Open bite

By open bite we mean an incorrect dental match in the vertical sense, essentially the presence of a gap between the two dental arches.

Question: I notice that my five and a half year old son has problems with swallowing and chewing when he eats.
Could it be due to the “open bite”? What is it about? What should I do?

Answer: By open bite we mean an incorrect dental match in the vertical direction, essentially the presence of a gap (opening) between the two dental arches with a dental contact only in the posterior sectors. The open bite can be anterior or lateral and, according to the characteristics that determine it, is classified in basal or dentoalveolar.

It can certainly cause problems with chewing, swallowing and speaking efficiency. Therefore, a visit to the orthodontist is advisable, so that the same can request the radiographic examinations necessary to undertake a treatment plan, aimed at correcting the problem.

The open bite can be anterior or lateral. An anterior open bite is present when the upper incisors do not vertically cover the lower incisors.

Lateral or posterior open bite is typically caused by atypical swallowing or by changes in tooth eruption during commuting.

The skeletal open bite is distinguished by prevalent vertical growth of the face (dolicofacial subject with long and narrow face) which is expressed in a hyperdivergence of the maxillary and mandibular bases and the dental open bite for oral dysfunctions such as sucking, atypical swallowing, sigmatism or for a constriction of the dental arches and subsequent crowding of the teeth.

The orthodontic therapy of the skeletal anterior open bite is very complicated and time-consuming, due to the divergence of the bone bases.

It is also possible to close the bite with fixed equipment, with extractions or with temporary skeletal anchoring means (miniscrews), even if it is not possible to correct the skeletal malocclusion in full (“dental camufflage”).

Patients with a severe skeletal open bite require a combined orthodontic-surgical approach. In these cases, the orthodontist first straightens the teeth and levels the dental arches using fixed equipment to allow the maxillofacial surgeon to reposition the jaws.

In this type of malocclusion it is useful to consult an otolaryngologist to check breathing and a speech therapist to obtain a good muscular balance between lips, tongue and cheeks. In this way orthodontic correction with mobile or fixed appliances will be faster, safer and more stable over time.

Reference:

https://www.ajodo.org/article/S0889-5406(19)30515-3/fulltext