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An open bite means your front teeth don't touch when you close your mouth. We correct open bites with braces, clear aligners, habit-breaking appliances, and surgical options for severe cases.
An anterior open bite is a condition where the front teeth do not make contact when the back teeth are fully closed, leaving a visible gap between the upper and lower front teeth. Open bite makes it difficult to bite into foods like sandwiches and apples, and often causes speech issues such as a lisp. It is commonly caused by prolonged thumb-sucking, tongue thrusting, or skeletal growth patterns. Treatment with braces or clear aligners is highly effective, with habit-breaking appliances for children and surgical orthodontics available for severe adult cases.
An open bite — clinically known as anterior open bite — is a malocclusion where a visible gap remains between the upper and lower front teeth when the jaw is fully closed and the back teeth are in contact. It is one of the more complex orthodontic conditions to treat.
Open bite can be dental (caused by habits that prevent front teeth from erupting fully) or skeletal (caused by vertical excess in jaw growth). The most common causes in children are prolonged thumb-sucking, finger-sucking, and pacifier use past age 4, which push the front teeth apart and prevent them from meeting. Tongue thrusting — a habit where the tongue pushes forward against the front teeth during swallowing — is another major cause and can perpetuate an open bite even after the original habit stops. Chronic mouth breathing can also contribute by altering jaw growth patterns.
Open bite significantly impacts daily function. Patients struggle to bite into foods, often tearing food with their side teeth instead. Speech clarity is affected, particularly with sounds like "s," "z," and "th," which require the tongue to contact the front teeth. Left untreated, the condition places excessive chewing force on the back teeth, which can lead to premature wear, cracking, and TMJ problems. Effective treatment depends on identifying and addressing the underlying cause alongside orthodontic correction using braces, clear aligners, early intervention, or surgical orthodontics for severe skeletal cases.
When you bite down fully, a visible gap remains between your upper and lower front teeth — the defining sign of an open bite.
Sandwiches, apples, pizza, and other foods that require front-teeth biting become frustrating or impossible to eat normally.
A lisp or difficulty pronouncing certain sounds — especially "s," "z," and "th" — is a common functional sign of an open bite.
Chronic mouth breathing is both a cause and symptom of open bite. The open gap makes it easier to breathe through the mouth rather than the nose.
Pushing the tongue forward against or between the front teeth when swallowing is a key sign — and a habit that perpetuates the open bite.
Active or recent thumb-sucking or finger-sucking habit in a child, especially past age 4, is a strong predictor of open bite development.
Dr. Brandon Zipper creates an individualized plan based on the cause of the open bite (habit vs. skeletal), the patient's age, and the severity. Addressing the root cause is essential for long-term success.
We use 3D digital scans, cephalometric X-rays, and a detailed clinical exam to determine whether the open bite is dental (habit-related) or skeletal (jaw growth pattern). Identifying the root cause — thumb-sucking, tongue thrust, mouth breathing, or skeletal excess — is critical for preventing relapse.
For children with habit-related open bite, we may place a habit-breaking appliance (such as a tongue crib or rake) to eliminate thumb-sucking or tongue thrusting. Combined with early orthodontic treatment, this allows the front teeth to erupt into their proper positions as the child grows.
Braces are highly effective for open bite correction, using elastics and precise wire mechanics to close the vertical gap. Clear aligners can also treat mild to moderate open bites in compliant patients. Temporary anchorage devices (TADs) may be used to intrude back teeth, allowing the bite to close naturally.
For severe skeletal open bites in adults where jaw growth has completed, surgical orthodontics may be recommended. This involves braces to align the teeth, followed by orthognathic surgery to reposition the jaws, and post-surgical orthodontic finishing. Dr. Zipper coordinates with experienced oral surgeons for these cases.
Open bite has a higher relapse risk than most conditions, so retention is critical. Custom retainers maintain the correction. Dr. Zipper may also recommend myofunctional therapy to retrain tongue posture and swallowing patterns, addressing the underlying habits that caused the open bite.
Open bite can occur at any age, but the treatment approach differs significantly depending on the patient's stage of growth and the underlying cause.
The cost of open bite treatment at Zipper Orthodontics depends on the severity, the underlying cause, the treatment method, and whether surgery is involved.
Habit-related open bites in children treated with appliances and early intervention tend to fall on the lower end of this range. Comprehensive braces or aligner treatment for teens and adults typically falls in the mid-range. Cases requiring surgical orthodontics approach the upper end, though medical insurance may cover the surgical portion. Most dental insurance plans with orthodontic benefits cover $1,000 to $2,500. We verify your benefits before treatment begins and offer flexible monthly payment plans and interest-free financing. Your exact cost is determined at your free consultation.
Open bites are caused by a combination of genetic and behavioral factors. The most common causes include prolonged thumb-sucking or finger-sucking habits past age 4, tongue thrusting (pushing the tongue forward when swallowing), chronic mouth breathing, and skeletal growth patterns where the jaw grows more vertically than horizontally. TMJ disorders can also contribute. Dr. Zipper identifies the specific cause during a free consultation to ensure the treatment plan addresses the root issue.
Yes. Prolonged thumb-sucking is one of the leading causes of anterior open bite in children. The thumb pushes the upper front teeth forward and the lower front teeth backward while preventing proper eruption. If the habit continues past age 4 or 5, the risk of permanent open bite increases significantly. Dr. Zipper can recommend habit-breaking appliances and early intervention to correct the bite before it becomes a skeletal issue requiring more complex treatment.
Adults with open bite have several effective options. Mild to moderate cases can often be corrected with braces or clear aligners, sometimes combined with temporary anchorage devices (TADs) to intrude back teeth and allow the bite to close. Severe skeletal open bites may require surgical orthodontics — braces plus orthognathic surgery to reposition the jaws. Dr. Zipper evaluates each case individually and recommends the least invasive effective approach at your free consultation.
Open bite treatment typically takes 18 to 30 months depending on severity and the approach used. Mild habit-related cases in children may improve within 6 to 12 months once the habit is eliminated and early treatment begins. Moderate cases with braces or aligners usually require 18 to 24 months. Severe skeletal open bites requiring surgical orthodontics may take 24 to 30 months total, including pre-surgical orthodontics, surgery, and post-surgical finishing.
Open bite has a higher relapse rate than most orthodontic conditions, which makes retention and habit correction critical. If the underlying cause — such as tongue thrusting or mouth breathing — is not addressed, the open bite can return after treatment. Dr. Zipper emphasizes habit elimination as part of every open bite treatment plan and may recommend myofunctional therapy to retrain tongue posture and swallowing patterns. Consistent retainer wear is essential.
Yes. Most dental insurance plans with orthodontic benefits cover a portion of open bite treatment — typically $1,000 to $2,500 toward the total cost. Because open bite causes clear functional problems (difficulty biting, speech issues), some plans classify it as medically necessary, increasing coverage. If surgical orthodontics is required, medical insurance may cover the surgical portion. Zipper Orthodontics verifies benefits upfront and offers flexible payment plans and financing.
Dr. Brandon Zipper, DMD, MS — board-certified orthodontist and AAO member — treats open bites for patients of all ages in Boca Raton, Boynton Beach, and throughout South Florida.
