Open Bite (When the Front Teeth Don't Touch)
What Is an Open Bite?
Have you ever noticed that your child's front teeth don't touch when they bite together?
Maybe they have trouble biting into a sandwich, pizza, or an apple. Perhaps you've noticed a gap between the upper and lower front teeth even when the back teeth are together.
This condition is called an open bite.
An open bite occurs when the upper and lower front teeth do not touch when the mouth is closed. While some open bites involve only the front teeth, others may affect larger portions of the bite.
Open bites can range from mild to severe and may be caused by habits, tongue posture, growth patterns, or a combination of factors.
The good news is that open bites are often very treatable, especially when the underlying cause is identified early.
Why Does an Open Bite Happen?
Open bites can develop for several different reasons.
Common causes include:
Thumb sucking
Finger sucking
Prolonged pacifier use
Tongue posture habits
Mouth breathing
Genetics
Jaw growth patterns
Airway-related concerns
Some open bites are primarily dental, meaning the teeth have erupted into unfavorable positions.
Others are primarily skeletal, meaning the way the jaws have grown contributes to the open bite.
Many children with open bites have a history of thumb sucking or prolonged pacifier use. These habits can affect how the front teeth erupt and how the bite develops over time.
Tongue posture may also play an important role.
Many people have heard that tongue thrust causes open bites. While tongue movement during swallowing has traditionally received significant attention, many orthodontists today believe that tongue posture throughout the day plays a much larger role.
A tongue that rests between the front teeth for hours each day can influence how teeth erupt and how the bite develops.
Understanding the cause of the open bite is one of the most important parts of treatment planning because different causes often require different solutions.
How Does an Open Bite Change Over Time?
Open Bite in Baby Teeth
Open bites are commonly seen in young children with thumb-sucking habits, finger-sucking habits, or prolonged pacifier use.
The encouraging news is that many of these open bites improve naturally once the habit stops.
This is one reason we often begin with conservative approaches before recommending orthodontic treatment.
Open Bite During the Transition to Adult Teeth
This is an important stage for monitoring.
As permanent teeth begin erupting, we can better determine whether the open bite is improving, remaining stable, or becoming more pronounced.
If habits continue during this stage, the open bite often persists.
This is also when we begin evaluating whether orthodontic intervention may be helpful.
Open Bite in Permanent Teeth
Once the permanent teeth have erupted, open bites are less likely to correct themselves.
Patients may experience:
Difficulty biting into foods
Speech concerns
Bite instability
Cosmetic concerns
At this stage, treatment often focuses on correcting the bite and addressing any habits or tongue posture patterns that may contribute to the problem.
Open Bite in Adults
Adults with open bites often learn to adapt to their bite over time.
However, they may still experience:
Difficulty biting into foods
Speech concerns
Tooth wear
Smile concerns
Bite instability
Treatment can still be highly successful in adulthood, although more complex cases may require more advanced treatment approaches.
Will My Child Outgrow an Open Bite?
Sometimes.
If an open bite is caused primarily by a thumb-sucking habit or prolonged pacifier use, it may improve once the habit stops.
However, if the habit continues or if the open bite is related to jaw growth patterns, it is much less likely to correct itself.
This is why regular orthodontic evaluations are so valuable.
The goal is to identify the cause of the open bite and determine whether observation, habit correction, or treatment is the best next step.
Does an Open Bite Need to Be Fixed?
Not always.
Some mild open bites cause few functional concerns and can be monitored.
However, treatment may be recommended when an open bite causes:
Difficulty biting into foods
Speech concerns
Bite instability
Cosmetic concerns
Ongoing habits affecting dental development
The decision to treat depends on the severity of the open bite, its cause, and how it is affecting the patient.
Does My Child Need an Appliance to Stop Thumb Sucking?
Not always.
In fact, we usually encourage families to try simple, conservative approaches before considering orthodontic treatment.
Many children successfully stop thumb sucking with:
Positive reinforcement
Reward systems
Thumb guards
Bitter-tasting nail solutions
Gentle reminders
Family support and encouragement
One of the most important factors is whether the child is personally ready to stop.
As parents know, it is difficult to force a child to give up a habit they are not ready to quit. The same principle applies to orthodontic treatment.
Even orthodontic textbooks recognize the importance of motivation. Successful habit correction is much more likely when a child wants to stop rather than feeling forced to stop.
Because of this, Dr. Martinez spends time talking with both parents and children before recommending treatment. We want to understand where the child is in the process and whether they are ready to make a change.
At the same time, parents play an important role. We encourage families to begin these conversations early and continue working through conservative options whenever possible.
If those approaches are unsuccessful and the habit is beginning to affect the development of the teeth and bite, orthodontic treatment may be recommended.
When Is the Best Time to Fix an Open Bite?
One of the most common questions parents ask is:
"Should we fix it now, or should we wait?"
The answer depends on the cause of the open bite.
If the open bite is related to a thumb-sucking habit, timing is extremely important.
At Smile Squad, we generally prefer to see evidence that a child is ready to stop the habit before beginning orthodontic treatment. Starting treatment before a child is committed to breaking the habit often leads to frustration for everyone involved.
For many habit-related open bites, treatment is considered once the upper front permanent teeth are beginning to erupt and the child is motivated to stop the habit.
This timing allows us to address the problem while the bite is still developing and while the permanent teeth are emerging.
For open bites caused primarily by jaw growth patterns rather than habits, treatment timing depends on the individual's growth and development.
Every child is different, which is why a personalized evaluation is so important.
Our goal is not to treat as early as possible. Our goal is to treat at the right time.
How Is an Open Bite Fixed?
Treatment depends on the cause of the open bite, the patient's age, and whether any habits are still present.
Observation
Some open bites improve naturally, especially when a thumb-sucking or pacifier habit stops at an early age.
In these cases, monitoring may be all that is needed.
Habit Elimination
For many children, the first step is helping them eliminate the habit contributing to the open bite.
This may include:
Thumb-sucking cessation
Finger-sucking cessation
Eliminating prolonged pacifier use
Improving oral posture habits
In many cases, stopping the habit allows the teeth to begin moving toward a healthier position naturally.
Spur Appliances
When orthodontic treatment is needed, Dr. Martinez often prefers a spur appliance.
Spur appliances are small orthodontic attachments designed to help retrain tongue posture and discourage thumb-sucking habits.
One of the reasons Dr. Martinez prefers spur appliances is that they encourage long-term behavioral change rather than simply acting as a barrier.
A tongue that rests between the front teeth throughout the day can influence how teeth erupt and how the bite develops. For this reason, treatment often focuses on helping the tongue learn a healthier resting position.
Tongue Cribs
Tongue cribs are another appliance sometimes used to manage habits and open bites.
A tongue crib works primarily by creating a physical barrier between the tongue and the front teeth.
While tongue cribs can be effective in many situations, Dr. Martinez often prefers appliances that help retrain tongue posture rather than simply blocking tongue movement.
The best appliance depends on the individual patient, their habits, and their treatment goals.
Braces
Braces are often used to align teeth and close an open bite once harmful habits have been addressed.
Clear Aligners
Clear aligners can be an excellent option for many open bite patients.
In fact, unlike deep bites, certain open bites may respond particularly well to aligner treatment because of the way aligners influence tooth eruption and bite relationships.
Whether aligners are appropriate depends on the patient's age, growth, and the cause of the open bite.
Temporary Anchorage Devices (TADs)
In some adolescents and adults, temporary anchorage devices may be used to help correct more complex open bites without surgery.
Orthognathic Surgery
For severe skeletal open bites involving significant jaw discrepancies, jaw surgery combined with orthodontic treatment may provide the most ideal correction.
Fortunately, surgery is not necessary for most patients with an open bite.
Signs Parents Should Watch For
You may want to schedule an orthodontic evaluation if you notice:
Front teeth that don't touch
Difficulty biting into foods
Thumb-sucking habits
Finger-sucking habits
Prolonged pacifier use
Tongue resting between the front teeth
Speech concerns
Mouth breathing
A visible gap between the front teeth when biting
Why Early Diagnosis Matters
Early diagnosis does not necessarily mean early treatment.
The purpose of an early evaluation is to determine why the open bite developed and whether it is likely to improve, remain stable, or worsen over time.
By identifying habits, tongue posture patterns, and growth concerns early, we can develop a treatment plan that is tailored to each child's specific needs.
Some children benefit from observation alone. Others benefit from habit correction or orthodontic treatment.
The goal is not to treat every child early. The goal is to provide the right treatment at the right time.
Why Families Trust Smile Squad
Open bites can be caused by many different factors, which is why proper diagnosis is so important.
Treating the teeth without addressing the underlying cause often leads to frustration and relapse.
Dr. Martinez has spent more than a decade treating thousands of orthodontic patients and helping families navigate concerns related to thumb sucking, tongue posture, bite development, and growth.
In addition to private practice, Dr. Martinez serves as faculty at UNLV, where he teaches orthodontic biomechanics, ABO literature review, esthetics in orthodontics, and Phase I diagnosis and treatment planning. He also developed the Phase I orthodontic curriculum used within the UNLV orthodontic residency program.
At Smile Squad, our orthodontic and pediatric dental specialists work together to identify concerns early, understand the underlying cause of the problem, and create individualized treatment plans designed for long-term success.
Our goal is simple: provide the right treatment at the right time.
Frequently Asked Questions About Open Bites
What is an open bite?
An open bite occurs when the upper and lower front teeth do not touch when the back teeth are together.
Can thumb sucking cause an open bite?
Yes. Thumb sucking is one of the most common causes of open bites in children.
Can a pacifier cause an open bite?
Prolonged pacifier use can contribute to the development of an open bite in some children.
Will my child's open bite close on its own?
Some habit-related open bites improve after the habit stops. Open bites related to growth patterns are less likely to correct themselves.
What is tongue posture?
Tongue posture refers to where the tongue rests when a person is not speaking or swallowing. A tongue that rests between the front teeth may contribute to the development or persistence of an open bite.
What is the difference between a tongue thrust and tongue posture?
Tongue thrust refers to tongue movement during swallowing. Tongue posture refers to where the tongue rests throughout the day. Many orthodontists believe resting tongue posture has a greater influence on bite development than swallowing alone.
Do tongue cribs work?
Tongue cribs can be effective for many patients. The best appliance depends on the patient's habits, tongue posture, and treatment goals.
Why does Dr. Martinez often prefer spur appliances?
Spur appliances help encourage healthier tongue posture and long-term habit correction rather than simply acting as a barrier.
Can clear aligners fix an open bite?
Many open bites can be treated successfully with clear aligners, particularly when the case is appropriately selected.
At what age should an open bite be evaluated?
Most children should have an orthodontic evaluation by age 7, or sooner if parents notice concerns about the bite.
Concerned About an Open Bite?
If you've noticed a gap between your child's front teeth when they bite together, or if you're concerned about thumb sucking, tongue posture, or bite development, an orthodontic evaluation can help determine what's causing the problem.
Dr. Martinez and the Smile Squad team have extensive experience helping children, teens, and adults with open bites. Together, we'll identify the cause, determine the best timing for treatment, and create a personalized plan designed for long-term success.