Treatment of Open Bites

An open bite case is one of the most difficult conditions to treat and more often than not, it is caused by repeated actions of the patient himself that strain the teeth alignment. At Premier Smiles, we have treated many open bite cases successfully with minimally invasive techniques.


  • Thumb sucking
  • Prolonged or incorrect use of bottles & pacifiers
  • Tongue & oroficial muscle activity (tongue thrusting, chewing on pencils, etc.)
  • Unfavorable growth patterns
  • Mouth breathing
  • Imbalances between jaw postures, occlusal and eruptive forces and head position
  • TMJ
  • Hereditary

Open bite problems are typically identified at an early age. Because it can cause the front teeth to flare out while the jaw is still developing, teeth can become misaligned. This can cause the smile to be adversely affected. It can also cause what is often called ‘long face syndrome’, which is a discrepancy in the amount of growth in anterior and posterior facial heights.

If malocclusion occurs, the teeth do not rest properly against one another and there may be a lack of vertical overlap. The bite may become open in the front or the back of the mouth, or both.

In older age, open bite can be caused by temporomandibular joint disorder (TMJ). When a patient experiences chronic jaw pain, they may habitually use their tongue to push the teeth apart to relieve the jaw.

Often if the habits contributing to open bite are stopped before 8 years old, it will likely self-correct.

Thumb devices may be used to train away from the damaging behavior, as well as passive habit breaking appliances or functional appliances that block the bite. Instruction on proper swallowing may also be necessary.

Patients with a history of thumb sucking and normal facial proportions have a favorable prognosis for treatment by orthodontics or clear aligners, so long as the thumb sucking has stopped.

Those who have increased facial proportions frequently require orthognathic surgery, microimplants, or plates to close the open bite.

Early Prevention is Key!
The best cure is early prevention! Gently eliminate thumb sucking and reduce pacifier dependence in your child. In addition to appearance issues with the smile and bite, patients can develop poor speech, all of which leads to poor self esteem issues. If the patient has continued with thumb sucking for over ten years, psychological therapy is recommended.

For a complimentary examination appointment to see if you have a dental alignment problem and what treatment could be right for you, please contact Dr. Arhiri at 610-647-7611 or email

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