Last reviewed: April 2026 · Based on current clinical protocols at DenCos, Hoofddorp
An open bite is a type of malocclusion where the upper and lower front teeth do not make contact when the mouth is closed, leaving a visible gap between the biting edges. Invisalign can correct most dental open bites in adults through a combination of incisor extrusion (moving front teeth downward) and molar intrusion (pushing back teeth upward). A retrospective study of 50 open bite patients found that Invisalign improved the mean overbite from −3.5 mm to +1.5 mm (P < 0.001), with 90% of patients reporting high satisfaction. At DenCos in Hoofddorp, open bite corrections are performed by Dr. Jing Guo — a registered specialist orthodontist (BIG 19918762902, PhD 2011) with Diamond Apex Status (top 1% of Invisalign providers in Europe).
This article explains what causes an open bite, the treatment options available, how Invisalign corrects it, and when surgery may be necessary.
What is an open bite and what types exist?
An open bite occurs when the front teeth fail to overlap vertically — the upper and lower incisors do not touch even when the back teeth are fully in contact. The condition is clinically defined as a negative overbite, typically greater than 2 mm.
There are two main types:
- Anterior open bite — the most common form. The front teeth do not touch while the back teeth meet normally. This is the type most frequently treated with Invisalign.
- Posterior open bite — less common. The back teeth do not meet while the front teeth make contact. This often has a skeletal origin.
Open bites can also be classified by cause:
- Dental open bite — caused by the position of the teeth within normal jaw anatomy. These respond well to orthodontic treatment including Invisalign.
- Skeletal open bite — caused by abnormal vertical growth of the jaws. These are more complex and may require surgical intervention.
A scoping review of 30 studies published in 2025 confirmed that clear aligners can achieve measurable incisor extrusion and posterior intrusion for anterior open bites when appropriate attachments and auxiliaries are used. At DenCos, Dr. Guo uses iTero 3D scanning and cephalometric imaging to determine the exact type and severity before recommending a treatment approach.
An open bite is not just a cosmetic concern — it can affect biting function, speech clarity, and jaw comfort. Specialist evaluation determines whether the cause is dental or skeletal.
What causes an open bite?
Open bites develop from a combination of habits, genetics, and growth patterns. Understanding the cause is essential because treatment success depends on addressing the root factor, not just the tooth positions.
Common causes include:
- Thumb sucking or pacifier use — prolonged childhood habits push the front teeth apart and prevent normal vertical development
- Tongue thrusting — a swallowing pattern where the tongue pushes forward between the front teeth during each swallow, maintaining or worsening the open bite
- Mouth breathing — chronic mouth breathing alters facial muscle balance and can promote vertical jaw growth that leads to an open bite
- Genetic jaw growth patterns — some individuals inherit a long face growth pattern (hyperdivergent) that predisposes to skeletal open bite
- Temporomandibular joint (TMJ) disorders — condylar resorption or other joint pathology can cause progressive open bite in adults
At DenCos, Dr. Guo assesses not only the tooth positions but also the underlying cause. If a tongue thrust habit is identified, the treatment plan may include referral for myofunctional therapy alongside Invisalign — because correcting the teeth without addressing the habit leads to relapse. This comprehensive approach, combined with access to periodontist Dr. Gang Wu (BIG 29918905102) for gum and bone assessment, exemplifies DenCos's interdisciplinary treatment model.
Fixing an open bite without addressing its cause — such as a tongue thrust or mouth breathing — leads to relapse. At DenCos, the cause is identified before treatment begins.
How does Invisalign correct an open bite?
Invisalign corrects anterior open bites through two primary mechanisms working simultaneously:
- Incisor extrusion — the front teeth are gradually moved downward (extruded) until they make contact with the opposing teeth
- Molar intrusion — the back teeth are pushed upward (intruded) into the jawbone, which rotates the jaw closed and helps the front teeth meet
The retrospective study of 50 patients demonstrated that this dual approach improved the mean overbite by 5.0 mm (from −3.5 mm to +1.5 mm) over an average treatment duration of 18 months with 24 aligner sets. A separate study found that regardless of whether molar intrusion was specifically planned, open bite correction with Invisalign was primarily achieved through incisor extrusion and retroclination, and that aligners are an effective appliance for adult open bite treatment.
The treatment at DenCos typically involves:
- SmartForce attachments — precision composite shapes bonded to the front teeth to enhance the aligner's grip for extrusion movements
- Bite ramps — built-in features on the aligners that help train the bite into the correct vertical relationship
- Elastics — in some cases, rubber bands are used to provide additional vertical force
- ClinCheck overcorrection — Dr. Guo programmes deliberate overcorrection in the ClinCheck plan because digital software may overestimate movement predictions, as noted in the 2025 scoping review
At DenCos, Dr. Guo's Diamond Apex experience with 3,000+ cases provides the clinical knowledge to select the right combination of mechanics for each patient's open bite. The ClinCheck simulation shows you the projected result before treatment begins.
Invisalign corrects open bites by extruding front teeth and intruding molars — a dual mechanism that is planned digitally and verified with 3D simulation before your first aligner.
What are the treatment options for an open bite?
The right treatment depends on the type, severity, and cause of the open bite. At DenCos, Dr. Guo evaluates all options during the initial consultation:
| Treatment | Best for | Duration | Key considerations |
|---|---|---|---|
| Invisalign | Mild–moderate dental open bites in adults and teens | 12–24 months | Removable, discreet, ClinCheck simulation |
| Fixed braces | Moderate–severe open bites, complex cases | 18–30 months | Full bracket control, elastics, possible TADs |
| Braces + TADs | Severe dental open bites requiring significant molar intrusion | 18–30 months | Temporary anchorage devices provide skeletal anchoring |
| Orthognathic surgery | Severe skeletal open bites | 12–18 months (surgery + braces/aligners) | Jaw repositioning — most definitive for skeletal cases |
| Habit therapy | Open bites caused by tongue thrust or habits | Ongoing alongside orthodontic treatment | Essential to prevent relapse |
At DenCos, approximately 85% of orthodontic cases are treated with Invisalign. For open bites specifically, Dr. Guo selects the approach based on the 3D analysis — if Invisalign alone is insufficient, she may recommend fixed braces or a combined approach. The decision is always based on clinical evidence, not convenience.
A 2023 study in the American Journal of Orthodontics confirmed that clear aligners are an effective appliance for adult anterior open bite treatment, with treatment stability comparable to other orthodontic approaches when proper retention is maintained.
The best open bite treatment depends on the cause and severity. At DenCos, the recommendation is based on 3D analysis — not a one-size-fits-all approach.
How long does open bite correction take?
Treatment duration varies by severity and the approach chosen:
| Open bite severity | Typical treatment time | Aligner sets (Invisalign) |
|---|---|---|
| Mild (1–2 mm gap) | 12–15 months | 18–22 sets |
| Moderate (2–4 mm gap) | 15–20 months | 22–28 sets |
| Severe (>4 mm gap) | 20–24+ months | 28+ sets, refinements likely |
The study of 50 open bite patients reported a mean treatment duration of 18 months with an average of 24 aligner sets. Refinement stages are common in open bite cases because the vertical movements (extrusion and intrusion) are among the most challenging to achieve predictably with any orthodontic system.
At DenCos, Dr. Guo's experience means she programmes the necessary overcorrection from the start, reducing but not eliminating the need for refinements. Consistent aligner wear of 20–22 hours per day is critical for open bite correction — more so than for simple alignment cases.
Open bite correction is one of the more challenging orthodontic treatments. Diamond Apex experience means Dr. Guo anticipates the complexities from the start.
Why is retention especially important after open bite correction?
Open bites have a higher relapse tendency than other types of malocclusion. The scoping review of 30 studies emphasised that long-term stability depends on addressing the original cause and maintaining rigorous retention.
Relapse risk factors include:
- Persistent tongue thrust — if the swallowing pattern is not corrected, the tongue continues to push the front teeth apart
- Mouth breathing — ongoing nasal obstruction can recreate the muscle imbalance that caused the open bite
- Inadequate retention — skipping retainer wear is particularly risky for former open bite patients
At DenCos, retention is planned from the beginning of treatment:
- Fixed retainer — a thin bonded wire behind the front teeth provides 24/7 passive retention
- Removable retainer — worn at night to maintain the vertical correction
- Myofunctional referral — if a tongue thrust is identified, DenCos refers for habit correction therapy to address the underlying cause
As a Diamond Apex provider, DenCos receives up to 52% discount on Invisalign retainers from Align Technology — the highest available — making retention affordable for patients. Dr. Guo's retainers are scanned and designed with the same iTero precision as the treatment aligners.
Open bite correction without proper retention is incomplete. At DenCos, retention planning starts on day one — including fixed retainers, night-time retainers, and habit therapy when needed.
Next step
Think you might have an open bite? Register as a new patient at DenCos in Hoofddorp or call 023-792 0463 to schedule a consultation with specialist orthodontist Dr. Jing Guo. The initial iTero 3D scan and cephalometric analysis will reveal the exact type and cause of your open bite, and the ClinCheck simulation will show you what correction is achievable. Patients from Haarlem, Amsterdam, Amstelveen, Haarlemmermeer, and the wider region are welcome — no referral is required.