Deep bite and open bite are vertical problems. Both need a diagnosis of whether the cause is dental or skeletal, together with an assessment of growth pattern and face type, before mechanics are chosen. Deep bite is usually corrected by levelling, intrusion or posterior extrusion, and open bite correction relies on habit control, posterior intrusion with anchorage, and careful retention.
Start with the vertical diagnosis
Measure the overbite, look at the curve of Spee and the incisor display at rest and on smiling, and assess the lower facial height and the mandibular plane angle. Face type guides the plan: a short face with a low mandibular plane angle responds differently to mechanics than a long face with a high angle, where extrusive forces can worsen the profile.
Deep bite: how it is treated
Dental causes include over-eruption of the incisors and a deep curve of Spee, while skeletal causes include a short lower face and a rotation of the jaws. Mechanics include levelling with continuous archwires, anterior bite planes that let the posterior teeth erupt in a growing patient, intrusion of the incisors with utility arches or mini implants, and avoiding unplanned incisor proclination, which can look like correction without being intrusion.
Open bite: how it is treated
An open bite can come from digit or tongue habits, tongue posture, or vertical skeletal excess. Treatment combines habit control and myofunctional therapy with vertical elastics, whose extrusive effect needs monitoring, and posterior intrusion with mini implants in selected cases. Severe skeletal open bite may need surgical correction, so refer early when the diagnosis points that way.
The role of growth, and retention
In growing patients, growth can be guided, while in adults correction depends on dentoalveolar movement. Both problems relapse when the cause is not controlled, so retention planning begins at diagnosis. The mini implant guide covers the anchorage side.
Key takeaways
- Diagnose whether the problem is dental or skeletal, and read growth pattern and face type first.
- Deep bite is corrected by intrusion or posterior extrusion, and incisor proclination can mimic correction.
- Open bite needs the cause controlled, otherwise it relapses.
Frequently asked questions
Can a general dentist treat deep bite?
Mild to moderate deep bite with a dental cause can be managed by a trained general dentist with suitable mechanics and monitoring. Severe skeletal deep bite should be planned with specialist input.
Why do open bites relapse?
Habits, tongue posture and vertical skeletal growth keep acting on the teeth. Correcting the cause and extending retention reduce relapse.