Open bite treatment with clear aligners
An open bite is when some of your upper and lower teeth do not touch when you close your mouth. Most often it is at the front, leaving a visible gap when you bite. Open bite treatment with aligners can work well for many people, and one reason is that aligners cover the back teeth too, which can help with the vertical changes an open bite needs.
What is an open bite?
There are two main types:
- Anterior open bite: the front teeth do not meet when the back teeth are together. You may not be able to bite through food with your front teeth.
- Posterior open bite: some back teeth do not meet. This is less common.
An open bite can affect chewing and speech, for example a lisp on "s" sounds, and it puts more load on the teeth that do meet.
What causes an open bite?
Understanding the cause is important, because treatment without addressing it may not last.
- Tongue thrust: pushing the tongue between the front teeth when swallowing or speaking
- Childhood habits: long-term thumb or finger sucking, or dummy use
- Mouth breathing: sometimes linked to blocked airways or allergies
- Tooth position: front teeth that have not erupted far enough, or back teeth that have erupted too far
- Jaw growth pattern: in some people the jaws themselves grow in a way that opens the bite
How open bite treatment with aligners works
The goal is to bring the front teeth together vertically. Depending on the cause, the plan may combine several movements.
Extruding the front teeth
The aligners can gradually bring the front teeth down (upper) or up (lower) so they meet. Attachments on these teeth are usually needed because the aligner needs something to grip to pull a tooth out of the gum slightly. See aligner attachments explained.
Intruding the back teeth
Because aligners cover the biting surfaces of the back teeth, they can help hold or gently intrude those teeth. When the back teeth sit slightly lower, the jaw can close a little more and the front teeth come closer together.
Tipping and space management
Sometimes front teeth that flare forwards are brought back and upright, which also helps close the gap. Space may be created with IPR or by closing existing gaps. Learn about IPR in aligner treatment.
Elastics
Some plans use vertical elastics between the upper and lower front teeth. Alignova plans can include elastic cutouts and precision hooks when your dentist prescribes them.
Dealing with habits
If tongue thrust, thumb sucking or mouth breathing caused the open bite, they can re-open it after treatment. Your dentist may recommend:
- Tongue and swallowing exercises, sometimes with a speech or myofunctional therapist
- Seeing an ENT specialist if mouth breathing is linked to a blocked nose
- Strategies to stop finger or thumb habits
The aligners themselves also cover the teeth, which can make some people more aware of their tongue position.
When aligners may not be suitable
A large skeletal open bite, caused by the way the jaws have grown, may need a different approach. In adults this may mean braces combined with jaw surgery, planned with a specialist. In children, early treatment may focus on habits and growth. Your dentist will assess this with an examination and usually X-rays before recommending anything.
Why aligners can suit open bites
With fixed braces, the back teeth are free to erupt further during treatment, which can sometimes work against closing an open bite. Clear aligners cover the biting surfaces of all the teeth in the arch, so they act a little like a thin bite block. This is one reason many dentists consider aligners a useful option for suitable open bite cases. It does not make them right for every case, and the final decision rests with your dentist after an examination.
What planning looks like at Alignova
Your dentist sends a scan or impressions with their treatment goals. Our lab prepares an orthodontist-reviewed 3D setup with each stage, attachment and IPR planned. Your dentist reviews the plan, asks for changes and approves it before anything is made. The aligners are then printed, thermoformed, trimmed, checked and sent to the clinic in sequence. See how it works.
During treatment
Wear each aligner about 20 to 22 hours a day and make sure it seats fully, especially over the front teeth where extrusion attachments sit. If an aligner is not fitting snugly at the front edges, tell your dentist. In Alignova cases, the patient app asks for three photos at each aligner change, which helps your dentist spot fit problems early. AI-assisted photo review is in development and not live yet. Read about aligner monitoring.
Keeping the result
Open bites are known for their tendency to relapse, especially if habits continue. Wearing retainers as advised and keeping up any tongue exercises are important. See retainers after aligners.
Frequently asked questions
Can clear aligners close an open bite?
Many open bites caused by tooth position can be treated with aligners. Large skeletal open bites may need a different or combined approach.
Will my lisp go away after treatment?
Closing an open bite can help with some speech sounds, but it is not guaranteed. Speech therapy may also help if the lisp is linked to tongue habits.
Why is tongue thrust important?
The tongue pushing between the front teeth can keep a bite open. Addressing it improves the chance that the result lasts.
Can an open bite come back?
Yes, especially if habits continue. Retainers and habit control help keep it closed.
Clear aligners are a prescription treatment. Whether they suit you is decided by a licensed dentist or orthodontist after an examination.
Take the free smile check and a partner dentist will contact you about an assessment.