent force needed for skeletal correction.
Clear Aligners for Overbite Correction
Clear aligners offer a removable and less noticeable option for correcting overbites. For mild to moderate dental overbites, the aligners can correct the issue through precise tooth movements, similar to traditional braces. However, for cases involving a skeletal component, the aligner system must utilize specific auxiliary features to reposition the jaw.
One innovation for clear aligners is the Mandibular Advancement feature, which is designed to treat the backward positioning of the lower jaw. These specialized aligners incorporate precision wings situated between the premolars and molars on both the upper and lower trays. When the patient bites down, these wings interlock, holding the lower jaw in a forward position and guiding its growth in younger patients. This innovative system allows for simultaneous tooth alignment and skeletal correction, often eliminating the need for separate functional appliances.
For moderate overbites, orthodontists frequently use standard clear aligners in conjunction with orthodontic elastics. These elastics attach to tooth-colored buttons or precision cuts on the aligners, creating a controlled force vector between the upper and lower jaws. This elastic force helps to pull the upper teeth back and the lower teeth forward, addressing both the dental and skeletal aspects of the bite. Consistent patient compliance, typically wearing the aligners for 20 to 22 hours per day, is paramount for the success of any clear aligner treatment.
The Orthodontic Treatment Timeline
The time required to correct an overbite is dictated by the patient’s age and the severity of the malocclusion. For simple dental overbites, treatment with braces or aligners may take as little as six to eighteen months. However, more complex cases involving a significant skeletal discrepancy or the need for functional appliances will require a longer commitment.
For children whose jawbones are still developing, treatment is often conducted in two phases. Phase I, or early interceptive treatment, typically occurs between the ages of six and ten and focuses on correcting the skeletal issue using functional devices like the Herbst appliance. This initial phase usually lasts between nine and eighteen months, aiming to create a better foundation for the permanent teeth to erupt.
Phase II, or comprehensive treatment, usually begins in adolescence, once most or all of the permanent teeth have come in. This phase involves the placement of fixed braces or clear aligners to refine the final tooth positions and perfect the bite relationship. For severe skeletal overbites in adult patients, where growth modification is no longer possible, the treatment timeline may extend beyond 24 months and often necessitates orthognathic surgery.