Anterior open bite in children and adult: causes and orthodontic treatment

Anterior open bite is the condition where the front teeth of both the upper and lower jaws do not meet when the back teeth are clenched. Very common in growing children and can affect chewing, speech, swallowing and facial aesthetics.

Possible causes of open bite:

There are multiple factors that can contribute to an open bite (i.e., dental or skeletal).

Common Causes of Anterior Open Bite

1. Thumb Sucking and Pacifier Habits: Both causes of anterior open bite because they exert pressure on the anterior teeth and have the potential to alter the development of the anterior teeth.

2. Tongue Thrusting: The abnormal position of the tongue in the mouth can be the cause for the anterior teeth to be pushed forward by the tongue resulting in the lack of vertical overlap of the anterior teeth.

3. Mouth Breathing: Mouth breathing due to enlarged adenoids or airway obstructions can lead to changes in the growth and development of the face.

4. Genetics and skeletal influence: The presence of a vertical disphasic tendency and increased vertical height of the lower third of the face can also affect the development of an open bite.

5. Neuromuscular imbalance: An inadequate lipseal (due to uncoordinated muscle activity of the facial musculature) can adversely impact the overall positioning of the teeth and the growth of the jaws.

Orthodontic Treatment

There are a number of factors to consider in developing an orthodontic treatment plan for anterior open bites in children: age, severity of open bite, and the cause of the open bite.

1. Habit Interception

The elimination of thumb sucking and pacifier use is best done through the use of habit breaking appliances such as:
1.1 Palatal Crib: breaks thumb sucking habit and allows for a spontaneous improvement.

2. Myofunctional Therapy

Exercises that can help reposition the tongue, improve swallowing, and improve lip function may be a viable option in correcting myofunctional issues, and it may be helpful to work with the same speech therapists.

3. Growth Modification

In growing children, orthodontists may use:


• Headgear

• Functional Appliances to inhibit facial growth in growing children.

• Orthodontic Treatment Braces are used to align the teeth, close the bite and improve occlusion.

• Temporary anchorage devices (TADs) may assist in molar intrusion in some cases.

• Surgical Treatment / Orthodontic surgery: In non-growing patients, severe open bite of the skeleton may necessitate orthodontic surgery along with orthodontic treatment.

Conclusion

Prompt diagnosis and treatment is essential in managing the anterior open bite. Addressing unhealthy habits and directing the direction of facial growth during childhood can dramatically improve a child’s function, appearance and long-term occlusion stability.

Done by

Specialist Orthodontist

Dr. Ahlam Habib