Open Bite Treatment

What an open bite actually is

In clinical terms, an open bite is what happens when certain teeth don’t make contact even when the jaw is fully closed. The most common version is anterior — the front teeth don’t touch, leaving a visible vertical gap when the back teeth are closed. Less common is a posterior open bite, where one or both sides of the back teeth fail to meet. Both interfere with how the bite functions, but they have different causes and different treatment paths.

A second distinction matters more for treatment planning: whether the open bite is dental or skeletal. In a dental open bite, the teeth themselves are positioned incorrectly while the underlying jaw structure is normal — these usually respond well to orthodontic correction with braces or aligners, sometimes with the help of small temporary anchorage devices that allow precise tooth movement. A skeletal open bite is structurally different. The jaw bones grew in a pattern that prevents the teeth from meeting; the lower face may appear longer than typical, the chin may be set back, and the airway may be involved. Severe skeletal cases often require coordinated orthodontic treatment with jaw surgery, though milder skeletal open bites can sometimes be improved orthodontically alone.

The causes behind an open bite are typically structural, behavioral, or both:

• Prolonged thumb sucking or pacifier use in early childhood, which can shape the developing arches and prevent the front teeth from settling into contact
• Tongue thrust patterns — where the tongue rests forward against the front teeth instead of against the palate, the constant pressure prevents the front teeth from meeting
• Mouth breathing and airway compromise, where children breathing primarily through their mouth often hold their tongue and jaw in positions that contribute to open bite development
• Genetic skeletal patterns that produce a longer lower face shape with a steeper jaw angle
• Tooth eruption issues, where front teeth fail to fully erupt into occlusion

What’s caused the open bite matters as much as how to fix it — because correcting one without addressing the other sets up the same problem to return.

Why an open bite is rarely just about the teeth

In most adult cases, an open bite tells a deeper story about how the mouth, tongue, and airway are working together — a story that often goes back further than the patient realizes. The teeth are the visible evidence; the underlying pattern is usually structural.

The Roth Williams approach to functional occlusion — the clinical methodology both Dr. Chantal Hakim and Dr. Isaac Hakim trained in — asks a different first question than most orthodontic practices. Rather than how do we straighten these teeth, it asks: what is causing them to settle in this position, and what will hold them once they’re moved? For open bites, the answer almost always involves three connected systems.

The first is the tongue. Where it sits at idle — pressed against the palate, or forward against the teeth — exerts continuous pressure that either supports normal arch development or works against it. A tongue resting forward can prevent front teeth from meeting, and it can undo orthodontic correction afterward unless the posture itself is addressed during treatment, not just the teeth.

The second is the airway. Open bites and airway compromise frequently travel together: narrow upper arches, a recessed jaw position, and the long-face skeletal pattern that often accompanies open bite all reduce airway volume. Patients who’ve struggled with mouth breathing, snoring, restless sleep, or daytime fatigue may discover their open bite is part of a broader pattern that affects how they breathe at night — which is why we evaluate the airway alongside the bite, not as a separate question.

The third is the jaw joint. When the front teeth don’t meet, the back teeth do all the work — and they do it under loads they weren’t built to carry. Over time, this drives uneven wear, jaw joint discomfort, and the kind of low-grade chronic tension that patients often don’t connect to their bite at all. (See our approach to TMJ and jaw function for more on how this connects.)

Evaluating all three before recommending treatment isn’t a marketing posture. It’s practical: orthodontic correction that ignores the underlying pattern doesn’t hold.

An open bite maloccluson can make eating foods like sandwiches especially challenging.

How we approach open bite treatment

Treatment at The Orthospaceship begins with a complete functional and structural assessment — not just photos and a digital scan, but a clinical evaluation of jaw joint position, tongue function, airway considerations, and whether the open bite is dental or skeletal in origin. The diagnostic includes in-house cone beam CT imaging, which provides a three-dimensional view of the upper airway and skeletal structure that two-dimensional X-rays cannot show.

From that diagnostic, the treatment plan emerges. It often involves one or a combination of these approaches, sometimes sequenced over time, sometimes layered in parallel:

Myofunctional therapy and habit correction. When tongue posture or oral habits are contributing to the open bite, this is often where treatment begins. Tongue training, habit elimination protocols, and (for younger patients) habit appliances can resolve the underlying cause before — or alongside — orthodontic correction. For some mild dental open bites, this work alone begins to close the bite without braces or aligners.

Braces with temporary anchorage devices (TADs). For moderate dental open bites, small bone-supported anchors give us the leverage to move teeth in directions conventional braces alone cannot achieve. Specifically, they let us intrude back teeth so the bite can close anteriorly. For most adult open bites of moderate severity, this is the most predictable approach.

Invisalign for mild dental cases. Clear aligner therapy with the right attachments and elastic protocols can correct mild dental open bites, particularly in patients whose tongue function is already good or has been retrained through myofunctional work.

Coordinated orthodontic and jaw surgery treatment for severe skeletal cases. When the underlying jaw structure is the source of the open bite, orthodontics alone cannot achieve a stable result. We coordinate with experienced oral and maxillofacial surgeons in the Beverly Hills and Los Angeles area, planning the orthodontic phases before and after surgery so the patient moves through the process with one integrated treatment plan rather than two disconnected ones.

Airway-focused intervention when relevant. For patients whose open bite connects to airway compromise, treatment may include arch development to support a wider, more open upper airway. This is particularly impactful for younger patients still in active growth, when arch development can support the bite and the breathing at the same time.

The treatment plan emerges from what the diagnostic reveals — not from what works for an average case. The goal is correction that holds, which requires addressing what’s driving the bite, not just moving the teeth.

Open bite treatment across ages

What changes when an open bite is corrected

The differences are functional first, aesthetic second — and patients often notice the functional changes more.

The everyday things ease up.

Biting cleanly into food that previously required side-teeth maneuvering — sandwiches, apples, anything that needs a clean front-tooth bite — stops being something to plan around. A lisp or sibilant softening that hung on from childhood often clarifies once the front teeth meet correctly; the change can be gradual, with some patients noticing it months after treatment ends, when their tongue has fully adapted to the new bite.

Other changes show up where patients didn’t expect them.

 Back teeth that have been carrying loads they weren’t designed for stop bearing the full force of every bite — afternoon jaw tightness eases, headaches loosen their grip. When airway considerations were part of the treatment plan, sleep and breathing often improve too: easier breathing through the nose, fewer middle-of-the-night wakings, more consistent rest. Patients sometimes notice these changes before they consciously connect them to the bite work.

And then there’s the smile itself.

 The simple act of letting the front teeth show in photos — something many patients have spent years quietly avoiding — comes back without effort. Confidence returns the way it left: one moment at a time.

What your complimentary open bite consultation looks like

The first appointment is unhurried. You’ll meet Dr. Chantal Hakim or Dr. Isaac Hakim — both are graduates of the Roth Williams Center for Functional Occlusion and dual board-certified through the American Board of Orthodontics. The consultation includes a clinical examination of how your teeth meet, a structural assessment of the jaw joints, an evaluation of tongue function, and a conversation about any symptoms you’ve noticed: chewing difficulty, speech, sleep, jaw tension.

If the case calls for it, we’ll capture diagnostic imaging — a digital iTero scan of the teeth and bite, and cone beam CT imaging when the airway or skeletal pattern needs three-dimensional evaluation. Both happen in-house, in the same visit.

By the end of the appointment, you’ll know what’s driving the open bite, what treatment approaches are realistic for your case, and what timelines and ranges of investment look like. There’s no commitment to begin treatment that day. The consultation exists so you have the information to decide.