Treatment of open bite in children and adults

​​All existing variations in the placement of teeth in rows in humans are divided by dentists into two groups: physiological (correct) and pathological (with various anomalies). In this article, we will talk in detail about the causes and treatment of open bite in adults and children.

• With a closed jaw, there are no gaps or gaps between the teeth.
• The junction line of the central incisors of both rows runs strictly along the midline of the face.
• In the lateral region, the teeth are compressed in one line, without overlapping one row on the other.
• Chewing food does not cause any inconvenience or pain.
• The oval of the face with a physiological bite has an impeccable shape, and the teeth themselves are arranged in even, beautiful rows.

Varieties of bite anomalies

One of the most common types of malocclusion is the open bite. If, during occlusion of the jaw, individual teeth or a group of teeth in the upper and lower rows do not contact each other, this indicates a pathology of the bite. The gap between the teeth in an open bite can be in the lateral or anterior areas. An open lateral bite implies non-closure of chewing molars, while one or more pairs of teeth may not contact each other. This kind of pathology often leads to a speech defect and can be associated with various ENT diseases. In addition, due to a violation of the chewing function, diseases of the digestive system and the gastrointestinal tract can occur.

If the incisors of the upper row are more than half on the lower row of incisors, this indicates a kind of pathology such as a deep bite. The cause of a deep bite is most often insufficient face height. Due to the disproportion of the face, a deep bite can be present not only on the front, but also in the region of the lateral teeth. After the treatment, the face acquires the correct shape, the lips stop turning outward, the habit of pursing the lips is gradually eradicated.

With a clenched jaw, the incisors of the upper and lower rows do not touch, as a result of which a cleft is formed between them - this pathology is called an anterior open bite (frontal bite). The external manifestation of an anterior open bite is a constantly ajar mouth. Anterior open bite is considered by orthodontists to be the most complex form of malocclusion. Correction of the anterior bite is carried out with the help of mechanical action and the use of non-removable bracket systems.

In case of inferior development of one of the sides of the jaw, a crossbite . This pathology leads to a violation of the chewing function (due to loose closure of the teeth on one side, a person is forced to chew food on one side). This leads to the development of pathology of the temporal and jaw joints, facial asymmetry, pain when opening the mouth. Correction of a crossbite is carried out using removable devices or a bracket system in combination with mechanisms for the full expansion of the jaws. However, structures often have to be reinstalled due to the impossibility of reliable fastening.

Causes

The most common causes of open bite are:

• Maxillofacial injuries;
• Heredity;
• Illness of the mother during the period of bearing a child;
• Incorrect arrangement of teeth;
• Violation of the body's metabolic processes;
• Malfunctions of the endocrine gland;
• Rickets;
• In children - sucking fingers and other objects, using a pacifier for more than a year and a half;
• Violation of the swallowing function (at the time of swallowing, the tongue is between the teeth);
• Tumor of the palate or tongue.

Open bite symptoms

The main symptom of malocclusion is the gap between the teeth with a tightly clenched jaw. Depending on the vertical length of the gap, open bite is divided into three types:

• the gap between the teeth is less than 2 mm;
• slot width 2-5 mm;
• a gap of 5 mm or more.

Depending on the length, the open bite has three dividing groups:

• partially or completely frontal teeth do not touch;
• frontal teeth and premolars do not touch;
• with a clenched jaw, only the second molars are in contact.

The above bite pathologies lead to the impossibility of complete closure of the lips, which is why the patient's mouth is constantly ajar. The sharp sides of the anterior teeth are concave, and the concavity can be either one side of the upper or lower jaw, or both. The separation of the anterior teeth can reach up to 1.5 mm or more. The patient has to make efforts to keep the lips closed, thus covering the bite defect, as a result, the upper lip is extended, and the crease of the lower lip is smoothed out.

Treatment

To determine how to treat an open bite , it is necessary to conduct an accurate diagnosis, as a result of which concomitant jaw diseases are also detected. Only a detailed diagnosis will help the doctor prescribe a productive treatment for open bite.

Depending on the age of the patient and the degree of bite deformation, he is prescribed orthodontic, surgical or combined treatment.

For example, to correct a milk bite, treatment occurs with the help of prevention, which can lead to a decrease in pathogenetic factors (sucking fingers, nipples, normalizing the position of the tongue when swallowing, rickets, etc.). Treatment is carried out in a complex - therapeutic effect and special myogymnastics.

Eliminate bad habits

To help the child wean from thumb sucking, you can use special cardboard sleeves that are worn on the elbow bends, fixing the baby's handle in a straight position. The child does not have the ability to put fingers in his mouth.

If the child bites his nails, you should persistently and gently remove his hand every time. This habit can signal a nervous breakdown or tension in the baby. Therefore it is better to visit the neuropathologist. For some girls, a manicure serves as a psychological barrier. If you make up a 5-8-year-old baby's nails, she will simply be afraid to spoil her beautiful varnish, thereby overcoming the pathological reflex.

Breathing exercises to stabilize nasal breathing, which can be done with a child at home:

• During morning hygiene, you need to take water into your mouth and push it out with force with a trickle. Repeat several times.
• The child takes a mouthful of water and holds it behind his cheeks for a while. This procedure does not allow the child to breathe through the mouth, gradually accustoming to nasal breathing.
• The training of the circular muscles is carried out alternately by stretching the lips into a tube, and then into a wide smile. In addition, soap bubbles are excellent gymnastics for circular muscles.
• Learning to whistle. The child stretches his lips, trying to reproduce the whistle.
• The child tries to hold a plastic spoon or ruler with his lips for several minutes.

To get the result, the exercises should be performed systematically, preferably several times a day.

Correction of bite during the period of changing teeth in a child

To correct an open bite in the transitional period (the period of replacement of milk teeth by molars), biological and hardware methods, crowns or mouth guards that increase the bite are added to the main methods of treatment and myogymnastics. At the beginning of the shift period, fixed preparations are used to move the teeth. If it is necessary to move the teeth of one jaw, a vestibular arch can be used, which, with the help of special rings, is attached to the supporting milk or first permanent teeth.

An open malocclusion in the second period of mixed dentition can be corrected using a plate with a special stop under the tongue. The presence of a screw on the plate provides uniform pressure on the dental arches, thereby contributing to their expansion. Also, Angle's apparatus can be used to expand the dental arches. To reduce the effect of the Angle apparatus on the region of the posterior teeth, it is better to use it alternately with extraoral traction.

For the treatment of permanent occlusion, plates with a tongue rest on one jaw can also be used. But more effective for this period is the use of non-removable devices. For example, the Angle apparatus with a shaped arch, rings and hooks specially designed for this purpose, which help move the teeth with the help of rubber traction.

If simultaneous dentolvelar shortening of the posterior teeth and lengthening of the anterior teeth is required, the Hurst-Cojacaru apparatus is used. Its main function is to guide the teeth in the right direction and mechanically influence the correction of the open bite.