How to Fix an Open Bite Without Invasive Jaw Surgery

An open bite — where the front teeth don't meet when you close your mouth — can affect chewing, speech, and confidence. Many patients assume that jaw surgery is the only solution, but that isn't always the case. Depending on the cause, severity, and your individual anatomy, non-surgical approaches such as clear aligners, elastics, and habit correction may be able to close an open bite effectively. This guide explains your options, what clear aligners can and can't do, and how to take the next step.

Who This Guide Is For

This article is written for UK patients who have an open bite (or suspect they might) and want to understand their treatment options — particularly whether surgery can be avoided. It may be relevant if you:

• Have been told you have an open bite and want to understand what that means
• Are researching open bite correction options before booking an assessment
• Want to know whether clear aligners or invisible braces can help with your bite
• Are anxious about the prospect of jaw surgery and want to explore alternatives
• Had orthodontic treatment previously but your open bite has returned

Important: If your open bite is causing significant difficulty eating, breathing through your nose, or speaking clearly, it's especially important to seek a professional assessment promptly. This guide provides general information — not a diagnosis or personal recommendation.

Key Definitions in Plain English

What Is an Open Bite?

An open bite is a type of malocclusion (bite problem) where certain teeth don't make contact when the jaw is fully closed. The most common type is an anterior open bite, where the front teeth don't meet — leaving a visible gap even when the back teeth are biting together. Less commonly, a posterior open bite affects the back teeth.

Open bites range from mild (a small gap of 1–2mm) to severe (gaps of 5mm or more, sometimes with a skeletal component involving the jaw bones themselves).

Dental vs. Skeletal Open Bite

This is a critical distinction that affects which treatments are suitable:

• Dental open bite: The jaw bones are in a relatively normal position, but the teeth themselves have erupted incorrectly or been pushed out of alignment — often by habits like thumb-sucking or tongue thrusting. These cases are often more amenable to non-surgical correction.
• Skeletal open bite: The jaw bones themselves have grown in a way that creates the open bite (for example, excessive vertical growth of the back of the upper jaw). These cases may require surgical intervention, particularly in adults whose jaw growth is complete.

Many open bites have both dental and skeletal components. The proportion of each determines which treatment approaches are realistic.

Other Terms You May Encounter

• Attachments: Small tooth-coloured bumps bonded to specific teeth during aligner treatment. They help the trays grip teeth and achieve more complex movements like intrusion (pushing teeth up into the gum).
• Bite ramps: Built-in features on the inside of aligner trays that help guide the bite into a better position. They can be particularly useful in open bite correction.
• IPR (Interproximal Reduction): Carefully removing tiny amounts of enamel between teeth to create space for alignment. This is common in both aligner and fixed-brace treatments.
• Refinements: Additional sets of aligner trays produced after the initial series, based on a new 3D scan, to fine-tune the result. Most cases need at least one round of refinements.
• Elastics (rubber bands): Small bands worn between upper and lower attachments or hooks to apply inter-arch forces — commonly used to help close an open bite with aligners.
• Retainers: Custom-made devices worn after treatment to hold teeth in their new positions. Retention is especially important after open bite correction, as these cases have a higher tendency to relapse.
• Tracking: How well teeth are following the planned movement sequence. Poor tracking means adjustments or refinements may be needed.
• 3D scan: A digital impression of your teeth using an intraoral scanner, replacing traditional putty moulds.

What Causes an Open Bite?

Understanding the cause helps determine which treatment approach is most appropriate. Open bites can develop from a combination of factors:

Habit-Related Causes (Dental)

• Tongue thrusting: A habitual pattern where the tongue pushes forward against or between the front teeth during swallowing or at rest. Over time, this sustained pressure can push the front teeth apart, creating or maintaining an open bite.
• Thumb or finger sucking: Prolonged digit-sucking beyond early childhood can tip the upper front teeth forward and prevent them from erupting fully, leading to an open bite.
• Mouth breathing: Chronic mouth breathing (often due to nasal obstruction or enlarged adenoids) can alter facial growth patterns and contribute to an open bite developing during childhood.
• Pacifier use: Extended use beyond the age of 3–4 may contribute to dental open bites in some children.

Skeletal and Genetic Causes

• Excessive vertical jaw growth: Some individuals have a growth pattern where the back of the upper jaw grows downward more than usual, causing the front teeth to separate.
• Jaw size discrepancy: Differences in upper and lower jaw size or position can create an open bite as part of a broader skeletal pattern.
• Genetics: Facial growth patterns are partly inherited, meaning open bites can run in families.

Other Contributing Factors

• Temporomandibular joint (TMJ) issues: In some cases, changes in the jaw joint can alter the bite over time.
• Tooth loss: Missing teeth (particularly back teeth) can allow remaining teeth to over-erupt, altering the bite.
• Previous orthodontic relapse: An open bite that was corrected but returned — often because retainers weren't worn consistently or because the underlying habit wasn't addressed.

What Clear Aligners Can Do (and What They Can't)

Clear aligner technology has advanced significantly and can now address many open bite cases that would previously have required fixed braces. However, they still have important limitations.

What Aligners Can Typically Address

• Mild to moderate dental open bites — where the gap is caused primarily by tooth position rather than jaw structure
• Intrusion of over-erupted teeth — aligners can be effective at pushing back teeth upward (intruding them), which helps close the bite
• Anterior open bites up to approximately 3–5mm — depending on the case specifics and whether the cause is dental
• Open bites with concurrent crowding or spacing — aligners can address multiple issues simultaneously
• Cases where habits have been resolved — if the tongue thrust or digit-sucking has stopped, aligners can correct the resulting dental misalignment

What Aligners May Struggle With

• Severe skeletal open bites — where the jaw bones themselves are the primary issue, aligners alone are unlikely to achieve a stable correction
• Large open bites (6mm+) — these typically require fixed braces, possibly with temporary anchorage devices (TADs), or surgical correction
• Active tongue thrust — if the habit that caused the open bite is ongoing, any orthodontic correction (whether aligners or braces) may relapse unless the habit is addressed
• Cases requiring significant molar intrusion — while aligners can intrude teeth, very large vertical movements may exceed their predictable range
• Growing patients with skeletal contributions — children and adolescents with skeletal open bites may need growth modification appliances before or instead of aligners

Non-Surgical Pathways: How Open Bites Can Be Corrected Without Surgery

For open bites that are primarily dental in origin, or have only a mild skeletal component, several non-surgical approaches may be effective — either alone or in combination.

Clear Aligners with Elastics

This is one of the most common non-surgical approaches for adult open bite correction. The aligners move teeth into better positions while inter-arch elastics (small rubber bands hooked between the upper and lower trays) apply vertical forces to help close the bite. Attachments and bite ramps built into the trays provide additional control.

Key requirements for this approach:

• Wear time of approximately 22 hours per day — this is especially critical for open bite cases, where compliance directly affects whether the bite closes
• Consistent elastic wear as prescribed — elastics only work when they're being worn
• Regular monitoring appointments to check tracking and adjust the plan if needed
• Willingness to undergo refinement rounds — open bite cases often need more refinements than straightforward crowding cases

Fixed Braces (Non-Surgical)

Traditional fixed braces — or a combination of braces and aligners — may be recommended for more complex open bites that are still within the non-surgical range. Fixed braces offer continuous force application and can incorporate features like:

• Posterior intrusion mechanics to push back teeth upward
• Temporary anchorage devices (TADs or mini-screws) for additional vertical control
• Inter-arch elastics for bite closure

Habit Correction

If a tongue thrust or other habit is contributing to the open bite, addressing the habit is essential — regardless of which orthodontic system is used. Without habit correction, there's a significant risk of the open bite returning after treatment. Options include:

• Myofunctional therapy: Exercises designed to retrain the tongue's resting position and swallowing pattern. This is sometimes done with a speech therapist or myofunctional therapist.
• Tongue cribs or spurs: Appliances (fixed or removable) that discourage the tongue from pushing forward between the teeth.
• Behavioural strategies: For children with thumb-sucking habits, positive reinforcement and habit-breaking techniques may be recommended before orthodontic treatment begins.

In many cases, the most effective approach combines orthodontic treatment with habit correction simultaneously or sequentially.

When Jaw Surgery Is Discussed

It's important to mention jaw surgery (orthognathic surgery) honestly and without creating unnecessary fear. Surgery is not needed for every open bite — but it is the most predictable and stable option for certain cases.

Surgery May Be Considered When:

• The open bite is primarily skeletal — caused by how the jaw bones have grown, not just tooth position
• The open bite is severe (typically 6mm+ with a clear skeletal pattern)
• Non-surgical treatment has been attempted and relapsed
• There are functional issues beyond the bite — such as difficulty breathing, significant facial asymmetry, or jaw joint problems
• The patient is an adult with complete jaw growth (surgery is not performed on growing patients)

What Surgery Involves

Orthognathic surgery is carried out under general anaesthetic, typically in a hospital setting. The surgeon repositions one or both jaws and fixes them with plates and screws. Recovery usually takes several weeks, and orthodontic treatment (braces or aligners) is needed before and after surgery to align the teeth to the new jaw position.

Surgery is a well-established treatment with good outcomes for appropriate cases. If your clinician discusses it as an option, it doesn't mean other approaches have failed — it may simply be the most predictable route to a stable, functional result for your specific anatomy.

Many patients who are initially anxious about the idea of surgery find it helpful to have a full assessment first, so they can understand whether it's necessary before worrying about the details.

Step by Step: How Clear Aligner Treatment for Open Bite Typically Works

Suitability Checklist: Could Non-Surgical Open Bite Correction Work for You?

This checklist is a rough guide only — a clinical assessment is the only reliable way to determine suitability.

When to Seek Advice

If you notice any of the following, it may be worth having a conversation with a dental professional — not necessarily for immediate treatment, but for an assessment of what's happening:

• A visible gap between your upper and lower front teeth when you bite down
• Difficulty biting into food with your front teeth (needing to tear food with your side teeth instead)
• A lisp or speech difficulties that may be related to how your teeth meet
• Awareness that you habitually push your tongue between your front teeth when swallowing
• An open bite that seems to be getting worse over time
• A previously corrected open bite that has returned

None of these are emergencies, but they are valid reasons to seek a professional opinion. Early assessment means more options and often simpler treatment.

Risks, Side Effects, and Limitations

Open bite correction — whether surgical or non-surgical — carries specific considerations that you should understand before starting treatment.

Risks Common to All Orthodontic Open Bite Treatment

• Relapse: Open bites have a higher relapse rate than other orthodontic issues. Diligent retainer wear is essential, and addressing any underlying habits (like tongue thrusting) significantly reduces relapse risk.
• Root resorption: A small degree of root shortening can occur with any orthodontic treatment. Intrusion movements (commonly used in open bite correction) may carry a slightly higher risk, though this is usually clinically insignificant.
• Treatment may take longer than expected: Open bites are among the more complex movements for aligners. Multiple refinement rounds are common, and total treatment time can exceed initial estimates.
• The bite may not close completely: In some cases, particularly those with a skeletal component, non-surgical treatment may improve but not fully resolve the open bite. Your clinician should discuss realistic expectations before treatment begins.

Risks Specific to Aligner Treatment for Open Bite

• Compliance-dependent: Aligners require disciplined wear. For open bite cases especially, falling below 22 hours per day — or not wearing elastics consistently — can mean the bite doesn't close as planned.
• Attachment visibility: Open bite cases often need more attachments than simpler cases, which may be slightly visible on the teeth. These are removed at the end of treatment.
• Not all movements may be achievable: If the planned intrusion or bite closure doesn't fully track, the result may fall short of the simulation. Refinements can address this, but there are limits to what aligners can predictably achieve.

Risks Specific to Surgical Open Bite Correction

• General anaesthetic risks (standard surgical risks)
• Temporary numbness in the lips, chin, or cheeks (nerve-related, usually resolves but can occasionally be prolonged)
• Recovery time of several weeks, with dietary restrictions
• Need for pre-surgical and post-surgical orthodontics (braces or aligners)
• In rare cases, relapse can still occur even after surgical correction

How Long Treatment May Take

Open bite correction is generally more complex and time-consuming than straightforward alignment cases. The following ranges are approximate — your clinician will give you a more specific estimate based on your assessment.

What Affects Treatment Time?

• Severity of the open bite: Larger gaps and more complex skeletal involvement take longer
• Compliance: Consistent 22-hour wear time and elastic use are critical — poor compliance can add months to treatment
• Habit resolution: If a tongue thrust is still active, treatment may stall or the bite may reopen during treatment
• Refinement rounds: Open bite cases commonly need 1–3 rounds of refinements, each adding approximately 2–5 months
• Biology: Individual variation in how quickly bone remodels and teeth respond to force
• Age: Tooth movement may be slightly slower in older adults, though treatment is still effective

Costs in the UK: What Drives Price

The figures below are approximate UK ranges and are not quotations. Actual costs depend on the provider, complexity, and what's included in the fee.

What Drives the Price?

• Case complexity: Open bites typically fall into the moderate-to-complex category, which costs more than simple alignment cases
• Refinement rounds: More refinements mean more trays and more appointments — check whether these are included in the quoted fee
• What's included: Always clarify whether the price covers refinements, retainers, monitoring appointments, and any emergency visits
• Provider and location: Costs vary across the UK, with London typically at the higher end
• Additional treatment: If myofunctional therapy or habit correction appliances are needed, these may be separate costs

For a broader look at what affects aligner pricing, see our guide on invisible braces costs in London.

How to Keep Results: Retention and Aftercare

Retention after open bite correction is arguably more important than for any other type of orthodontic treatment. Open bites have a well-documented tendency to relapse, particularly if the underlying cause (such as a tongue thrust) hasn't been fully addressed.

Retention Strategy

• Fixed retainers: A thin bonded wire behind the upper and/or lower front teeth provides passive retention without requiring patient compliance. These are commonly recommended for open bite cases.
• Removable retainers: Clear retainer trays worn every night, long-term. Your clinician will advise on how long to continue — for open bite cases, indefinite nightly wear is often recommended.
• Combination approach: Many clinicians recommend both fixed and removable retainers for open bite patients, as double protection against relapse.

Aftercare Tips

• Wear your retainers exactly as prescribed — this is especially critical after open bite correction
• If you still have a tongue-thrusting habit, continue any myofunctional exercises your therapist has recommended
• Attend all follow-up appointments — your clinician will monitor the bite stability over time
• If a retainer breaks or detaches, contact your provider immediately — even a few weeks without retention can allow relapse in open bite cases
• Maintain good oral hygiene with regular brushing, flossing, and routine dental check-ups
• Be aware that some degree of settling is normal in the first few weeks after active treatment, but the bite should remain stable

Frequently Asked Questions

Can an open bite be fixed without surgery?

In many cases, yes — particularly if the open bite is dental in origin (caused by tooth position rather than jaw structure). Clear aligners with elastics, fixed braces, or a combination approach can often close mild to moderate dental open bites. However, severe skeletal open bites may require surgical correction for a stable result. A clinical assessment is needed to determine which approach is appropriate for your case.

What causes an open bite in adults?

Common causes include tongue thrusting (a habitual pattern where the tongue pushes against the front teeth), skeletal growth patterns, previous orthodontic relapse, tooth loss, and in some cases TMJ changes. Often, multiple factors contribute. Understanding the cause helps determine the most effective treatment and reduces relapse risk.

Can clear aligners close an open bite?

Clear aligners can close many mild to moderate dental open bites, typically using a combination of tooth intrusion, attachments, bite ramps, and inter-arch elastics. They are particularly effective when the open bite is caused by over-erupted back teeth or tooth position issues. Severe or skeletal open bites may be beyond what aligners can predictably achieve.

How long does open bite correction take with aligners?

Treatment time varies considerably. A mild dental open bite might take 6–12 months including refinements, while a moderate case could take 12–20 months or longer. Open bite cases typically require more refinement rounds than simpler alignment work, so it's important to plan for potential extensions to the initial estimate.

Will my open bite come back after treatment?

Open bites do have a higher relapse tendency than other orthodontic issues. The risk is significantly reduced by consistent retainer wear, addressing any underlying habits (particularly tongue thrusting), and choosing a treatment approach appropriate to the severity of the case. Your clinician will design a retention plan tailored to your risk profile.

What is tongue thrust and how does it affect treatment?

Tongue thrust is a swallowing or resting pattern where the tongue pushes forward against or between the front teeth. This sustained pressure can create or maintain an open bite, and if it isn't addressed, it can cause the open bite to return after orthodontic treatment. Myofunctional therapy (tongue retraining exercises) is often recommended alongside orthodontic correction.

Is open bite correction more expensive than regular braces or aligners?

Generally, yes. Open bite cases are more complex, typically require more appointment time, more aligner trays, more refinements, and sometimes additional appliances (like elastics or TADs). This means the treatment fee is usually higher than for straightforward crowding or spacing cases. Costs vary by provider and complexity.

Do I need elastics with aligners for an open bite?

In most open bite cases treated with aligners, yes. Elastics (small rubber bands) apply vertical forces between the upper and lower arches that help close the bite. They need to be worn consistently as directed — typically all the time except when eating. Your clinician will show you how to attach them to hooks or buttons on your aligners or teeth.

Can children's open bites be treated without surgery?

Many childhood open bites can be addressed non-surgically, especially when caught early. Habit-breaking appliances, growth modification devices, and early orthodontic intervention can guide jaw growth and tooth eruption. Children still growing have more options available than adults. A paediatric dental or orthodontic assessment can identify the most appropriate timing and approach.

What happens if I don't treat my open bite?

An untreated open bite can make biting into food difficult, may affect speech clarity, and can place excessive force on the back teeth (which are doing all the biting work). Over time, this increased load on back teeth may contribute to wear, fractures, or TMJ discomfort in some patients. However, not all open bites cause symptoms, and the decision to treat should be discussed with a dental professional based on your specific situation.

How do I know if my open bite is dental or skeletal?

This can only be reliably determined through a clinical assessment that includes X-rays (particularly a lateral cephalogram, which shows the relationship between the jaw bones, teeth, and skull). Your clinician uses these images along with a clinical examination to determine whether the open bite is caused by tooth position, jaw structure, or a combination of both — and which treatments are realistic.

Can I get open bite treatment on the NHS?

NHS orthodontic treatment is available for cases that meet specific clinical criteria (assessed using the IOTN — Index of Orthodontic Treatment Need). Severe open bites that significantly affect function may qualify. However, many mild to moderate open bites and most purely cosmetic concerns do not meet the NHS threshold and would need to be treated privately. Your dentist can advise whether an NHS referral is appropriate.

Disclaimer: This article is for general information only and does not constitute dental or medical advice. Treatment needs, timelines, and costs vary by individual case. All cost figures are approximate UK ranges for reference and are not quotations. Open bite correction outcomes depend on case severity, biological response, compliance, and whether underlying habits are addressed. Treatment suitability can only be determined through an in-person clinical assessment by a GDC-registered dental professional.