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FAQ:  Open Bite

My son has worn braces for the past four years. Although his teeth are straight, he still has an open bite. The orthodontist stated he wants to remove the braces at this point since they have been on his teeth for a long time and he wants to avoid any damage to his roots or teeth.

He suggested two options: One to remove the braces and just get a retainer. He mentioned the open bite would not improve with the retainer but probably would not get worse. However, he mentioned there is still a slight chance that it could become worse even with the retainer. The second option would be at some point to have surgery to take care of the open bite.

Is it true that not all braces can control the open bite? What would happen if he didn't use any type of retainer for a few years? Would his teeth possibly straighten out on their own? If surgery is the route we go, what age would you suggest to go with the surgery? ...Visitor from NJ

By today's standards 4 years is a long time for orthodontic treatment. True, orthodontic treatment has its limitations when it comes to skeletal structure and sometimes a combination of orthognathic surgery and orthodontics is necessary.

When probability is that both treatments will be necessary, the preliminary orthodontic treatment is done to line up the teeth in the most favorable position for the future surgery and improve the smile esthetically for the time period until surgery is appropriate.

Orthognathic surgery (done in the hospital by an Oral and Maxillofacial Surgeon) is rarely accomplished prior to full bone growth. This is usually measured by an x-ray, typically of the wrist, which shows that the skeletal growth is matured. Usually sooner in females this is not until late teens.

I would recommend a second opinion with an oral surgeon/orthodontic team that are accustomed to working together and on these specific types of potential surgical cases.

If you need a referral to an appropriate team, there are a couple in my area whom I'm familiar with. If it needs to be closer to you I can request if they know anyone experienced and well skilled in these areas.

Editorial Staff
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