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Anterior open bite

A very common condition we commonly treat, anterior open bite is highly correctable with outcomes that allow the front teeth to meet and function properly.

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What Is Anterior Open Bite

Understanding Anterior Open Bite

Anterior open bite is a condition where the upper and lower front teeth do not touch when the mouth is closed, leaving a visible gap. This can affect chewing, speech, and overall bite function, and may also influence facial balance. Management may include orthodontics, jaw surgery, or a combination of both depending on the cause.

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Clinical Presentation

Side View

Profile Analysis

From the side, anterior open bite is associated with increased vertical proportions and downward rotation of the lower jaw.

Key Assessments:

Increased lower facial height
Mandibular downward rotation
Open bite profile
Lip strain on closure
Frontal View

Frontal Analysis

Anterior open bite is characterized by lack of vertical overlap between the front teeth, often accompanied by increased lower facial height and lip separation.

Key Assessments:

Separation of front teeth
Increased lower facial height
Lip incompetence at rest
Vertical facial imbalance
Bite View

Occlusal Relationship

Anterior open bite presents with lack of contact between the upper and lower front teeth, often associated with vertical skeletal or dental discrepancies.

Key Assessments:

Anterior open bite
Lack of incisal contact
Posterior contact dominance
Vertical occlusal discrepancy

Anterior Open Bite

Common Functional Issues

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Eating

Lack of contact between the front teeth makes biting into foods difficult, shifting function to the back teeth.

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Speech

Speech may be affected for sounds that require tongue–incisor contact, such as “s” and “z,” resulting in a lisp.

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TMJ

Altered bite relationships can place abnormal forces on the joints, especially if compensatory movements are present.

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Mouth Breathing

Often associated with tongue posture or habits that promote mouth breathing and affect bite development.

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Nasal Congestion

Nasal airway patterns may be altered, especially if habits or skeletal factors contribute to the open bite.

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Psychosocial Effects

Visible spacing between the front teeth can impact smile aesthetics and social confidence.

Before & After Gallery

View Gallery
Anterior open bite

Jaw Surgery Procedures

Orthognathic surgery corrects anterior open bite by impacting the posterior maxilla to allow the front teeth to come together properly, often combined with lower jaw repositioning. Most commonly, double jaw surgery is performed, combining Le Fort I osteotomy and BSSO to improve bite, function, and facial balance.

BSSO

BSSO Result Illustration

BILATERAL SAGITTAL SPLIT OSTEOTOMY

Repositions the lower jaw to help close the open bite and improve alignment, most commonly performed with upper jaw surgery.

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Le Fort I

Le Fort I Osteotomy Result Illustration

LE FORT I OSTEOTOMY

The upper jaw is repositioned, often with posterior impaction, to close the bite and restore function

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Double Jaw

Double Jaw Surgery Result Illustration

DOUBLE JAW SURGERY

Combined repositioning with occlusal plane rotation provides the most stable correction for skeletal open bite.

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Life-Changing Benefits

Closing an open bite restores proper function, improves speech, and enhances long-term stability.

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Improved biting function
Improved speech articulation
Reduced joint strain
Improved chewing efficiency
improved dental health
Increased confidence

Surgical Management of Anterior Open Bite

Upper Jaw

Le Fort I osteotomy corrects anterior open bite by separating the upper jaw from the surrounding facial skeleton, allowing the posterior maxilla to be impacted upward. This rotates the occlusal plane and brings the front teeth into contact, closing the open bite. The jaw is secured with titanium plates and screws, improving chewing, speech, and facial proportions. Each case is planned with advanced imaging and surgical simulation.

Both Jaws

When anterior open bite is severe or accompanied by additional skeletal discrepancies, double jaw surgery is recommended. A Le Fort I osteotomy with posterior maxillary impaction is combined with a bilateral sagittal split osteotomy to simultaneously reposition both jaws. A counterclockwise rotation of the mandible works in coordination with the occlusal plane change to close the open bite and optimize chin position and facial balance. Both jaws are secured with titanium plates and screws, improving chewing, speech, breathing, and facial harmony.

Presurgical Considerations

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Growth Completion

Key Assessment Points:

Bite opening no longer changing
Tooth eruption complete
Any condylar changes stabilized
Habit influence eliminated
Orthodontic preparation before jaw surgery.

Orthodontic Preparation

Key Assessment Points:

Address arch width
Posterior intrusion mechanics
Coordinate arches
Tongue habit control
Clinical jaw evaluation with a patient.

TMJ & Functional Assessment

Key Assessment Points:

TMJ function evaluation
Condylar position stability
Tongue posture assessed
Airway pattern reviewed

Timeline for Anterior Open Bite Correction

Month 0

Initial Consultation

Comprehensive history, clinical evaluation, 3D scans, X-rays, photographs, and impressions to assess jaw position and bite.

2–4 weeks after initial consultation

Treatment Planning Visit

Once your records are reviewed and the doctor has coordinated with your orthodontist, you’ll return either in person or via telemedicine to review your treatment plan, see prediction images, and go over the steps and timeline ahead.

6–12 months

Orthodontic Preparation (if necessary)

Braces or aligners gradually guide the teeth into proper positions to prepare the jaws for surgical
correction. In select cases, a surgery-first approach may be possible.

3-6 weeks prior to surgery

Final Surgical Planning

Virtual surgical planning determines precise bone movements for optimal symmetry, stability,
and facial balance.

2–4 weeks prior to surgery

Pre-Op Medical Clearance

Medical exams, lab testing, and final instructions ensure the body is fully prepared for surgery.

Typically a one-night hospital stay

Surgery Day

Corrective jaw surgery is performed to reposition the jaws, improve bite function, and enhance facial balance.

3–9 months after surgery

Post-Surgical Orthodontics

Final orthodontic treatment fine-tunes tooth position and bite, optimizing aesthetics, function, and long-term stability.

Experience Matters

“We personally plan your care, perform your surgery, and guide your recovery. No residents, no fellows, no handoffs.“

Choosing the right surgical team matters. You should feel informed, comfortable, and confident in every step of the process. At our practice, your care is provided by one of the most highly trained and experienced jaw surgery teams in the country.

When you come to our office, you meet directly with your surgeons. We are the ones who plan your treatment, perform your surgery, see you after surgery, and remain personally available to you throughout your recovery. Unlike larger institutions, your care is not delegated to residents, fellows, or doctors in training. Every critical aspect of your treatment is handled by your surgeons.

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Founding Members of the American Society of Orthognathic Surgery

What Our Patients Are Saying

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★★★★★

Dr Lee and the team at Northeast Facial are incredible. I was very nervous about my procedure but Dr Lee walked me through it step by step, never once making me feel rushed. Silvanna at the front desk went above and beyond to help me schedule an appointment that worked for me. I would highly recommend NEFOSS!

Stephanie Brown

★★★★★

“I had double jaw surgery done with Dr. Jacob in June 2021. I am extremely happy with my results. No more jaw pain and chewing problems. I also feel much more confident with my new smile. The surgery was definitely well worth it, thanks to Dr. Jacob and his team!”

Amelia Chen

★★★★★

“I would definitely recommend Dr. Jacob and his team at NEFOSS! Dr. Jacob and the team of doctors are very knowledgeable about all aspects of the TMJ process. They are such a nice group of doctors! The office staff is also very helpful and very friendly.”

Tiffany Puopolo

Frequently Asked Questions

Here are some common questions about anterior open bite and its correction.

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