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open bite, or is it underbite? Teeth that overlap, or don’t. How to tell?

If you have teeth that don’t meet each other at the front, and you wonder what you should call it properly to your dentist, this is for you. To say you have an underbite, or open bite, is like apples and oranges. Read some more!

open bite before treatment dr adel zakhary
an open bite case before treatment ar Dr Adel Zakhary

The normal relationship

Normally, teeth are designed to meet each other as previously described. This relationship is what is known as a positive overlap of teeth, and dentists know it by its stage name – overbite. Its when the tip of the bottom front tooth strikes the back of the upper front tooth. Under this configuration, the teeth are said to be in contact and further, are able to incise (hence the technical name of the respective tooth – incisor) or bite food off.

What is Underbite?

It is when teeth are not touching each other but look like they do when viewed strictly from the front. Some literature described it as bulldog appearance, but we do not consider the literature exact, as the appearance is more involved with both the overlap in the two planes, the vertical and horizontal planes.

open bite, on the other hand..

Is when teeth do not touch OR overlap each other. There is a distinct gap between the teeth, especially in closing on the back teeth. This is easily discernible from the front teeth, then turning the head to the side, to find a perfect, dark zig-zag between the back teeth top and bottom, while the front ones do not touch in any way. There is a visible gap.

Is it an overlap, or do they touch?

Sometimes, teeth can struggle to reach their proper position and touch each other, for example, when a physical obstruction prevents them from doing so, or if adenoids or other systemic diseases exist. When this occurs, we ask our patients to report if the teeth could in fact touch each other on closing on the back teeth. With the significance being that if there is touching of teeth, then seldom this requires tooth movement with braces or orthodontics. Sometimes, it may be hard to tell, especially when the patient has a bone problem in such a way, that teeth front to back can not touch each other under the patient’s own effort

underbite case before treatment dr adel zakhary
underbite case before treatment at Dr. Adel Zakhary

How can open bite or underbite be treated?

When you visit our clinic for the first time, we take your impression and make a 3D model. This is then inserted to the computer and is analyzed to reveal which teeth can touch (from the dent marks on their surface), and which do not. We also connect this with your photographs and overlay your face above the teeth, while also using taken X-rays, to connect all three together and establish your profile. Once that is done, you get to see how will the treatment proceed, what type of brace are we going to use, the teeth to be taken out (if any), and finally, the desired final outcome. As a general rule with bites, and because dentists usually elect to remove teeth, orthodontists perform what is known as a wax-up. It is essentially your corrected case with a full complement of teeth (without taking teeth out). Through a series of calculations, angular measurements, and extrapolations of tooth movements, we can then determine if teeth are to be removed for closing the bite. Please be aware that not only is it one of the most difficult conditions to treat, but also open bite or underbite problems have a high tendency to relapse following retainer removal, and therefore requires the fixed wire retainer.

What to do if you can’t tell if its open bite or underbite

If you can’t tell if the teeth are touching or not, you can have yourself checked at our clinics

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