Orthodontic treatment for open bite
My son is 15 years old. He has an open bite. His bottom and top teeth will not come together. My dentist said I should take him to an orthodontist, but the first visit alone is over $200. What can be done to correct his open bite?
Question:An anterior open bite is defined by a vertical space between the upper and lower front teeth. It can be caused by a number of conditions. It is usually associated with vertical growth problems. A young child with an open bite usually has a nonnutritive sucking habit (i.e. sucks on fingers). Open bite may also be related to tongue positioning, but not tongue movement during swallowing. Nasal obstruction may also lead to the formation of an open bite. Excessive eruption of the posterior teeth and downward posturing of the lower jaw will usually lead to an open bite. Both horizontal and vertical jaw development is inherited.
When open bites in children are related to habits, these malocclusions can spontaneously correct once the habit ceases. Once adolescence is reached, however, it is rare for the open bite to correct itself. In these cases, growth modification therapy can be an effective solution. One strategy would be high pull headgear attached to the upper first molars. This would help restrain vertical growth of the upper jaw so the lower jaw can rotate upward and forward.
This does not control eruption of both upper and lower teeth. Because overeruption of both upper and lower teeth can lead to an open bite, it may be necessary to control both arches. This can be accomplished by placing bite blocks between the upper and lower teeth. If these blocks are fitted to a functional appliance, the lower jaw can also be postured forward. For this treatment to be successful, cooperation from the child is absolutely necessary. Admittedly, asking the child to wear both the headgear and the functional appliance may be expecting quite a bit. To help encourage cooperation, the functional appliance should be worn nearly full time, while the headgear can be worn at night.
If the teeth have already erupted beyond normal adult dimensions, intrusive forces may be necessary. Again, bite blocks may produce a small amount of intrusion, but it may not be enough. Some practitioners have had success with placing magnets in upper and lower splints. The magnets repel each other as the splints come together causing an intrusive force on the teeth.
Because open bite orthodontic cases can have several different aspects, diagnosis and treatment planning needs to be determined on a case by case basis. This is best done with a thorough evaluation, including clinical exam, radiographs and study models. It is impossible for me to tell you the cost of treatment as treatment recommendations and fees are quite variable.
Ask your dentist if he/she knows of an orthodontist who charges a nominal fee for an initial consultation. Some orthodontists will do an initial consultation free of charge. A free initial consultation will not include radiographs or study models, but it may provide you with treatment options, a timeline and fees. If your dentist is unable to make this recommendation, call the local dental society or the local dental school for assistance. The sooner you obtain treatment for your son, the easier and possibly less expensive it will be. If he loses the ability to utilize potential growth, surgery may be required to resolve his open bite.
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