Tech tip: anterior open bite with clear aligners

The following information is for reference when specifically dealing with dentoalveolar tooth movements with clear aligners and excludes all medical, functional, developmental and skeletal causes for open bites.

An anterior open bite is generally defined as a condition where the upper & lower posterior teeth are touching when the patient bites down, but the anterior teeth are not in occlusion.


An open bite can occur during transition from primary to permanent dentition, and is considered to be a temporary stage of normal dentoalveolar growth and development.


Anterior open bite, like most other malocclusions, can either be hereditary or have environmental causes and are usually a combination of both.

Some of the more common environmental causes are:

  • Thumb, finger or pacifier sucking
  • Abnormal tongue function (such as tongue thrusting) or large tongue that occupies the space between the teeth
  • Trauma or pathology to one or both condyles
  • Neurologic disturbances, iatrogenic factors, e.g. extruding molars during treatment
  • Airway pathology

Some conditions, such as TMJ degeneration, can manifest as an open bite. Factors like onset and disease progression can also come into play. Along with this, other factors such as habits, mode of respiration, tongue size, smile display are all considerations—each of these a complex topic in itself.

Open bite & clear aligners

If an anterior open bite is present before, during, or after treatment with clear aligners, a comprehensive evaluation must be completed in order to properly determine the reason for the openbite, whether it is due to a dental, skeletal, muscular, or other etiology; only then can the appropriate course of treatment be applied.

Some dental open bites can be corrected with clear aligner treatment, pending examination and diagnosis to determine eitology of the open bite. When you submit your case, be sure you provide your technician with your treatment details for how you plan to correct the anterior open bite in the "Additional instructions" section. 

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Until next time…

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