Open bite: causes and treatment

Page updated October 14, 2026. Medically reviewed by Dr. Abraham Thomas and Dr. Jennifer Loucks-Buren.

An open bite is when your upper and lower teeth don't touch when your mouth is closed. In an anterior open bite the front teeth don't meet; in a posterior open bite the back teeth don't. It's treated by stopping habits like thumb sucking or tongue thrusting, with braces or aligners, and in severe adult cases with jaw surgery.

What an open bite is

An open bite is a malocclusion in which the upper and lower teeth don't touch each other when the mouth is closed (AAO). Cleveland Clinic describes it as upper and lower front teeth that don't touch when you close your mouth (Cleveland Clinic). When most people say "open bite" they mean an anterior open bite, where the front teeth slant outward and don't meet (Healthline).

Anterior vs posterior open bite

What causes an open bite

Healthline names four main causes (Healthline):

• Thumb or pacifier sucking, or sucking on objects like pencils, which strains the alignment of the teeth.
• Tongue thrusting: pushing the tongue between the front teeth when speaking or swallowing, which can also create gaps.
• TMJ disorders: some people with chronic jaw pain use the tongue to push the teeth apart to rest the jaw.
• Skeletal problems: jaws that grow apart rather than parallel, often influenced by genetics.

The AAO adds mouth breathing during early dental development (AAO), and notes that bite problems often run in families, with prolonged bottle or pacifier use and cleft lip or palate also playing a part (AAO).

Problems an open bite can cause

• Speech: many people with an open bite develop a lisp (Healthline).
• Eating: difficulty biting and chewing, and swallowing problems (AAO).
• Wear and fractures: with an anterior open bite, the back teeth take the whole load, putting them at higher risk of gum problems, loosening and fractures (AAO) (Healthline).
• Appearance: front teeth that look like they stick out (Healthline).

How an open bite is diagnosed

Dentists can spot bite problems at regular check-ups, using impressions, X-rays and photos of how the teeth meet, and may refer you to an orthodontist (Cleveland Clinic). You can also go straight to an orthodontist without a referral (AAO). The key question is whether the open bite comes from a habit or from how the jaws have grown, because a skeletal open bite needs different treatment (Healthline).

Open bite vs other bite problems

Open bite treatment

Treatment depends on age and whether adult or baby teeth are present. Options include behavior changes, braces or aligners, and surgery (Healthline):

Other tools include a roller appliance that stops the tongue thrusting against the front teeth, and headgear that guides jaw growth (Healthline); see orthodontic headgear. Vertical elastics, from the upper teeth to the teeth directly below, are used to close open bites during braces treatment (Healthline). The AAO says adults can treat an open bite with braces or clear aligners (AAO).

Open bite in children

An open bite is much easier to treat before the adult teeth have fully come in (Healthline). Healthline suggests a dental evaluation at about age 7, while some baby teeth remain, which is a good time to start behavior changes (Healthline); the AAO also recommends an orthodontic check by age 7 (AAO). Bite problems are best treated while a child is still growing, and you don't need a dentist's referral (AAO).

Helping a child stop thumb sucking or pacifier use is part of prevention; Cleveland Clinic suggests discouraging both past age 4 to reduce the risk of bite problems (Cleveland Clinic).

Open bite in adults

An open bite can be treated at any age, but in adults it's more complicated and may need a combination of behavior changes and braces, or jaw surgery (Healthline). Adults can treat it with braces or clear aligners for better function, oral health and appearance (AAO). See adult braces and jaw surgery cost.

Can Invisalign fix an open bite?

Possibly. The AAO says adults can treat an open bite with braces or clear aligners (AAO), and Healthline notes that Invisalign's own website lists open bite among the problems it treats (Healthline). Aligners may be less predictable for severe malocclusions (AAO), and a skeletal open bite may need surgery (Healthline). Ask your orthodontist whether your case suits aligners; see how Invisalign works.

Tongue thrust and habits

Because habits cause many open bites, stopping the habit is part of treatment. For a child whose adult teeth are coming in, Healthline says behavior modification, which may include therapy to correct tongue thrusting, might be the best approach (Healthline). Without changing the habit, the tongue can keep pushing the teeth apart. Ask your orthodontist whether therapy or an appliance to discourage thrusting is part of the plan (Healthline).

Questions to ask your orthodontist

• Is my open bite anterior or posterior, and is it from a habit, the jaws, or both?
• Do I need habit therapy as well as braces?
• Will I need surgery, and when (Cleveland Clinic)?
• How long will treatment take (Cleveland Clinic)?
• How will we keep the bite closed afterward?

How much open bite treatment costs

We haven't found a published price specific to open bite treatment. Cost follows the treatment you need: metal braces cost $3,000 to $7,000 and clear aligners $4,000 to $7,000 in CareCredit data published in 2022 (CareCredit), and complex bite problems tend to take longer, which raises the price. Jaw surgery is a separate, much larger cost; see jaw surgery cost. Try the braces cost calculator with "complex" selected for a rough estimate.