If your child bites their back teeth together but their front teeth still don’t touch, they may have what orthodontists call an open bite.
An open bite occurs when there is a vertical gap between the upper and lower teeth when the bite is closed. In children, it is often most noticeable in the front of the mouth, although open bites can occur in other areas as well.
Sometimes an open bite is related to a habit, such as thumb sucking or prolonged pacifier use. In other cases, tongue position, tooth eruption, or the way the jaws are developing may play a role.
The important thing is to understand why the bite is open before deciding whether treatment is needed.
What Is an Open Bite?
In a typical bite, the upper front teeth overlap the lower front teeth slightly when the back teeth come together.
With an anterior open bite, the back teeth may fit together normally while a space remains between the upper and lower front teeth.
Some open bites are easy for parents to notice. You may see a visible gap when your child smiles or bites down. Others are more subtle and may only become apparent during a dental or orthodontic examination.
An open bite is a type of malocclusion, which simply means that the upper and lower teeth do not fit together as they normally should.
Why Would a Child Develop an Open Bite?
There is no single cause of an open bite. Several factors can contribute to its development.
One of the most familiar causes is a sucking habit that continues beyond the toddler years. Thumb sucking, finger sucking, and prolonged pacifier use can place repeated pressure on the front teeth and the surrounding bone.
According to the American Association of Orthodontists (AAO), sucking habits that continue beyond about age 4 can contribute to changes in tooth position, the supporting bone, and the development of an open bite.
Tongue position can also play a role. If a child regularly pushes their tongue forward against or between the front teeth when swallowing, that repeated pressure may contribute to an open bite. The AAO describes tongue thrust as a swallowing pattern that can affect the position of the teeth and supporting structures over time.
Other children may develop an open bite because of the way their teeth erupt or the way their upper and lower jaws grow.
That is why two children who appear to have similar gaps between their front teeth may have very different causes — and may need very different treatment approaches.
Can Thumb Sucking or Pacifier Use Cause an Open Bite?
Yes. A thumb, finger, or pacifier positioned between the upper and lower front teeth can interfere with the normal eruption of those teeth and may place pressure on the upper front teeth.
The effect can depend on how often the habit occurs, how forceful it is, and how long it continues. A child who occasionally sucks a thumb while falling asleep is different from a child who keeps a thumb or finger in their mouth for hours each day.
If the habit stops early enough, some bite changes may improve naturally as the child grows and the permanent teeth erupt. If the habit continues or the open bite becomes more established, orthodontic treatment may eventually be recommended.
What Does Tongue Position Have to Do With an Open Bite?
The tongue normally rests inside the mouth and moves in a coordinated way during swallowing. With a tongue thrust, the tongue may press forward against or between the front teeth.
Over time, repeated pressure can affect tooth position.
Parents may notice the tongue appearing between the teeth when their child swallows or speaks. Some children may also have difficulty producing certain speech sounds or tend to breathe through their mouth. Tongue thrust can be associated with speech concerns, mouth breathing, and open bite.
However, the tongue is not necessarily the original cause of an open bite. Sometimes the tongue simply moves into a space that already exists between the teeth.
During an orthodontic evaluation, we look at whether tongue posture is contributing to the open bite or whether the tongue is adapting to a space created by the existing bite.
Can an Open Bite Affect Eating or Speech?
It can.
Children with a larger open bite may have difficulty biting through foods with their front teeth. They may compensate by moving food farther back in the mouth or relying more heavily on their side teeth.
Certain bite problems can also be associated with speech differences, particularly sounds that require coordination between the tongue and front teeth.
That said, not every child with an open bite will have noticeable functional problems. The size of the opening, its underlying cause, the child’s age, and how the rest of the bite fits together all matter.
Will My Child Grow Out of an Open Bite?
Sometimes — but not always.
If an open bite is primarily related to a sucking habit and the habit stops while the child is still young, the bite may improve naturally as the teeth continue to erupt and the jaws develop.
An open bite that is more strongly related to jaw growth, tooth position, or persistent tongue forces may be less likely to correct on its own.
This is one reason timing matters.
The American Association of Orthodontists recommends that children have an orthodontic evaluation by age 7. At this age, an orthodontist can often evaluate the developing permanent teeth and jaw relationship and determine whether a bite problem needs treatment or simply monitoring.
An early evaluation does not automatically mean early braces. In many cases, the recommendation may simply be to monitor the bite as your child grows.
Does Every Child With an Open Bite Need Orthodontic Treatment?
No.
The first question is why the open bite is present.
If a child is young and the bite appears closely related to a habit that has recently stopped, monitoring may be appropriate. If the bite is affecting function, becoming more pronounced, or appears to be related to jaw growth, treatment may be recommended.
We also consider whether the permanent teeth are erupting normally, whether other bite problems are present, and whether your child’s stage of growth provides an opportunity to guide development.
Orthodontic treatment should be based on a comprehensive diagnosis rather than simply the presence of a visible gap. The AAO emphasizes evaluating malocclusion in the context of function, development, and the individual patient’s needs.
How Is an Open Bite Treated in Children?
Treatment depends on the cause of the open bite and your child’s stage of dental and jaw development.
For some children, the first step is addressing a thumb or finger-sucking habit. In other cases, an orthodontic appliance may be used to help discourage a persistent habit or address unwanted tongue pressure.
If tooth position is the primary concern, braces or other orthodontic appliances may be used to move the teeth into a healthier relationship.
When jaw growth contributes to the open bite, treatment planning can be more complex. Your child’s growth pattern, bite, and severity of the open bite all influence which approach may be appropriate.
There is no single appliance or treatment that is right for every child with an open bite.
What We Look for During an Orthodontic Evaluation
When we evaluate a child whose front teeth do not touch, we look at much more than the space between the teeth.
We may consider:
- How large the open bite is
- Which teeth are involved
- Whether the back teeth fit together normally
- Thumb, finger, or pacifier habits
- Tongue posture and swallowing pattern
- Speech concerns
- Mouth breathing
- How the permanent teeth are erupting
- Upper and lower jaw growth
- Other bite problems, such as crowding or crossbite
- Your child’s age and stage of growth
These details help us determine whether the bite may improve naturally, should be monitored, or would benefit from orthodontic treatment.
When Should I Have My Child’s Open Bite Checked?
You do not need to wait until all of your child’s permanent teeth have erupted.
If you notice that your child’s front teeth remain apart when the back teeth are fully together, mention it at their next dental visit or schedule an orthodontic evaluation.
An earlier evaluation can be particularly helpful if your child:
- Still has a thumb or finger-sucking habit
- Has difficulty biting into food
- Has a noticeable tongue thrust
- Has speech concerns
- Has other developing bite problems
At Tebo Orthodontics, we evaluate how the teeth, bite, and jaws are developing before recommending treatment. Some children may benefit from early orthodontic care, while others may simply need to be monitored as they grow.
If your child’s front teeth do not touch when they bite down, an orthodontic evaluation can help determine what is causing the open bite, whether it may improve with growth, and whether treatment is appropriate now or later.
