What Is an Open Bite and Why Does It Need Treatment
An open bite is a type of malocclusion (misalignment of the teeth) where there is a gap between the upper and lower teeth when you bite down. The most common form is an anterior open bite, where the front teeth do not touch. A posterior open bite, where the back teeth do not meet, is less common.
Open bites are more than a cosmetic concern. They can make it difficult to bite into food, affect speech clarity, and place excess stress on the teeth that do make contact. Over time, the back teeth that absorb extra force may wear down faster or develop cracks.
Treatment is recommended to restore proper bite function, protect tooth structure, and improve aesthetics. The right treatment depends on whether the open bite is caused by tooth position (dental open bite) or jaw structure (skeletal open bite).
Dental vs Skeletal Open Bite
A dental open bite is caused by the position of the teeth themselves. Habits like thumb sucking, tongue thrusting, or prolonged pacifier use can push the front teeth outward, preventing them from meeting. This type is generally more responsive to orthodontic treatment with aligners or braces.
A skeletal open bite results from the way the upper and lower jaws grew. If the jaws grew at different rates or in different directions, the teeth may not be able to meet regardless of their position. Skeletal open bites are more complex and may require orthognathic (jaw) surgery in combination with orthodontic treatment.
Causes of an Open Bite and How Invisalign Addresses Them
Understanding the root cause of your open bite helps your orthodontist determine if Invisalign is a viable treatment option.
Common Causes of Open Bite
- Thumb sucking or finger habits during childhood that push the front teeth forward
- Tongue thrusting, a habit where the tongue pushes against or between the front teeth during swallowing or at rest
- Prolonged pacifier use or bottle feeding beyond age 3
- Skeletal growth patterns where the lower jaw grows downward and backward
- Temporomandibular joint (TMJ) disorders that alter jaw positioning
- Tooth loss that allows remaining teeth to shift
How Invisalign Corrects an Open Bite
Invisalign uses a series of custom-made clear plastic aligners to move teeth gradually into the desired position. For open bite correction, the aligners work to intrude the back teeth (push them upward into the jawbone) and sometimes extrude the front teeth (pull them downward into contact).
Intrusion of the back teeth is a key mechanism. When the back teeth are slightly shortened, the jaw can rotate closed, allowing the front teeth to meet. Invisalign aligners can generate the controlled forces needed for this movement, especially when used with SmartForce attachments, which are small tooth-colored bumps bonded to certain teeth to improve aligner grip.
Research published in the <em>Angle Orthodontist</em> has shown that Invisalign can achieve clinically significant open bite closure in cases of mild to moderate severity. However, the results depend heavily on patient compliance with wearing aligners 20 to 22 hours per day.
What to Expect During Invisalign Treatment for Open Bite
Treatment follows a structured process from initial evaluation through active treatment and retention.
Initial Consultation and Treatment Planning
Your orthodontist will examine your teeth and bite, take digital scans or impressions, and review X-rays, including a cephalometric X-ray that shows the relationship between your jaws and skull. These images help determine whether your open bite is dental, skeletal, or a combination.
If Invisalign is appropriate, your orthodontist will use 3D digital planning software to map out each stage of tooth movement. You will be able to preview the expected outcome before treatment begins.
Active Treatment Phase
You will receive a series of aligner trays, each worn for 1 to 2 weeks before switching to the next set. The total number of trays depends on the complexity of your case, typically ranging from 20 to 50+ trays.
SmartForce attachments will likely be placed on several teeth. These small composite bumps are nearly invisible and help the aligners apply the precise forces needed for intrusion and rotation movements. Elastics (small rubber bands) may also be prescribed to help correct the bite relationship.
You will visit your orthodontist every 6 to 10 weeks for progress checks. At these appointments, your provider will assess tracking and may make adjustments to the treatment plan if needed.
After Active Treatment
Once your teeth have reached their target positions, you will transition to retainers. Open bite cases carry a higher risk of relapse than other orthodontic corrections, particularly if the underlying cause (such as tongue thrusting) is not addressed.
Your orthodontist may recommend a fixed retainer bonded behind your front teeth, a removable clear retainer, or both. Consistent retainer wear is critical for maintaining results long term.
Treatment Timeline and Retention
The overall timeline for open bite correction with Invisalign depends on the severity of the case and your compliance with wearing aligners.
Expected Timeline
Months 1 to 3: Initial tooth movement begins. You may notice slight changes in how your teeth fit together. Attachments and elastics are placed during this phase.
Months 3 to 9: Significant movement occurs, including back tooth intrusion. The open bite gap begins to close visibly.
Months 9 to 18: Fine-tuning of tooth position and bite alignment. Refinement aligners may be ordered if additional adjustments are needed.
Months 18 to 24: Final alignment and transition to retainers. Some cases resolve sooner, and more complex cases may extend beyond 24 months.
Retention and Long-Term Stability
Open bite correction requires diligent retention. Studies show that open bites have a relapse rate of up to 35% if retention protocols are not followed. Your orthodontist will recommend a specific retainer schedule. Many patients need to wear a retainer full-time for the first 6 to 12 months, then transition to nighttime-only wear indefinitely.
If tongue thrusting contributed to your open bite, your orthodontist may refer you to a myofunctional therapist. Myofunctional therapy retrains the tongue and facial muscles to support proper oral posture and reduce relapse risk.
Cost of Invisalign for Open Bite Correction
Invisalign treatment for open bite correction typically costs between $3,500 and $8,000. Costs vary by location and provider, the complexity of the case, and the total number of aligner trays required.
Factors That Affect Cost
- Geographic region and local cost of living
- The orthodontist's experience with open bite cases
- Whether refinement trays are needed mid-treatment
- The type and number of attachments and elastics used
- Whether additional treatments (such as myofunctional therapy or elastics) are prescribed
Insurance and Financing
Many orthodontic insurance plans cover a portion of Invisalign treatment, typically up to a lifetime maximum of $1,000 to $2,500. Coverage often applies equally to braces and Invisalign. Check with your insurer to confirm your specific benefits.
Most orthodontic offices offer in-house payment plans that spread the cost over the treatment period, often with no interest. Third-party financing through CareCredit or similar services is another option.
When to See an Orthodontist About Your Open Bite
If your front teeth do not touch when you bite down, you should schedule a consultation with an orthodontist. Early evaluation is especially important for children and teens, as interceptive treatment during growth can sometimes prevent the open bite from worsening.
For adults, an orthodontic consultation will determine whether Invisalign, braces, or a surgical-orthodontic approach is the best path. Signs that you should seek an evaluation include difficulty biting into food with your front teeth, a lisp or speech issue related to your bite, visible gap between upper and lower front teeth when your mouth is closed, or jaw pain and uneven tooth wear.
An orthodontist has 2 to 3 years of specialty training beyond dental school in tooth movement, jaw growth, and bite correction. For open bite cases, this specialized training is particularly important.
Find an Orthodontist for Open Bite Treatment
Correcting an open bite requires an experienced orthodontist who can evaluate whether Invisalign, braces, or a combined approach is right for your case. Use the MySpecialtyDentist.com directory to search for board-certified orthodontists near you, compare their credentials, and book a consultation.
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