Open Bite

What this means for your treatment decision

Aligners can be effective for many dental open bites, partly because the aligner material covers biting surfaces and can help intrude certain teeth, but any contributing habit generally needs to be addressed too, or the bite tends to reopen.

Dental versus skeletal open bite

A dental open bite occurs when the front teeth have erupted or tipped in a way that prevents contact, often linked to an ongoing habit, while the jaw bones themselves are proportioned normally. A skeletal open bite involves the jaw growth pattern itself — a longer lower face or a downward-rotating jaw growth direction — producing a gap that tooth movement alone struggles to close completely. Determining which pattern you have shapes both the treatment plan and how confident we can be about the outcome.

What commonly causes an anterior open bite

• Tongue thrust — pushing the tongue forward against or between the front teeth, especially when swallowing
• History of prolonged thumb or finger sucking
• Chronic mouth breathing, often linked to airway or allergy issues
• A skeletal growth pattern with a longer lower facial height
• A combination of more than one of the above, which is common

Why habits must be evaluated, not just teeth

A scan can show that front teeth aren't touching, but it can't tell you why. Identifying an active tongue thrust, a lingering oral habit, or a breathing pattern that's keeping the tongue pushed forward requires observation during a clinical exam — sometimes watching you swallow or speak, and discussing history of thumb-sucking or nasal breathing issues. Treating the teeth without addressing an active contributing habit is a common reason open bite corrections relapse.

How aligners treat a dental open bite

Clear aligners can be particularly well suited to open bite correction in certain cases because the aligner material sits over the biting surfaces of the back teeth, which can help gently intrude them, reducing the vertical gap at the front as the bite rotates closed. Attachments may be used on specific teeth to achieve the intrusive or extrusive movements the correction requires. This is a more specialized use of aligner technology than routine straightening, and not every open bite responds the same way.

Addressing the underlying habit alongside tooth movement

• Myofunctional therapy or tongue-posture exercises may be recommended to retrain how the tongue rests and swallows
• Habit-breaking approaches are often recommended if thumb or finger sucking is ongoing
• Airway or breathing concerns may warrant a referral for evaluation outside orthodontics
• Habit correction and tooth movement often need to progress together, not sequentially

When an open bite needs more than aligners

If the open bite is primarily skeletal — driven by jaw growth direction rather than tooth position — orthodontic tooth movement has real limits. In growing children and teens, growth-guidance approaches are sometimes considered while there is still growth to work with. In adults with a pronounced skeletal open bite, treatment may need to be coordinated with other specialists, and this would be discussed directly rather than attempted with aligners alone if the exam points that way.

Living with treatment

Patients with an open bite who are also doing habit-correction work, such as myofunctional exercises, should expect this to run alongside orthodontic treatment, not replace it. It's common to notice the front teeth beginning to touch gradually over the course of treatment rather than suddenly, and to feel some new sensation at the front teeth as they come into contact for the first time in years in some adult cases.

Why retention matters so much here

Open bites are widely recognized as one of the more relapse-prone bite corrections, precisely because the habit that helped cause them can persist after the teeth have moved. Consistent retainer wear and, where applicable, continued habit management are central to keeping a corrected open bite closed over the long term.

Questions patients ask