What This Guide Covers
This guide explains when Invisalign can fix an open bite and when it cannot. It is written for adults and parents of teens who have been told they have an open bite and want to understand their options.
An open bite is a malocclusion (misalignment of the teeth) where the upper and lower front teeth do not touch when the mouth is closed. A gap remains between them even when the back teeth are fully together. This can affect chewing, speech, and appearance. [2]
Open bites fall into two main categories. A dental open bite is caused by the position or angle of the teeth themselves. A skeletal open bite is caused by the way the jawbones grew. Many cases involve a combination of both. The category matters because it determines which treatments can work.
Throughout this guide, you will learn how clear aligners approach open bite correction, what their limits are, how they compare to braces and surgery, and how to find the right specialist to manage your care.
How Invisalign Treats an Open Bite
Invisalign closes an open bite by pushing the back teeth upward into the jawbone, a movement called posterior intrusion. This allows the jaw to rotate slightly closed, bringing the front teeth closer together.
The Mechanics Behind Open Bite Correction
Clear aligners apply gentle force to all the teeth they cover. For open bite correction, the key movement is intrusion of the posterior teeth (pushing the molars and premolars deeper into the bone). When the back teeth move upward, the lower jaw can rotate forward and upward, closing the gap between the front teeth.
Invisalign uses SmartForce attachments, which are small tooth-colored bumps bonded to specific teeth. These attachments give the aligners extra grip to produce forces that flat plastic alone cannot generate. In open bite cases, attachments are typically placed on the premolars and molars to help with intrusion.
Elastics (small rubber bands) may also be prescribed. These connect from hooks on the aligners to attachments on the teeth, adding vertical forces that help close the bite. Not every open bite case requires elastics, but moderate cases often do.
The amount of posterior intrusion clear aligners can achieve is limited. Published case reports and clinical experience suggest that aligners can typically intrude posterior teeth by about 1 to 2 millimeters. For mild to moderate dental open bites, this amount of movement is often sufficient.
Dental Open Bite vs. Skeletal Open Bite
A dental open bite results from tooth-level problems. Common causes include prolonged thumb sucking, tongue thrusting habits, or teeth that erupted at abnormal angles. The jawbones themselves grew normally. Because the issue is with tooth position, moving the teeth can typically resolve it.
A skeletal open bite results from abnormal jaw growth. The upper jaw (maxilla) may have grown downward excessively in the back, or the lower jaw (mandible) may have grown at a steep angle. In these cases, even perfectly positioned teeth cannot close the bite because the bones do not allow it.
Many patients have a combination of dental and skeletal factors. An orthodontist uses cephalometric X-rays (side-view skull images) and clinical measurements to determine how much of the open bite is dental and how much is skeletal. This analysis is the foundation for choosing the right treatment. [1]
Invisalign works best for dental open bites and mild skeletal contributions. When the skeletal component is significant, braces with skeletal anchorage or orthognathic surgery (jaw surgery) typically produce more predictable results.
Invisalign vs. Braces vs. Surgery for Open Bite
Each treatment option has strengths and limitations for open bite correction. The best choice depends on the severity and cause of the open bite.
Invisalign is generally suitable for mild to moderate dental open bites. Its advantages include comfort, aesthetics, and removability. Its main limitation is the amount of vertical force it can deliver. Aligners sit on the biting surfaces of the teeth, which can actually prevent full eruption of teeth that need to move downward.
Traditional braces offer greater mechanical control. Orthodontists can use temporary anchorage devices (TADs), which are tiny screws placed in the jawbone, to intrude back teeth with precise force. Braces also allow direct bonding of attachments and wires that produce movements aligners struggle to achieve. For moderate to severe open bites, braces with TADs are often the most effective non-surgical option.
Orthognathic surgery repositions the jawbones themselves. It is typically reserved for severe skeletal open bites where tooth movement alone cannot close the gap. Surgery is performed by an oral and maxillofacial surgeon in coordination with an orthodontist. Braces are usually worn before and after surgery to fine-tune tooth positions. In many cases, the results of surgical correction are the most stable long-term for severe skeletal cases.
- Mild dental open bite (2-3 mm gap): Invisalign is typically a reasonable option.
- Moderate dental open bite (3-5 mm gap): Invisalign may work with elastics and attachments, but braces with TADs may be more predictable.
- Severe open bite (greater than 5 mm) or skeletal open bite: Braces with TADs, surgery, or a combination is usually recommended.
What You Should Know Before Starting Treatment
Open bite correction with aligners requires careful case selection, habit changes, and realistic expectations about outcomes and stability.
Habit Correction Is Essential
Many open bites are caused or maintained by habits. Tongue thrusting, where the tongue pushes forward against the front teeth during swallowing, is the most common. Thumb sucking and prolonged pacifier use in childhood also contribute. Mouth breathing can play a role as well.
If the habit that caused the open bite is not addressed, the bite will typically reopen after treatment. This is true regardless of whether treatment involves aligners, braces, or surgery. The tongue exerts several pounds of force each time you swallow, and you swallow roughly 2,000 times per day.
Myofunctional therapy is a set of exercises that retrain the tongue and facial muscles. A myofunctional therapist or a speech-language pathologist can teach these exercises. Many orthodontists recommend myofunctional therapy before or during open bite treatment. This therapy is a significant factor in long-term stability.
Age Recommendations and Timing
Open bite treatment with Invisalign is most commonly performed in teens and adults whose jaw growth is complete or nearly complete. Growth completion typically occurs around age 16 to 18 in females and 18 to 20 in males. Treating before growth is complete can lead to unpredictable results because ongoing jaw growth may reopen the bite.
For children with open bites, early evaluation by an orthodontist is still valuable. The American Association of Orthodontists recommends a first orthodontic evaluation by age 7. [1] At this stage, the orthodontist can identify habits contributing to the open bite and may recommend habit-breaking appliances or myofunctional therapy. Definitive correction with aligners or braces is usually deferred until the permanent teeth have erupted.
There is no upper age limit for open bite correction. Adults in their 30s, 40s, 50s, and beyond can be treated successfully, provided their teeth and supporting bone are healthy. Adults with gum disease or significant bone loss may need periodontal treatment before orthodontic work begins.
Understanding Relapse Risk
Open bite has one of the highest relapse rates among all types of malocclusion. Published studies report relapse rates that vary widely depending on the severity of the original open bite, the treatment method used, and whether habits were corrected.
Relapse occurs when the front teeth drift apart again after treatment. Contributing factors include unresolved tongue thrust, inadequate retention, and natural growth changes. Even patients who achieve excellent results can experience some degree of relapse over time.
Retention is critical. Most orthodontists prescribe a fixed bonded retainer behind the front teeth, a removable retainer, or both. Full-time retainer wear for at least the first year is common, followed by nighttime wear indefinitely. Skipping retainer wear after open bite correction significantly increases the chance of relapse.
What to Expect During Invisalign Open Bite Treatment
Treatment typically takes 12 to 24 months and involves a structured process from initial evaluation through retention.
Step 1: Evaluation and Treatment Planning
The orthodontist will take digital scans or impressions of your teeth, panoramic and cephalometric X-rays, and photographs. These records allow the orthodontist to measure the open bite, assess the skeletal pattern, and determine whether Invisalign is appropriate for your case. [1]
If Invisalign is a good fit, the orthodontist will create a digital treatment plan using software called ClinCheck. This software shows a 3D simulation of how your teeth will move at each stage. You can see a projected final result before treatment begins. Keep in mind that the simulation is a plan, not a guarantee. Actual results depend on biology, compliance, and case complexity.
Step 2: Active Treatment with Aligners
You will receive a series of aligner trays. Each tray is worn for one to two weeks, depending on your orthodontist's protocol. You must wear the aligners for 20 to 22 hours per day. They are removed only for eating, drinking anything other than water, and brushing your teeth. [2]
SmartForce attachments will be bonded to several teeth at the beginning of treatment. These small resin bumps are tooth-colored and barely visible. They are essential for generating the forces needed to intrude posterior teeth and close the bite.
Your orthodontist may prescribe elastics at some point during treatment. These are small rubber bands that you hook onto designated spots on the aligners or attachments. Wearing elastics as directed is critical. Skipping elastics slows treatment and reduces effectiveness, especially for open bite cases.
You will visit the orthodontist every 6 to 10 weeks for progress checks. The orthodontist will assess whether the teeth are tracking with the aligners and whether the bite is closing as planned. Mid-course corrections, called refinements, are common. Refinement involves new scans and a new set of aligners to address any remaining discrepancies.
Step 3: Retention
After active treatment, you transition to retainers. For open bite cases, orthodontists often recommend both a fixed retainer bonded to the back of the front teeth and a removable retainer worn at night.
The fixed retainer provides constant passive force to keep the front teeth from drifting apart. The removable retainer adds additional coverage. You should expect to wear a removable retainer every night for years, and many orthodontists recommend lifelong nighttime wear for open bite patients.
Regular follow-up visits during the first year of retention help catch early signs of relapse. If the bite begins to open again, your orthodontist can intervene with a short course of additional aligners or adjust the retention strategy.
Cost of Invisalign for Open Bite
Invisalign treatment for open bite typically costs between $3,000 and $8,000. Costs vary by location, provider, and case complexity.
Open bite cases are generally more complex than simple crowding or spacing cases. This complexity often places them at the higher end of the Invisalign fee range. Cases that require longer treatment, more refinement trays, or additional appliances like elastics may cost more.
Dental insurance plans that include orthodontic benefits typically cover a portion of Invisalign treatment, often up to a lifetime maximum of $1,000 to $2,500. Coverage varies widely by plan. Contact your insurance provider to verify your specific orthodontic benefit before starting treatment. [2]
Many orthodontic offices offer payment plans that spread the cost over the duration of treatment. Health savings accounts (HSAs) and flexible spending accounts (FSAs) can also be used for orthodontic expenses. Ask the orthodontist's office about all available payment options during your initial consultation.
When to See an Orthodontist for Open Bite
Any open bite should be evaluated by an orthodontist, a dentist who completed an additional two to three years of specialized training in tooth movement and jaw alignment after dental school. [1]
General dentists who offer clear aligners may be able to treat mild crowding or spacing. However, open bite correction involves vertical control of the bite, which is one of the most challenging aspects of orthodontic treatment. Vertical problems require precise diagnosis, careful biomechanical planning, and close monitoring throughout treatment. These skills are central to orthodontic specialty training.
You should see an orthodontist if you notice a visible gap between your upper and lower front teeth when you bite down. Difficulty biting through food with your front teeth is another sign. Speech issues, particularly with sounds like "s" and "z," can also indicate an open bite.
Parents should bring children for an orthodontic evaluation by age 7 if they notice an open bite, prolonged thumb sucking, or mouth breathing. [1] Early evaluation does not always mean early treatment. But it allows the orthodontist to monitor growth and intervene at the right time.
Find an Orthodontist for Open Bite Treatment
Open bite correction requires the diagnostic skill and biomechanical expertise of a trained orthodontist. Whether your case calls for Invisalign, braces, or a combined approach, an orthodontist can identify the cause of your open bite and recommend the most effective treatment. Visit the orthodontics page on My Specialty Dentist to search for orthodontists in your area and schedule a consultation.
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