What Is An Open Bite And What Is The Treatment For Open Bite?Dr Sanchaita Kohli
Imagine not being able to close your mouth completely. Imagine your teeth not meeting with each other while eating. This is either very difficult to imagine or very distressing to even think about.
Biting is such a basic and repetitive body activity, much like breathing, that we take it for granted and cannot imagine being unable to do so. But this is a reality for some of us and the condition is called an “open bite”.
Open bite treatment is routinely performed by orthodontists and oral and maxillofacial surgeons in Delhi. Keep reading if you want to know how open bites should be treated.
What is an Open Bite and Why Does it Happen?
An open bite is a condition where some or all of the upper and lower teeth are unable to meet with each other to create a proper bite. This results in a positive gap between the teeth. This gap makes it extremely hard, often impossible, for food to be properly chewed by the teeth.
Open bites may be seen in the front teeth, called “anterior open bite” or in the back teeth, called “posterior open bite”. They may be seen on one side of the jaw (unilateral) or on both sides (bilateral).
Open bites occur due to abnormal patterns of jaw growth, that is, when the upper and lower jaws grow vertically away from each other, instead of growing in a forward direction close together. Maxillofacial surgeons commonly treat deformed jaws and can diagnose and treat this problem.
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The reason behind this faulty jaw growth may be:
Jaw growth patterns have a strong genetic component. This can be seen when we see similar facial bony structure of certain races and ethnicities (like wider jaws in many Australian people).
Some people have a genetic tendency for greater vertical jaw growth than horizontal. These people usually develop open bites as the jaws grow with age.
To a large extent, we can manipulate the way our jaws grow ourselves. Injury, medications, breathing patterns, food habits, orthodontic appliances, all have the potential to increase or decrease the growth of jaws and even change the direction of jaw growth.
The most common acquired causes for open bite are:
- Mouth Breathing and
- Thumb Sucking
Both these activities result in the mouth remaining constantly open, either for allowing air exchange or to accommodate the thumb.
When these habits are left unchecked or untreated at a young age (when the jaws are still growing), the jaws modify their growth direction to accommodate for them. This results in a permanent open bite to be created.
Why is Treatment for Open Bite important?
We often ignore minor tooth discrepancies, not realizing their implications. It is only when they start causing some deleterious effects that we notice their importance. Similarly, treatment for open bite is important to avoid the following sequelae:
- Poor chewing efficiency:
Having gaps between upper and lower teeth will inevitably cause difficulty in biting into food and chewing it properly. This decreases the overall efficiency of chewing and is an extremely distressing condition.
- Tongue thrusting:
When upper and lower teeth meet with each other, they contain the tongue inside the mouth. Spaces between these teeth allow the tongue to be thrust out of these gaps in an attempt to close the bite and retain the food inside the mouth.
The constant thrusting of the tongue exerts a considerable amount of force on the teeth, which displaces them outward and may create spacing between the teeth. This further changes the dental relationships, creating malocclusion.
- Facial deformity:
Because open bites usually result from abnormal jaw growth, most cases of open bite are associated with some form and degree of facial deformity. In most cases:
a. The face is disproportionately longer (because of vertical jaw growth)
b. There is a constantly open mouth
c. There is spacing and forward displacement of front teeth
d. Decreased chin prominence (because the lower jaw grows vertically downward and not forward)
e. Facial asymmetry may be seen (when open bite is seen on only one side of the jaw, it is usually due to undergrowth or overgrowth of either jaw on one side)
- Lip incompetence:
When the gap between the upper and lower front teeth is considerably large, the upper and lower lips are unable to meet. This causes the mouth to remain constantly open at rest and makes it difficult to maintain an oral seal while trying to keep food in the mouth during eating.
- Temporomandibular joint (TMJ) disorders:
The jaw joint, or the TMJ, functions in harmony with the dentition. Whenever there is malocclusion and imbalance in chewing forces, joint loading is altered. This leads to repeated low grade joint injury, which can lead to structural changes in the joint tissues in the long term and cause Temporomandibular joint disorders. It may be seen as joint clicking, joint pain, headaches, ear pain and a decreased range of jaw movement. This may require temporomandibular joint surgery for correction, if left unchecked.
It is, therefore, evident that open bites are not to be neglected. Timely treatment for open bite can avoid a host of complications and ensure healthy, functional and proportionate facial tissues.
What are the Options for Open Bite Treatment?
Open bites may be limited to one or two teeth, or a set of 4-6 teeth, or may be present throughout the dental arch between almost all teeth. They may also vary in size and intensity. The treatment for open bite, therefore, depends on the severity of the condition.
- Orthodontic tooth alignment: Mild to moderate cases with small, localized open bites may be corrected by gradually extrusion (pulling out) of the involved teeth by orthodontic treatment. It can also be used to correct open bites in growing jaws by means of jaw growth modification using traction appliances.
- Surgical (Corrective Jaw Surgery):
Severe cases, especially those associated with facial deformity, require surgical repositioning of the jaws into their correct position. This is done by a procedure called corrective jaw surgery, which is performed by a skilled maxillofacial surgeon. Surgical treatment of open bites is most often performed after jaw growth is complete so that the results are stable.The upper and lower jaws are cut and moved closer together and rigidly fixed in this position with plates and screws. This jaw repositioning not only improves the facial appearance but also brings the teeth into more favorable positions, closing the bite. The height of the face is desirably reduced and the chin projection is improved. The jaws are stabilized in a position that ensures maximum and stable tooth contact. The surgery is combined with orthodontic treatment for refining the final bite.
In cases where open bite is present on only one side of the jaw, correction of facial asymmetry is also required. This may be achieved by repositioning the affected jaw by changing its angulation. In some cases, jaw lengthening on the shorter side may be required by means of distraction osteogenesis.
Many cases of open bites limited to 4-6 teeth may be corrected by a smaller surgery. This is called a segmental osteotomy. Here, only the bone around the involved teeth is cut and repositioned more favorably. This is a quick solution as it may be performed without the need for orthodontic treatment.
All these surgeries are performed from inside the mouth, leaving no scars and stitches on the face. All cuts are made with piezosurgery, ensuring maximum safety to important nerves and soft tissues. Fixation is done with sterile medical grade titanium of premium quality. These are all hallmarks of an expert maxillofacial surgeon.
Regardless of the approach, treatment of open bite requires a good amount of pre-treatment planning on models and x-rays and detailed dialogue between the patient, the orthodontist and the maxillofacial surgeon.
How do I know which Open Bite Treatment option is right for me?
With any condition or illness, the most reliable way to accurately decide a treatment option is to heed the advice of an expert in the field. Open bite correction is one of the commonly performed face surgeries in Delhi. Clinicians with experience in open bite treatment will be able to assess the severity of the condition and predict if you will benefit from surgery.
Seeking guidance from a skilled maxillofacial surgeon is crucial in evaluating the need and type of surgical correction required. Dr. Sanchaita Kohli is a highly skilled oral and maxillofacial surgeon in Delhi, with several years of valuable experience behind her. She has worked in close association with orthodontists, plastic surgeons and ENT surgeons, making her highly trained in face surgery in Delhi. Her expertise in advanced 3D surgical planning techniques and modern surgical techniques like the ultrasonic bone surgery ensures greater surgical accuracy, more patient safety and lower surgical downtime. Having planned and treated a wide variety of facial deformities with modern corrective jaw surgery, she has a vast knowledge in this field.
Consult Dr. Sanchaita Kohli, a maxillofacial surgeon in Delhi, for assessment and treatment of open bite for comprehensive and detailed treatment planning and a safe and comfortable surgical experience.
Dr. Sanchaita Kohli
Oral and Maxillofacial Surgeon
Dr. Sanchaita Kohli is an Oral and Maxillofacial Surgeon with over 13 years of training and work experience at the country’s leading dental institute, Maulana Azad Institute of Dental Sciences, enabling her to plan and manage an extremely wide variety of craniofacial deformities, jaw diseases and facial trauma.