Open bites: easy to find but hard to fix!

I would venture to say that an open-bite is the most difficult bite to predictably correct for most orthodontists. By "predictably" I mean that it is impossible to forecast whether an open-bite correction will stay corrected after the braces are removed, EVEN IF RETAINERS ARE WORN NIGHTLY.  There certainly are bite problems that are difficult to correct in general (severe deep bites, severe crowding), more complicated than average (impacted teeth, skeletal problems requiring jaw surgery), or that require significant dental work after the orthodontics (missing teeth or severely worn teeth requiring crowns, veneers and implants).  Open-bites remain the correction with the least chance for long-term stability.

The following three examples show the before and after images of open-bite patients.

Started with tooth contacts limited to last molars only.  Still has no contact between the incisors, but has overlap of the front teeth.  This patient still has a mild "tongue-thrust."


Here we had complete closure.  I saw her today and her bite remains closed.  I'm always happy to take "credit" but this has more to due with the patient's "good luck!"

 This adult had the most extensive treatment plan of my orthodontic career.  She had surgery to BOTH jaws in order to achieve this result.  Her bite remains stabile, but I think this is probably 90% due to the skill of the surgeon (Dr. Michael Gunson in Santa Barbara, CA)!  Additionally, the patient wears her retainers religiously.