An open bite is one of the more unusual-looking orthodontic problems — when the back teeth are brought together, the front teeth do not meet. There is a visible gap between the upper and lower front teeth even with the jaws fully closed. For some people this gap is subtle; for others it is pronounced enough to make biting into food, pronouncing certain sounds, or feeling confident about their smile genuinely difficult. Despite being less commonly discussed than crowding or overbites, open bite treatment is a well-established orthodontic field and the condition is very treatable — particularly when identified and addressed early. This guide covers what causes an open bite, the health and functional implications of leaving it untreated, the treatment options available, and what realistic outcomes look like for adults and children. Key takeaway An open bite occurs when the upper and lower front teeth do not make contact when the back teeth are closed together. It can be caused by skeletal factors (the underlying jaw shape), dental factors (how the teeth have erupted), or habitual factors (prolonged thumb sucking or tongue thrusting). Treatment is more effective the earlier it begins — particularly for habit-related open bites in children, where stopping the habit and guiding tooth eruption can resolve the problem without extensive orthodontic intervention. In adults, treatment typically involves orthodontics (braces or aligners) and in severe cases may include jaw surgery for a stable, long-lasting result. An open bite is a malocclusion — a misalignment of the teeth when the jaws are closed — characterised by a vertical gap between the biting surfaces of the upper and lower teeth. The most common type is an anterior open bite, where the front teeth do not meet. A posterior open bite, where the back teeth on one or both sides do not make contact, is less common. Open bites are classified by their primary cause: 3–4% Approximate prevalence of anterior open bite in the general UK population Age 7 Recommended age for a first orthodontic assessment — early open bites may be caught when intervention is simplest Higher Relapse risk for open bite compared to other malocclusions — requires careful treatment planning and retention An open bite is not merely a cosmetic issue — though the aesthetic impact is real and affects many patients' confidence. The functional consequences can be significant: Understanding the full scope of these orthodontic problems is an important part of deciding whether and when to seek treatment. What appears to be a cosmetic concern often has functional implications that become more significant over time. Wondering if your bite can be corrected? 😀 A free virtual assessment gives you a qualified clinician's view on your case before you commit to any in-person appointments. Start your free assessment → The approach to open bite in children depends heavily on age, the cause, and the severity. The British Orthodontic Society recommends that children have their first orthodontic assessment at around age seven — not because treatment necessarily begins at this age, but because any emerging bite problems can be identified early, habits can be addressed while still reversible, and parents can be counselled on what to expect. For habit-related open bites in younger children — particularly those caused by thumb sucking or dummy use — the first intervention is habit cessation. Stopping the habit before the age of seven to eight, before the permanent front teeth have fully erupted, often allows the open bite to resolve spontaneously as the teeth move naturally into a more closed position. Appliances such as a tongue crib or habit breaker can be fitted to discourage thumb sucking if behavioural approaches are insufficient. Where the open bite is maintained by an abnormal tongue posture or swallowing pattern (tongue thrust), referral to a myofunctional therapist or speech and language therapist may be recommended alongside orthodontic treatment. Without addressing the tongue position, orthodontic correction of the open bite is at high risk of relapse — the tongue continues to push the teeth apart during swallowing. Where early intervention is clinically justified — typically for skeletal open bites where growth modification can still influence jaw development — functional appliances or removable plates may be used during the mixed dentition phase (when both primary and permanent teeth are present) to guide the bite into a better relationship before full fixed brace treatment begins. Adult open bite treatment is more complex than childhood treatment because skeletal growth is complete and cannot be redirected. Treatment options depend on the severity and type of the open bite: Orthodontic treatment alone Suitable for mild to moderate dental open bites where the jaw relationship is acceptable Combined orthodontic and surgical treatment Required for severe skeletal open bites where jaw surgery (orthognathic surgery) is needed for stable correction Open bite has one of the highest relapse rates of any orthodontic problem — this is an important fact that should be discussed openly during treatment planning. The relapse risk is particularly high where: The most stable outcomes for adult skeletal open bites are achieved with combined orthodontic and surgical treatment. Purely orthodontic correction of a skeletal open bite in an adult carries a meaningful relapse risk that should be factored into the treatment decision. Important If your open bite is related to a tongue thrust pattern, discussing myofunctional therapy before beginning orthodontic treatment is strongly advisable. Without addressing the tongue posture, the forces from swallowing can gradually reopen the bite even after successful orthodontic correction. A specialist orthodontist experienced in open bite cases will typically assess tongue function as part of the initial consultation. If you are looking for orthodontic practices that handle complex cases, the orthodontist finder can help you locate specialist clinicians in your area. Ready to Find Out What Can Be Done for Your Bite? A free virtual assessment lets a qualified clinician review your bite and give you an honest picture of treatment options, timelines, and what realistic outcomes look like for your specific case.What Is an Open Bite?
What Problems Does an Open Bite Cause?
Open Bite Treatment for Children
Stopping the habit first
Addressing tongue thrust
Early orthodontic intervention
Open Bite Treatment for Adults
Will the Open Bite Come Back After Treatment?
Open Bite Treatment: Causes, Risks, and How Orthodontics Can Help
Published · 8 min read · by Virtual Consultant Online
Dental open bite: caused by abnormal tooth eruption or tooth position, without an underlying skeletal component. Often associated with habits such as thumb sucking or dummy (pacifier) use beyond age three to four.
Skeletal open bite: caused by the underlying shape and relationship of the jaw bones — typically where the back of the jaw is positioned higher than the front, causing the lower face height to increase and the front teeth to diverge rather than meet.
Habit-related open bite: most commonly caused by prolonged thumb sucking, finger sucking, or persistent dummy use during the years when primary and permanent teeth are erupting, or by a tongue thrust swallowing pattern where the tongue pushes forward between the teeth.
Difficulty biting food: The inability of the front teeth to make contact makes it difficult or impossible to bite cleanly into food — bread, sandwiches, and raw vegetables are commonly problematic. Patients often compensate by using their side teeth to bite, or by tearing food rather than cutting it.
Speech difficulties: An open bite can affect the pronunciation of sounds that require the tongue to make contact with the upper front teeth — particularly the sounds "th", "s", "z", and "f". Speech therapy may be recommended alongside or after orthodontic treatment.
Excessive wear on back teeth: When the front teeth do not carry any biting load, all chewing force is concentrated on the back teeth. Over many years this can lead to accelerated wear of the molar and premolar surfaces.
Jaw joint problems (TMD): The altered bite mechanics associated with an open bite can contribute to temporomandibular joint dysfunction in some patients, causing jaw pain, clicking, or headaches.
Self-consciousness: The visible gap between the teeth when smiling or talking affects many patients' confidence and willingness to smile openly.
Fixed braces or clear aligners used to intrude (move up) the back teeth and allow the front teeth to close
Vertical elastics used to help close the gap between upper and lower front teeth
TADs (temporary anchorage devices) — small titanium screws placed in the jaw bone to provide anchorage for intrusion forces
Pre-surgical orthodontics aligns the teeth in their respective jaws
Jaw surgery repositions the bones to close the bite and correct the facial profile
Post-surgical orthodontics fine-tunes the result
A tongue thrust habit has not been fully addressed before or during treatment
The underlying skeletal pattern is steep (hyperdivergent facial type) — the jaw geometry continues to work against the corrected bite
Retention has not been adequately planned — vertical elastics or specific retainer designs may be needed for months or years after treatment
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References
BOS guidance on types of malocclusion including open bite, covering causes, functional implications, and treatment approaches for children and adults in the UK. Includes discussion of skeletal vs dental classification and the role of habit cessation in early treatment.
British Orthodontic Society — Open bite: Patient informationNHS overview of orthodontic problems including open bite, covering how malocclusions are assessed using the Index of Orthodontic Treatment Need and when NHS-funded treatment may be available for children and young people with clinically significant bite problems.
NHS — Orthodontics: Types of problems treatedOral Health Foundation patient information on bite problems including open bite, covering the causes, symptoms, and available treatments, as well as the importance of seeking assessment early and the increased complexity of adult treatment compared to childhood intervention.
Oral Health Foundation — Malocclusion and bite problemsBOS guidance on types of malocclusion including open bite, covering causes, functional implications, and treatment approaches for children and adults in the UK. Includes discussion of skeletal vs dental classification and the role of habit cessation in early treatment.
British Orthodontic Society — Open bite: Patient informationNHS overview of orthodontic problems including open bite, covering how malocclusions are assessed using the Index of Orthodontic Treatment Need and when NHS-funded treatment may be available for children and young people with clinically significant bite problems.
NHS — Orthodontics: Types of problems treatedOral Health Foundation patient information on bite problems including open bite, covering the causes, symptoms, and available treatments, as well as the importance of seeking assessment early and the increased complexity of adult treatment compared to childhood intervention.
Oral Health Foundation — Malocclusion and bite problems