At a glance
- An open bite occurs when the upper and lower front teeth do not touch when the back teeth are brought together, leaving a visible gap between them even when the jaw is fully closed.
- A crossbite occurs when one or more upper teeth sit inside, rather than outside, the corresponding lower teeth when biting together, which is the reverse of the normal relationship.
- An open bite can make it difficult to bite into certain foods with the front teeth and is often associated with speech difficulties, particularly with sounds that require the front teeth to meet.
- Correcting an open bite often involves addressing any underlying habit, such as thumb-sucking or tongue-thrusting, alongside orthodontic treatment with braces or aligners to guide the front teeth into proper contact.
- In growing children, crossbites are often corrected using a palatal expander, a fixed appliance that gradually widens the upper jaw over several months to properly accommodate the lower arch.
What Is an Open Bite
An open bite occurs when the upper and lower front teeth do not touch when the back teeth are brought together, leaving a visible gap between them even when the jaw is fully closed. This can affect only the front teeth, known as an anterior open bite, or in rarer cases involve the back teeth as well.
Common causes include prolonged thumb-sucking or pacifier use well beyond the toddler years, tongue-thrusting habits where the tongue pushes against the front teeth during swallowing or speech, and in some cases, underlying skeletal growth patterns that create a naturally open bite relationship between the jaws.
What Is a Crossbite
A crossbite occurs when one or more upper teeth sit inside, rather than outside, the corresponding lower teeth when biting together, which is the reverse of the normal relationship. This can affect just a few teeth at the front or side of the mouth, or in more extensive cases, involve the entire upper or lower arch.
Crossbites often develop due to a narrow upper jaw that fails to properly accommodate the width of the lower jaw, sometimes as a result of prolonged pacifier use, mouth breathing, or simply inherited jaw proportions. Left uncorrected, crossbites can lead to asymmetric jaw growth and uneven wear patterns on the affected teeth over time.
Consequences If Left Untreated
An open bite can make it difficult to bite into certain foods with the front teeth and is often associated with speech difficulties, particularly with sounds that require the front teeth to meet. Tongue-thrusting habits associated with open bites can also make orthodontic correction more prone to relapse if the habit is not addressed alongside the bite itself.
Crossbites, particularly when affecting one side more than the other, can cause the lower jaw to shift to one side to achieve a more comfortable bite, potentially leading to asymmetric facial development over time in growing children. Addressing crossbites early is particularly important to avoid these longer-term structural effects.
Treatment for Open Bite
Correcting an open bite often involves addressing any underlying habit, such as thumb-sucking or tongue-thrusting, alongside orthodontic treatment with braces or aligners to guide the front teeth into proper contact. In some cases, habit-breaking appliances are used in children to discourage the tongue-thrusting pattern while orthodontic movement takes place.
For adults with significant skeletal open bites, where the jaw bones themselves contribute substantially to the gap, a combined surgical and orthodontic approach may be recommended to achieve a stable, long-term correction.
Treatment for Crossbite
In growing children, crossbites are often corrected using a palatal expander, a fixed appliance that gradually widens the upper jaw over several months to properly accommodate the lower arch. This early correction takes advantage of the growth plates in the roof of the mouth that are still responsive to gentle expansion forces during childhood.
In older teenagers and adults whose jaw growth is complete, crossbites may require a combination of braces and, in some cases, surgically assisted expansion to achieve the necessary widening of the upper jaw. Early evaluation remains the best way to determine whether a simpler, non-surgical correction is still possible.
Questions patients ask us
- Can thumb-sucking cause an open bite?
- Yes, prolonged thumb-sucking or pacifier use beyond the age when the habit would naturally stop can push the front teeth out of alignment and create or worsen an open bite. Addressing the habit early, alongside orthodontic guidance, helps prevent the issue from becoming more pronounced.
- Is a palatal expander painful for children?
- Most children tolerate palatal expanders well, experiencing mild pressure or a feeling of tightness for the first few days after each adjustment, which typically settles quickly. The device is generally well accepted once children adapt to its presence in the first week or two.
- Can adults still get a crossbite corrected?
- Yes, though since the jaw bones are no longer growing, adults may require a combination of braces and, in more significant cases, surgically assisted expansion to achieve the necessary correction. A thorough assessment will determine the most suitable approach for your specific situation.
- Does an open bite always need surgery to fix?
- No, many open bites, particularly those caused by habits like tongue-thrusting rather than significant skeletal discrepancy, can be successfully corrected with orthodontic treatment and habit management alone. Surgery is generally reserved for more severe skeletal cases in adults.
Sources and further reading
Guidance from professional and public health bodies. Clinical decisions here are made on your own examination and radiographs.
- 1.Orthodontic treatment and retention — patient resources — American Association of Orthodontists
- 2.Patient information leaflets on appliances and retention — British Orthodontic Society
- 3.Oral health — fact sheet and global status report — World Health Organization
- 4.Policy statements and oral health definitions — FDI World Dental Federation
- 5.Dental health — conditions, treatments and patient guidance — NHS (UK)
- 6.Systematic reviews of oral and dental interventions — Cochrane Oral Health
- 7.Regulatory framework and dental education standards in India — Dental Council of India
When to see us
Get examined without waiting if any of the following applies to you:
- A broken bracket, poking wire or appliance causing ulceration
- A tooth that becomes painful, loose or discoloured during treatment
- Jaw joint pain, locking or a bite that has changed suddenly
Get a written plan and cost before you commit
If this is what you are dealing with, the next step is a consultation with radiographs — orthodontics cases are seen by the specialist who handles that field. You get a written plan and staged cost before anything begins.
reception@dramitsharmahospital.comThis article is general education and does not replace an in-person examination, radiographs or a diagnosis by a qualified dentist.
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