Open, Deep, or Cross Bite: What It Is and How It’s Corrected

 

🦷Open, Deep, or Cross Bite: What It Is and How It’s Corrected

What is Malocclusion and Why Is It Important?

Malocclusion is an alteration in the alignment between the upper and lower teeth when the dental arches are in contact. In ideal conditions, the teeth fit together perfectly, allowing for effective chewing, correct speech, and a harmonious smile. When this balance is lost, it can lead to aesthetic issues, difficulties with chewing, breathing, posture, and even the general health of teeth and joints.

Among the most common malocclusions are the open bite, deep bite, and cross bite. Each of these has specific characteristics and requires a targeted orthodontic approach for an effective and stable correction.

The Main Types of Malocclusion: Open, Deep, and Cross Bite

Open Bite

An open bite occurs when, upon closing the mouth, the upper and lower front teeth do not touch, leaving a visible space between them. The most common causes are:

• Prolonged use of a pacifier or thumb-sucking in childhood
• Forward tongue thrust during swallowing (atypical swallowing)
• Genetic or skeletal factors
• Mouth breathing or airway issues

An open bite can affect the front teeth (anterior open bite) or the side teeth. It can cause difficulties with chewing, speech defects, and aesthetic problems.

Deep Bite

A deep bite, or overbite, occurs when the upper front teeth excessively overlap the lower ones vertically. The main causes include:

• Genetic or hereditary factors in the shape of the jawbones
• Excessive eruption of the front incisors
• Missing back teeth, which “collapse” the bite

A deep bite can lead to wear on the lower incisors, palate trauma, gum recession, and, in the long term, jaw pain or headaches.

Cross Bite

A cross bite happens when one or more upper teeth close “inside” the lower teeth, either in the front area (anterior cross bite) or the back. The causes are multiple:

• Growth disharmonies of the jawbones
• Early loss of baby teeth
• Bad habits (thumb-sucking, pacifier, tongue thrust)
• Genetic factors

A cross bite can compromise chewing, increase the risk of tooth wear, and create facial asymmetry if not corrected in time.

What Are the Consequences of Malocclusions?

Malocclusions are not just an aesthetic problem; if neglected, they can cause various issues:

• Difficulty with chewing and eating
• Speech problems (e.g., lisp)
• Higher risk of cavities and gingivitis due to difficulty cleaning
• Pain in the head, neck, or temporomandibular joint (TMJ)
• Abnormal tooth wear or fractures
• Reduced self-esteem and psychological problems

Acting promptly can prevent many of these effects and improve quality of life.

How to Recognize a Malocclusion?

Diagnosis is made through a thorough orthodontic visit that includes:

• Clinical analysis of the teeth, bite, and facial profile
• Digital scans and impressions for precise 3D images
• Photographs and X-rays to evaluate bone structures
• Functional tests (chewing, swallowing, speech)

The Bakaj Clinic uses advanced digital technologies to accurately evaluate each situation and set up the most suitable treatment plan.

What Are the Orthodontic Solutions for Open, Deep, and Cross Bite?

Treatment is personalized based on age, the type and severity of the malocclusion, and the patient’s goals. The main strategies are:

Functional Orthodontics

In children and adolescents, functional appliances can be used to guide bone growth and correct disharmonies early. Examples:

• Removable devices that guide the arches into the correct position
• Orthopedic appliances to correct skeletal disharmonies
• Myofunctional therapies to correct tongue thrust or atypical swallowing

Early interception reduces the need for invasive treatments in the future.

Fixed Braces (Multi-bracket)

Fixed braces with metal or aesthetic brackets are effective for treating all types of malocclusion, even the most complex ones. They offer:

• Precise control of tooth movements
• The option to choose aesthetic solutions (clear brackets)
• Correction of open, deep, or cross bites even in adulthood

Transparent Aligners (Invisalign and similar)

Aligners are an aesthetic and comfortable solution, ideal for adolescents and adults:

• Customized trays that gradually move the teeth
• Removable for eating and cleaning teeth
• Suitable for mild or moderate cases of open, deep, or cross bites

A specialist evaluation determines the most effective solution on a case-by-case basis.

Bite Splints, Plates, Elastics, and Additional Devices

To support orthodontic treatment, the following can be used:

• Bite splints or plates to reduce a deep bite
• Elastics to correct the relationship between the arches
• Retainers to maintain the results over time

In the most severe cases in adulthood, a combined approach with orthognathic surgery may be indicated.

How Long Does Treatment Last?

The duration varies based on:

• Severity and type of malocclusion
• Age and patient cooperation
• Type of appliance chosen
• Regularity of check-ups and use of aids

On average, a complete treatment lasts from 12 to 30 months. In children, an early intervention can shorten and simplify subsequent therapy, while in adults, the times can be slightly longer.

What Results Can Be Achieved?

Modern orthodontics allows for the correction of open, deep, or cross bites in a predictable and safe manner. The expected benefits are:

• A harmonious and natural smile
• Stable alignment of teeth and bones
• Improved chewing, speech, and facial aesthetics
• Easier oral hygiene and a lower risk of future problems
• The disappearance of pain and discomfort caused by malocclusion

Retention (maintenance with a retainer) is fundamental to preserving the results over time.

Prevention: How to Avoid Bite Problems

Prevention plays a key role, especially in the young. The fundamental advice is:

• Early orthodontic visits (as early as 6-7 years old)
• Stopping bad habits (thumb-sucking, pacifier) by 2-3 years of age
• Teaching children proper oral hygiene from a young age
• Acting promptly in case of early loss of baby teeth or trauma
• Performing regular check-ups to monitor bone growth and tooth replacement

Good prevention and early intervention help to reduce the complexity of future malocclusions.

Frequently Asked Questions

• Do bite problems resolve on their own? Only in rare cases do they improve spontaneously; most require orthodontic intervention for a stable result.
• Is orthodontic treatment painful? There might be a slight discomfort in the first few days or after adjustments, but it is temporary and well-managed with modern techniques.
• Do aligners work as well as fixed braces? For many mild or moderate cases, yes, but a specialist’s evaluation is essential to choose the most suitable solution.
• Is surgery always needed for severe cases? Orthognathic surgery is only used in the most severe cases and after growth is complete, in combination with orthodontics.
• How can I maintain the results? By following instructions for using the retainer and having regular check-ups, the result will be stable and long-lasting.