What This Guide Covers and Who It Is For
This guide explains how braces fix an open bite and what the treatment process looks like from start to finish. An open bite means your upper and lower front teeth do not touch when your mouth is closed. You may notice a visible gap, difficulty biting into food, or speech changes like a lisp.
Open bites fall into two categories. A dental open bite is caused by tooth position, meaning the teeth themselves have erupted too much or too little. A skeletal open bite is caused by the jawbones growing at different rates or in different directions. The distinction matters because it determines which treatment approach an orthodontist will recommend. [2]
This guide is for adults, teens, and parents of children who have been told they have an open bite. It covers braces mechanics, timelines, costs, clear aligner options, and surgical considerations. If you are unsure whether your bite problem needs a specialist, the section on the orthodontics page can help you understand when to see an orthodontist.
How Braces Correct an Open Bite
Braces close an open bite by moving specific teeth up or down until the upper and lower arches meet properly. The exact mechanics depend on whether the problem is in the front teeth, back teeth, or the jaw itself.
The Two Main Mechanics: Intrusion and Extrusion
Orthodontists use two key tooth movements to close an open bite. Extrusion pulls the front teeth downward (upper arch) or upward (lower arch) so they can meet. Intrusion pushes the back teeth (molars) deeper into the jawbone so the jaw can rotate closed. In many cases, orthodontists use both movements at the same time.
Think of it like a seesaw. If the back teeth are too tall, they prop the jaw open and prevent the front teeth from touching. Pushing those back teeth down lets the jaw hinge closed naturally. If the front teeth are too short, pulling them into position closes the gap directly.
The choice between intrusion and extrusion depends on the patient's facial proportions. In patients with a long lower face, intrusion of the back teeth is typically preferred because it avoids making the face appear longer. An orthodontist evaluates this during the initial records appointment using X-rays and photographs. [2]
Elastics, TADs, and How They Help
Elastics are small rubber bands that connect hooks on the upper and lower braces. For open bite correction, vertical elastics are worn from the upper front teeth to the lower front teeth. They apply a steady pulling force that helps the front teeth erupt into contact. Patients typically wear these elastics 20 to 22 hours per day.
TADs, or temporary anchorage devices, are tiny titanium screws placed into the jawbone between tooth roots. They act as fixed anchor points that let the orthodontist push back teeth into the bone without unwanted movement of other teeth. A 2024 study in Clinical Oral Investigations found that TADs provided effective noninvasive correction of anterior open bites in adults. [1]
TAD placement takes about 10 to 15 minutes and is done under local anesthesia. Most patients describe the discomfort as mild, similar to getting a bracket bonded. The screws are removed easily once treatment is complete.
Why Habit Correction Is Part of Treatment
Tongue thrusting and thumb sucking are two of the most common causes of dental open bites. These habits push the front teeth apart over time. If the habit continues during or after braces, the open bite will typically return. [3]
For children, a habit appliance such as a tongue crib or palatal rake can be bonded behind the upper teeth. This device acts as a physical reminder that blocks the tongue or thumb from pressing against the teeth. For adults and older teens, myofunctional therapy, a series of exercises that retrain the tongue and facial muscles, is often recommended alongside braces.
Your orthodontist may refer you to a myofunctional therapist or speech-language pathologist if tongue posture is a significant factor. Successful habit elimination before or early in treatment leads to more stable results.
Practical Details: Age, Timing, and Preparation
Open bite treatment can begin at different ages depending on the cause and severity of the bite problem.
Best Age to Start Treatment
The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7. [2] At that age, an orthodontist can identify developing open bites early, especially those caused by habits. Early intervention with habit appliances can sometimes prevent the need for full braces later.
For dental open bites, full braces treatment typically begins once most permanent teeth have erupted, usually between ages 11 and 14. Adults can be treated at any age, though adult bone is denser and tooth movement may be slightly slower. Skeletal open bites in growing children may benefit from growth modification appliances before braces, while the same condition in adults usually requires surgical correction.
Braces vs. Invisalign for Open Bite
Clear aligners like Invisalign can close mild dental open bites in some patients. However, a 2024 study comparing TAD-assisted braces with clear aligner therapy for anterior open bites found that TADs provided more predictable and effective tooth movement for moderate to severe cases. [1] Clear aligners have difficulty generating the intrusive forces needed to push back teeth into the bone.
For mild open bites of 1 to 2 millimeters with no skeletal component, Invisalign may be a reasonable option. For gaps larger than 2 to 3 millimeters, or cases involving skeletal discrepancy, traditional braces with elastics and possibly TADs are typically the more reliable choice. Some orthodontists use a combination approach: aligners for initial alignment followed by braces for bite closure.
Your orthodontist can explain which option fits your specific bite after examining your X-rays, photographs, and dental models.
How to Prepare for Open Bite Treatment
Before braces are placed, your orthodontist will take records. This typically includes a panoramic X-ray, a lateral cephalometric X-ray (a side view of your skull), intraoral photos, and digital or physical impressions of your teeth. These records help the orthodontist measure the open bite precisely and plan tooth movements.
If you have any cavities, gum disease, or wisdom teeth that need attention, those issues should be resolved first. Your orthodontist may coordinate with your general dentist or an oral surgeon before starting. Arriving with a healthy mouth makes treatment smoother and reduces the risk of delays.
What to Expect: Step-by-Step Treatment Process
Open bite correction with braces follows a structured sequence that typically spans 18 to 30 months, depending on severity.
Phase 1: Alignment and Leveling (Months 1 to 8)
During the first phase, brackets are bonded to the teeth and connected with lightweight archwires. The goal is to straighten crowded or rotated teeth and create even arches. You will visit the orthodontist every 4 to 8 weeks for wire changes.
Soreness after each adjustment is normal and typically lasts 2 to 5 days. Over-the-counter pain relievers and soft foods help during this period. If TADs are part of the plan, they are often placed during this phase or at the beginning of the next phase.
Phase 2: Bite Correction (Months 8 to 20)
This is when the open bite itself is actively closed. Your orthodontist will likely prescribe vertical elastics connecting the upper and lower arches. If TADs have been placed, elastic chains or springs will connect from the TADs to the back teeth to push them into the bone. [1]
Wearing elastics exactly as directed is one of the most important things you can do. Poor elastic wear is a leading cause of extended treatment time. Most orthodontists ask patients to wear them full-time, removing them only to eat and brush. During this phase, you may notice your bite gradually closing over several months.
Phase 3: Finishing and Detailing (Months 20 to 30)
In the final phase, the orthodontist fine-tunes tooth positions and ensures the upper and lower teeth fit together with proper contact. Small bends in the archwires or additional elastic configurations may be used. This phase also includes verifying that the bite is stable when you chew and that your teeth are seated fully.
Once the orthodontist is satisfied with the result, the braces are removed. Debonding takes about 30 to 60 minutes. Bonded retainers (thin wires glued behind the front teeth) and removable retainers are typically prescribed. Open bite cases carry a higher risk of relapse than other bite problems, so consistent retainer wear is critical. [2]
When Surgery Is Needed: Orthognathic Surgery
Skeletal open bites caused by excessive vertical growth of the upper jaw often cannot be corrected by braces alone, particularly in adults whose growth is complete. In these cases, orthognathic surgery (jaw surgery) is combined with braces. [2]
The typical sequence involves 12 to 18 months of braces to align the teeth, followed by surgery to reposition the upper jaw, lower jaw, or both. After surgery, braces remain for another 6 to 12 months for final adjustments. Total treatment time for surgical cases is typically 2 to 3 years.
Surgery is performed under general anesthesia in a hospital setting by an oral and maxillofacial surgeon. Recovery involves a liquid or soft diet for several weeks and gradual return to normal activities over 4 to 6 weeks. While surgery adds complexity and cost, it provides the most stable long-term correction for severe skeletal open bites.
Cost of Braces for Open Bite Treatment
Braces for open bite correction typically cost between $5,000 and $8,000 for non-surgical cases. Costs vary by location, provider, and case complexity.
If TADs are needed, they may add $300 to $600 per screw to the total fee, though some orthodontists include them in the overall treatment cost. Cases requiring orthognathic surgery can exceed $20,000 when surgical fees, hospital costs, and anesthesia are included. The surgical portion may be partially covered by medical insurance rather than dental insurance if the surgery is deemed medically necessary.
Many orthodontic offices offer payment plans that spread the cost over the length of treatment. Dental insurance plans that include orthodontic benefits typically cover $1,000 to $3,000 of treatment costs, though coverage varies widely. [2] Check with your insurance provider about specific coverage for open bite treatment, as some plans distinguish between cosmetic and functional orthodontic needs.
When comparing quotes, ask whether the fee includes retainers, emergency visits, and any necessary TADs. A lower upfront quote that excludes these extras may end up costing more.
When to See an Orthodontist for an Open Bite
An orthodontist is the right specialist to evaluate and treat an open bite. General dentists can identify the problem but typically refer patients to an orthodontist for correction.
You or your child should see an orthodontist if you notice a visible gap between the upper and lower front teeth when biting down, difficulty biting through foods like sandwiches or pizza, a lisp or other speech changes, or mouth breathing as a primary breathing pattern. [3] Children should be evaluated by age 7 if a parent, dentist, or pediatrician notices any of these signs. [2]
Adults who had braces as teenagers but notice their open bite returning should also seek an orthodontic evaluation. Relapse can happen if retainers were not worn or if an underlying tongue thrust was never addressed. Early re-evaluation gives the orthodontist more options and may prevent the bite from worsening.
- Visible gap between upper and lower front teeth when biting down
- Difficulty biting into foods with front teeth
- Lisp or speech difficulties
- Chronic mouth breathing
- Previous orthodontic treatment with signs of relapse
Find an Orthodontist Near You
Open bite correction requires an orthodontist with experience in vertical bite problems, elastics, and TADs. Visit the orthodontics page on My Specialty Dentist to search for qualified orthodontists in your area. Most orthodontists offer a free or low-cost initial consultation where they can examine your bite, review X-rays, and explain your treatment options.
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