What This Guide Covers
This guide explains how Invisalign clear aligners work to fix an open bite, when they are a good option, and when other treatments may be needed.
An open bite is a type of malocclusion (a misalignment of the teeth or jaws). It means your upper and lower teeth do not touch when you close your mouth. The gap can appear in the front of your mouth (anterior open bite) or along the sides (posterior open bite). Anterior open bites are far more common and are the type most often treated with Invisalign. Prevalence estimates suggest anterior open bites affect roughly 3.5 percent of the population, though rates vary by age group and study. [1] [3]
If you or your teen has an open bite, you probably want to know whether clear aligners can fix it without traditional metal braces. The answer depends on what is causing the open bite, how severe it is, and your age. This guide walks through each of those factors so you can have an informed conversation with an orthodontist.
How Invisalign Treats an Open Bite
Invisalign treats open bites by using a series of custom plastic aligners to gradually move teeth into proper contact.
Types of Open Bite and Their Causes
Open bites fall into two broad categories: dental and skeletal. The distinction matters because it determines which treatments can work.
A dental open bite is caused by the position of the teeth themselves. Common causes include prolonged thumb sucking or pacifier use in childhood, tongue thrusting (pushing the tongue against or between the front teeth when swallowing), and prolonged bottle feeding. In these cases, the jaw bones are typically normal, but the teeth have been pushed or blocked from erupting fully. [3]
A skeletal open bite is caused by the shape or growth pattern of the jaw bones. The upper and lower jaws may grow at different rates or in different directions, creating a gap that no amount of tooth movement alone can close. Genetics play a large role in skeletal open bites. [3]
Many open bites have both dental and skeletal components. An orthodontist uses X-rays (including a lateral cephalometric radiograph), photographs, and a clinical exam to determine how much of the open bite is dental versus skeletal. This assessment guides the treatment plan. [1]
How Clear Aligners Move Teeth to Close the Gap
Invisalign aligners apply controlled force to specific teeth using a sequence of trays. Each tray is slightly different from the last, moving teeth in small increments toward the target position. It is important to note that the Invisalign system has received FDA 510(k) clearance as an orthodontic appliance. This means the FDA determined it is substantially equivalent to other legally marketed orthodontic devices. FDA clearance is different from FDA approval, which involves a more rigorous premarket review. [5]
For an open bite, the aligners typically need to intrude (push down) the back teeth, extrude (pull out) the front teeth, or do both. A systematic review of 11 clinical studies found that clear aligners can achieve clinically meaningful posterior intrusion, which is one of the key movements needed to close an anterior open bite. [4] Small tooth-colored bumps called attachments are often bonded to certain teeth. These attachments give the aligner a better grip and allow more precise movements. [2]
In some cases, the orthodontist may also use elastics (small rubber bands) that hook from the upper aligners to the lower aligners. Elastics add extra force to help close the bite. Not every open bite case requires elastics, but they are common in moderate cases.
Mild, Moderate, and Severe Open Bites
The severity of your open bite affects whether Invisalign is a realistic option.
Clinicians generally describe a mild anterior open bite as a gap of roughly 1 to 2 millimeters between the upper and lower front teeth. Invisalign can usually correct this type effectively. A moderate open bite involves a gap of roughly 2 to 4 millimeters and may still respond well to aligners, especially if the cause is primarily dental. Keep in mind that these millimeter ranges are clinical guidelines used by many orthodontists; there is no single universally adopted severity scale. [3] [4]
A severe open bite, often 5 millimeters or more, or one with a significant skeletal component, is much harder to treat with aligners alone. These cases frequently require traditional braces, orthognathic surgery (jaw surgery to reposition the bones), or a combination of braces and surgery. An orthodontist can measure the gap and assess the underlying bone structure to recommend the right approach. [3]
What the Research Shows About Effectiveness
A growing body of clinical evidence supports the use of clear aligners for open bite correction, though most studies involve mild to moderate cases. A retrospective study of 30 adult patients with anterior open bites treated using Invisalign found statistically significant improvement in overbite, with a mean change of approximately 3.7 millimeters. [8] A separate systematic review examining clear aligner treatment for open bites concluded that aligners can produce favorable outcomes, particularly when posterior intrusion is the primary movement needed. [4]
However, the evidence base still has limitations. Many studies are retrospective, involve small sample sizes, and lack long-term follow-up beyond two to three years. Head-to-head trials comparing Invisalign to traditional braces specifically for open bite correction are limited. Some research suggests that braces may offer more predictable control for complex movements such as large-magnitude extrusion. Your orthodontist can help you weigh the evidence for your specific case. [4]
What to Know Before Starting Treatment
Before choosing Invisalign for an open bite, consider your age, habits, and commitment to wearing aligners consistently.
Age Recommendations and Eligibility
Invisalign is available for teens and adults. Most orthodontists recommend waiting until all permanent teeth have erupted, which typically happens between ages 11 and 13. Younger children with open bites may benefit from early interceptive treatment with other appliances first. [1]
Adults of any age can be candidates for Invisalign if their teeth and gums are healthy. Open bite correction in adults is sometimes more complex because the jaw bones have finished growing. If the open bite has a significant skeletal component, an adult may need surgical correction along with orthodontic treatment. [3]
Teens using Invisalign for open bite correction need to wear aligners at least 20 to 22 hours per day. Invisalign Teen versions include compliance indicators (small blue dots that fade with wear) to help track usage.
Habits That Can Affect Treatment Success
Certain habits can keep an open bite from closing or cause it to return after treatment. These habits must be addressed before or during orthodontic work.
Tongue thrusting is one of the most common contributors. Every time you swallow, your tongue pushes forward against or between your front teeth. Over thousands of swallows per day, this pressure can prevent teeth from meeting. An orthodontist may recommend myofunctional therapy, a type of exercise program that retrains tongue posture and swallowing patterns. Research suggests that combining myofunctional therapy with orthodontic treatment can improve long-term stability of open bite correction. [6]
Thumb sucking and nail biting can also interfere with results. If these habits continue during treatment, the teeth may not move as planned. Addressing habits before starting Invisalign gives you the best chance of a stable result.
Typical Treatment Timeline
Invisalign treatment for an open bite typically takes 12 to 24 months. Mild cases may finish closer to 12 months. Moderate cases or those requiring elastics may take 18 to 24 months. [4]
Several factors influence the timeline. These include the severity of the open bite, how consistently you wear your aligners, whether you need additional refinement trays, and whether habit correction is needed alongside orthodontic treatment.
Refinement trays are extra sets of aligners ordered partway through treatment to fine-tune tooth positions. Many open bite cases require at least one round of refinements. Your orthodontist will monitor progress with check-up visits, typically every 6 to 10 weeks.
What to Expect During Invisalign Treatment for an Open Bite
Treatment follows a predictable process from initial consultation through active aligner wear and retention.
Consultation and Digital Treatment Planning
Your first visit includes a thorough exam. The orthodontist will take digital scans or impressions of your teeth, X-rays of your jaw, and photographs of your face and bite. These records help determine whether Invisalign is a good fit for your open bite. [1]
If you are a candidate, the orthodontist uses digital software to map out a step-by-step plan showing how your teeth will move from start to finish. You can often preview a simulation of your expected results before treatment begins. This plan also determines how many aligner trays you will need.
Wearing Your Aligners
Once your custom aligners arrive, the orthodontist will place any needed attachments on your teeth and fit your first set of trays. You will switch to a new tray every 1 to 2 weeks, depending on the prescribed schedule. [2]
Aligners must be worn 20 to 22 hours per day. You remove them only to eat, drink anything other than water, brush, and floss. Consistent wear is especially important for open bite cases because the movements required, particularly intrusion and extrusion, depend on sustained, steady force.
Mild soreness or pressure is normal for the first few days with each new tray. This usually fades within 48 hours. If your orthodontist prescribes elastics, you will attach them to small hooks built into your aligners. Wearing elastics as directed is critical for closing the bite.
Risks and Limitations to Discuss With Your Orthodontist
Like any orthodontic treatment, Invisalign carries some risks. Mild root resorption (a slight shortening of the tooth roots) can occur with any type of orthodontic tooth movement. Research shows this is usually minor and clinically insignificant, but your orthodontist may take periodic X-rays to monitor root length during treatment. [3]
Aligners depend entirely on patient compliance. If you do not wear them for the prescribed 20 to 22 hours per day, treatment can stall or the final result may be less than ideal. This is a particular concern for open bite correction, which requires precise and sustained force.
There is also a chance that Invisalign alone may not fully close your open bite. In some cases, an orthodontist may recommend switching to braces partway through treatment or adding supplemental appliances. Discuss the possibility of a midcourse change with your provider before you begin so you know what to expect.
Retention: Keeping Your Results
After active treatment, you will wear retainers to hold your teeth in their new positions. This step is especially important for open bite correction. Open bites have a higher tendency to relapse (return toward their original position) compared to other types of malocclusion. Some studies report relapse rates for anterior open bites in the range of 30 to 40 percent across various treatment modalities, though the definition of relapse varies between studies. [6]
Most orthodontists prescribe a removable retainer to be worn full-time for the first several months, then nightly long-term. Some patients also receive a bonded retainer, a thin wire glued behind the front teeth for added stability. Following your retainer instructions closely gives you the best chance of maintaining your corrected bite. [1]
If you had a tongue thrust or other oral habit, continuing myofunctional therapy exercises during the retention phase helps prevent relapse. The combination of retainers and corrected muscle patterns provides the most stable long-term outcome. [6]
Cost of Invisalign for Open Bite Correction
Invisalign treatment for an open bite typically ranges from $3,500 to $8,000. Costs vary by location, provider, and case complexity. These estimates reflect ranges commonly reported by orthodontic practices and dental cost surveys. Your actual cost may fall outside this range depending on your specific situation. [2] [7]
Several factors influence the final cost. A more severe open bite usually requires more aligner trays and longer treatment, which increases the price. The use of elastics, attachments, and refinement trays is typically included in the total fee, but this varies by practice. Geographic location also plays a role; treatment in a major metropolitan area often costs more than in a smaller city.
Dental insurance may cover part of the cost if your plan includes orthodontic benefits. Many plans cap orthodontic coverage at $1,000 to $2,000 for a lifetime maximum. Check with your insurance provider before starting treatment to understand your coverage. [2]
Most orthodontist offices offer payment plans that spread the cost over the length of treatment. Health savings accounts (HSAs) and flexible spending accounts (FSAs) can also be used to pay for Invisalign with pre-tax dollars. Ask about all payment options during your consultation.
When to See an Orthodontist for an Open Bite
Any open bite, whether mild or severe, should be evaluated by an orthodontist rather than treated solely by a general dentist.
An orthodontist is a dentist who has completed an additional two to three years of specialty training in tooth movement and jaw alignment. Open bites are among the more complex malocclusions to treat, and they carry a higher relapse risk. A specialist's training in biomechanics and growth patterns makes a meaningful difference in diagnosis and treatment planning. You can learn more about what orthodontists treat on the orthodontics page. [1]
You should see an orthodontist if you notice a visible gap between your upper and lower front teeth when your mouth is closed, if you have difficulty biting into food with your front teeth, if you notice a lisp or speech difficulty, or if your child has a persistent thumb-sucking or tongue-thrusting habit past age 4.
The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7. At this age, an orthodontist can spot developing open bites early and may recommend interceptive treatment to guide jaw growth before the problem becomes more difficult to correct. [1]
Find an Orthodontist Near You
An orthodontist can examine your bite, review your X-rays, and tell you whether Invisalign, braces, or another approach is the best fit for your open bite. Use our directory on the orthodontics page to search for a qualified orthodontist in your area and schedule a consultation.
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