In a healthy bite, the upper and lower teeth meet evenly when the mouth is closed. In an open bite, some teeth do not touch at all, even when the jaw is fully closed. This can affect how you bite, speak and feel about your smile.

The good news is that open bites can often be treated. This guide explains what an open bite is, why it happens, how it is diagnosed and which treatments are used, including clear aligners.

What is an open bite?

An open bite is a gap between the upper and lower teeth when the back teeth are together. There are two main types:

• Anterior open bite: the front teeth do not overlap or touch when you bite. This is the most common type people notice. It can make it hard to bite into some foods and can affect speech, for example causing a lisp.
• Posterior open bite: the back teeth do not meet, while the front teeth may touch. It can make chewing difficult.

Open bites are also described as dental or skeletal. A dental open bite is mainly about the position of the teeth. A skeletal open bite involves the shape and growth of the jaws. The difference matters because it affects which treatment is possible.

Why does an open bite happen?

There is often more than one cause. Common ones include:

• Thumb or finger sucking that continues beyond early childhood
• Prolonged pacifier use
• Tongue thrust, where the tongue pushes forward against the teeth when swallowing or speaking
• Jaw growth patterns, including genetics and a tendency for the jaws to grow vertically
• Mouth breathing, which can go along with a low tongue position
• Past orthodontic movements, trauma or joint problems in some cases

How common open bites are varies between studies and populations, so any single figure should be treated with caution.

How is an open bite diagnosed?

Your dentist or orthodontist will usually use:

• A clinical exam of your teeth, bite, tongue and jaw function
• Your dental and medical history, including habits and breathing
• Photographs and records of your teeth
• X-rays, often including a side view of the head, to see the jaws and how the teeth sit

The goal is to find the cause as well as the size of the gap. Treating the gap without treating a habit often leads to relapse.

How to fix an open bite: treatment options

1. Habit correction and tongue therapy

If a habit is the cause, stopping the habit is the first step. This may involve habit-breaking appliances, reminders and, in some cases, myofunctional therapy to retrain tongue posture and swallowing. In young children, dental open bites caused by habits can sometimes improve after the habit stops.

2. Clear aligners

Clear aligners can help in mild to moderate open bites that are mainly dental. They are often used to move the front teeth down into contact (extrusion) with attachments, and they are commonly combined with elastics. They work best when the patient wears them as prescribed and the cause has been addressed.

Some movements are harder for aligners alone. Pushing the back teeth into the bone to reduce their height (intrusion) is limited with aligners, so more complex cases may use extra anchorage, such as mini-implants.

3. Braces

Braces with elastics can treat anterior and posterior open bites, including more complex ones. Your orthodontist will plan the movements and elastics for your case.

4. Temporary anchorage devices (TADs)

TADs are small mini-implants, often titanium, placed temporarily in the bone. They give a fixed anchor point so teeth can be moved in ways that are difficult otherwise, such as intruding back teeth. They are used with braces or aligners.

5. Orthognathic (jaw) surgery

For skeletal open bites, where the problem is in the jaws, surgery may be needed. It is usually combined with braces or aligners before and after the operation.

Clear aligners and open bites: what to expect

Aligners can be a good option for the right open bite, and the plan should be built around the cause:

• Extruding the front teeth with attachments and elastics to close the gap
• Planned staging so the movement is gradual and the bite stays comfortable
• Careful attention to the back teeth, because their height affects how the front teeth meet
• Overcorrection and retention to reduce the chance of relapse

Your dentist will explain whether your open bite is suitable for aligners and which extra steps may be needed.

How long does treatment take?

Treatment time depends on the type and size of the open bite, the cause and how well the plan is followed. Mild dental cases may be treated in around a year, while more complex or skeletal cases can take longer. Your dentist can give you a realistic estimate after the exam and records.

Open bite in children

When should you check?

It helps to have a child’s bite checked early. Many organizations suggest a first orthodontic check around age 7, while the jaws are still growing and there is more room to guide development.

Will it correct itself?

Sometimes. An open bite caused by thumb sucking or a pacifier can improve in a young child once the habit stops. When the cause is tongue posture, jaw growth or genetics, it often does not resolve alone. A dentist can tell you which applies.

Why an open bite matters

An untreated open bite may be linked to:

• Difficulty biting into foods with the front teeth
• Speech changes, such as a lisp
• Extra wear on the teeth that do touch
• A tongue habit that keeps the problem going
• Changes in how the jaws work, though the link to jaw joint problems is not fully clear

Not every open bite causes problems, and some people live with one comfortably. The right choice depends on function, appearance and the patient’s goals.

Preventing relapse

Open bites have a reputation for coming back. To help keep the result:

• Treat the cause, for example tongue posture or a habit
• Wear retainers as advised
• Keep follow-up visits
• Tell your dentist if the gap starts to return

For dentists: planning open bite cases with aligners

Open bites need careful case selection and planning. Check whether the problem is dental or skeletal, consider the habit or tongue factor, plan attachments and elastics with a clear purpose and think about extra anchorage when intrusion is needed. Our guides on which cases clear aligners can treat, aligner attachment design and refinements and tracking problems can help. If you want a second look at a setup, an independent QC review checks staging, attachments and bite interference. See also our Treatable Cases page.

Frequently asked questions

Can clear aligners fix an open bite? Often in mild to moderate cases that are mainly dental. Skeletal open bites may need braces, mini-implants or surgery.

Can an open bite fix itself? In young children it sometimes improves when a thumb-sucking or pacifier habit stops. In many other cases it does not.

Is an open bite harmful? It can affect biting, speech and appearance, but not every open bite causes problems. A dentist can assess yours.

Will the open bite come back after treatment? It can, which is why treating the cause and wearing retainers matter.

Are mini-implants safe? They are widely used in orthodontics and are placed by trained dentists. Ask your provider about the benefits and risks.

What is the first step? A full exam with a dentist or orthodontist, so the type and cause can be found.

Talk to your dentist

If you or your child may have an open bite, the best first step is an exam with a dentist or orthodontist. If you are a dentist or lab that wants planning support for open bite cases, contact OrthoAlign Solution.

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