An open bite is one of the most mechanically complex issues an orthodontist faces. Unlike crowding, where teeth simply need to be unraveled, an open bite involves vertical discrepancies where the upper and lower teeth do not touch when the jaw is closed. This can lead to speech impediments, chewing difficulties, and uneven wear on the back teeth.
At Wagner Orthodontics, treating an open bite requires more than just straightening teeth—it requires a deep understanding of the skeletal and dental physics at play. Whether utilizing traditional braces or advanced clear aligner technology, the goal is to close the vertical gap while ensuring long-term stability for our patients in Longview, WA.
Key Takeaways
- Open bites are complex: They involve vertical spacing between teeth and can be caused by skeletal growth, dental positioning, or habits like tongue thrusting.
- Biomechanics matter: Treatment isn’t just about pushing teeth together; it involves intrusion (pushing teeth up) and extrusion (pulling teeth down) to level the bite.
- Technology is key: 3D imaging allows for precise diagnosis of skeletal versus dental open bites.
- Options exist: Both braces and Spark Clear Aligners are effective tools when paired with the right mechanics.
What is an open bite, and how is it treated?
An open bite is a type of malocclusion where the upper and lower teeth do not touch when the mouth is closed, creating a visible vertical gap. Treatment at Wagner Orthodontics focuses on intruding the back teeth (molar intrusion) to allow the lower jaw to rotate upward and forward, closing the bite. We use force-driven mechanics, such as vertical elastics, TADs (Temporary Anchorage Devices), or clear aligners with specialized attachments to achieve this complex movement.
The Physics of Malocclusion
To understand how we treat open bites, it helps to understand why they happen. There are generally two types:
- Anterior Open Bite: The front teeth don’t touch, but the back teeth do. This is often caused by habits (thumb sucking, tongue thrusting) or skeletal growth patterns where the jaw grows vertically rather than horizontally.
- Posterior Open Bite: The back teeth don’t touch, but the front teeth do. This is rarer and often linked to incomplete eruption of molars.
From a physics standpoint, correcting this isn’t as simple as pulling the front teeth down (extrusion). While some extrusion is helpful, relying on it too much can lead to a “gummy” smile and unstable results. Instead, modern orthodontics often focuses on posterior intrusion. By applying an upward force to the molars, we reduce the vertical height of the bite. This acts like a hinge: when the back of the jaw moves up, the front of the jaw swings shut, naturally closing the gap between the front teeth.
How do orthodontists use braces to close an open bite?
Braces close open bites by using a combination of vertical elastics and specialized archwire bends to guide teeth into position. At Wagner Orthodontics, we use high-grade stainless steel or clear ceramic brackets that give us precise control over the vertical movement of every tooth. By using an “extrusive” force on the front teeth and an “intrusive” force on the back teeth, braces work to level the arch and bring the bite into proper occlusion.
Force-Driven vs. Shape-Driven Mechanics
When Dr. Wagner places braces, he isn’t just gluing metal to teeth; he is engineering a force system.
- Torque: This refers to the twisting force applied to the tooth to control the angle of the root in the bone. In open bite cases, controlling the torque of the incisors is critical to preventing them from flaring forward, which makes the open bite worse.
- Adhesive Chemistry: The bond between the bracket and the tooth must be strong enough to withstand vertical tension. We use light-cured resin composites that bond micromechanically to the enamel. This ensures that when elastic rubber bands pull on the teeth to close the bite, the bracket stays firmly in place.
- Vertical Control: One specific technique involves the Multiloop Edgewise Archwire (MEAW) concept or similar reverse-curve wires. These wires are shaped to counteract the open bite, applying a constant, gentle force that pushes back teeth up and pulls front teeth down.
Can clear aligners treat a complex open bite?
Yes, clear aligners are highly effective for treating open bites, often with superior control over vertical dimension compared to braces. Clear aligners cover the chewing surfaces of the teeth, creating a “bite block” effect that naturally intrudes the molars over time. When combined with attachments (small composite shapes bonded to teeth), aligners can exert specific forces to extrude front teeth while simultaneously keeping back teeth from over-erupting.
Advanced Technology at Wagner Orthodontics
At Wagner Orthodontics, we utilize Spark Clear Aligners to manage these complex cases. The plastic material used in Spark aligners is designed for sustained force retention, meaning it keeps working throughout the week.
We start with 3D Imaging and Digital Impressions. Using our state-of-the-art scanners, we eliminate the need for messy putty. This digital model allows Dr. Wagner to see the relationship between the roots and the jawbone. We can then digitally map out the movements, ensuring that the intrusion of molars and extrusion of incisors are physiologically safe and esthetically pleasing. This digital planning is crucial for open bites, as it allows us to visualize the final bite before treatment even begins.
Frequently Asked Questions
Q: Can an open bite correct itself?
A: In young children, an open bite caused by thumb sucking may self-correct if the habit stops before permanent teeth erupt. However, once the adult teeth are in and the jaw has hardened, a skeletal or dental open bite will rarely correct itself without orthodontic intervention.
Q: Do I need jaw surgery for an open bite?
A: In the past, severe skeletal open bites in adults often required orthognathic surgery. However, with the advancement of TADs (Temporary Anchorage Devices) and modern clear aligner mechanics, Dr. Wagner can now treat many complex open bite cases non-surgically that previously would have required an operation.
Q: How long does it take to fix an open bite?
A: Treatment time varies based on severity, but open bite cases generally range from 18 to 30 months. Because open bites are prone to relapse (the teeth wanting to move back), the retention phase is just as important as the active treatment phase.
Start Your Smile Journey Today
Treating an open bite is a science that requires precision, expert planning, and the right technology. Whether you choose traditional braces or Spark Clear Aligners, the team at Wagner Orthodontics has the expertise to guide you toward a functional, healthy smile.
Call or visit our office in Longview to schedule your complimentary consultation. Let us show you how advanced orthodontics can transform your smile and your confidence.
