Metal Mouth Message Board

CCinBraces wrote:I know this is old but--my ortho never even mentioned closing the open bite with elastics. Is that a fairly normal thing to do? I guess Im wondering why this hasn't been mentioned or attempted with me. Anyone else want to share their open bite experiences?

During my first round of braces about a dozen years ago, I had elastics to close my open bite. It reopened within a year of having the braces off due to ongoing tongue thrusting. Elastics are still utilized in kids and adolescents, but not as much in adults due to poor stability of results once the braces are removed. It also may lengthen the appearance of the upper front teeth, which isn't usually desirable.
Shortly after I get braces in 4 weeks, I will be getting TADs to intrude the molars. This seems to be the up-and-coming treatment of choice for fixing an open bite, short of jaw surgery. Much more stability when done this way, according to the literature.

CCinBraces wrote:I know this is old but--my ortho never even mentioned closing the open bite with elastics. Is that a fairly normal thing to do? I guess Im wondering why this hasn't been mentioned or attempted with me. Anyone else want to share their open bite experiences?

In general, elastics are a pretty routine part of braces, open bite or not. But I have seen people on this forum have theirs corrected with elastics.

CCinBraces wrote:I know this is old but--my ortho never even mentioned closing the open bite with elastics. Is that a fairly normal thing to do? I guess Im wondering why this hasn't been mentioned or attempted with me. Anyone else want to share their open bite experiences?

Yes i think closing an Open Bite with Elastics is how its normally done.

I had a pretty bad Anterior Open Bite before i got braces and since day 1 i had to use elastics, now i have to put 2 elastics on during the day and 3 at night (the 3rd is for my midlines to start correcting), after 10 months of elastics im starting to think i may have 2 years of elastics (supposed to have braces for 2 years)

Thanks @Mimo.

I was told 40k to 70k for jaw surgery. Yikes.

I don't believe 2mm is a very severe open bite...Im wondering if this is why it wasn't mentioned to me. I will be asking my ortho, however. How often do you wear the box elastics? I assume you can't work with them on if speaking is needed? Also, mind me asking if yours is skeletal?

oops! Thanks to everyone!** I missed some of the replies earlier.

*Hammerman---my tongue thrusting is quite bad and caused a lot of issues since my first round of braces. TADS were mentioned to me but he now says he doesn't think they will do much for me. Then again, premolar extraction also won't solve the whole issue. Seems like a losing situation here. Just curious--any idea what the cost of TADS are? And they still won't help/correct the tongue thrust--any word on that?
Who knew tongues are such nuisances.

Tongue thrusting (i.e. during swallowing) is not an issue...it's resting position of tongue that matters. Your tongue should be on the roof of your mouth sitting behind the teeth when you are at rest. This is something you can think about/be aware of. I believe some people even get a tongue reduction.

Make sure you speak to an orthodontist that has considerable experience with closing open bites by intruding molars using TADs or orthodontic bone anchors. Anyone else is a waste of time. And even if molar intrusion will fix your bite there are still other reasons that surgery can be a good idea - e.g. anterior vertical maxillary excess.

Cost, depends on what you get done, placement/removal may still need to be done by a surgeon, but can be done in-office. Should be vastly cheaper than jaw surgery.

CCinBraces wrote:Thanks @Mimo.

I was told 40k to 70k for jaw surgery. Yikes.

I don't believe 2mm is a very severe open bite...Im wondering if this is why it wasn't mentioned to me. I will be asking my ortho, however. How often do you wear the box elastics? I assume you can't work with them on if speaking is needed? Also, mind me asking if yours is skeletal?

I had a slight open bite and wore triangle elastics on each side of my mouth day and night. After a few months I then moved on to a boxed elastic in front. I had to wear that only at night. However, I could still talk. It's not like my mouth was clamped shut or anything, so if I had to wear that during the day to work I could have.

Imk, may I ask if you have experienced any regression. I also have a slight open bite and am wearing elastics in a triangle formation. I have been wearing them for about a week and my open bite has already closed completely on one side and is near closed on the other. But all this talk of TADS and elastics not being stable has me worried. I would love to hear your experience.

testimony777 wrote:Imk, may I ask if you have experienced any regression. I also have a slight open bite and am wearing elastics in a triangle formation. I have been wearing them for about a week and my open bite has already closed completely on one side and is near closed on the other. But all this talk of TADS and elastics not being stable has me worried. I would love to hear your experience.

Tads and elastics not being stable?

Sometimes closing an anterior open bite is enough to fix the problem, the tongue will go where it is supposed to. Other times, the poor tongue posture will make the open bite relapse.

Not everyone needs TADs that has an open bite. It all depends on the severity. But they seemed to help in my case. I guess we will have to wait a few years from now when my braces are off and see if things stay put.

To anyone with poor tongue posture aka tongue thrust I'd also check this out: http://www.iaom.com/pdf/memberDirectory.pdf and see if there are any professionals in your area. Many dentists, speech language pathologists, hygienists, and other professionals are trained in this field.

HummerMan3 wrote:
During my first round of braces about a dozen years ago, I had elastics to close my open bite. It reopened within a year of having the braces off due to ongoing tongue thrusting. Elastics are still utilized in kids and adolescents, but not as much in adults due to poor stability of results once the braces are removed. It also may lengthen the appearance of the upper front teeth, which isn't usually desirable.
Shortly after I get braces in 4 weeks, I will be getting TADs to intrude the molars. This seems to be the up-and-coming treatment of choice for fixing an open bite, short of jaw surgery. Much more stability when done this way, according to the literature.

I have also heard/been worried about this lengthening of the upper front teeth. 2 of the head orthos at the university where I am treated both said that a little bit of lengthening is actually not a bad thing because as we age our faces sag. But too much can cause problems, even gum problems from too much extrusion.

And yes most definitely, intruded molars are significantly easier in retention as opposed to anterior teeth, well, because of chewing and biting down.

testimony777 wrote:Imk, may I ask if you have experienced any regression. I also have a slight open bite and am wearing elastics in a triangle formation. I have been wearing them for about a week and my open bite has already closed completely on one side and is near closed on the other. But all this talk of TADS and elastics not being stable has me worried. I would love to hear your experience.

Sorry for the delay in responding, I just saw your question now for some reason. As far as some regression I can say for me, yes. But just a little bit. My orthodontist said she likes to "over-correct" just a little because of that exact reason. So basically I just had to wear elastics for longer even though my bite was completely closed. Then she didn't want me to wear any elastics at the end of my treatment to make sure everything was stable before removing the braces. I just recently had my braces removed and that is when I noticed my bite wasn't as tight as it was with the braces on but I am still really happy with my bite and It is definitely closed. Also, I don't know if I had poor tongue posture before braces, I guess I never payed much attention to it but as I was reading causes of open bites I realized I was kinda a mouth breather and I read that can contribute to an open bite. So, during braces I've made some changes and made it a point to make sure I kept my mouth shut, breathed through my nose and had my tongue in the proper position. Now that I'm brace-free it's just natural for me and I don't even think twice about it.

jfriend33 wrote: Tads and elastics not being stable?

Sometimes closing an anterior open bite is enough to fix the problem, the tongue will go where it is supposed to. Other times, the poor tongue posture will make the open bite relapse.

Not everyone needs TADs that has an open bite. It all depends on the severity. But they seemed to help in my case. I guess we will have to wait a few years from now when my braces are off and see if things stay put.

To anyone with poor tongue posture aka tongue thrust I'd also check this out: http://www.iaom.com/pdf/memberDirectory.pdf and see if there are any professionals in your area. Many dentists, speech language pathologists, hygienists, and other professionals are trained in this field.

Thanks for this feedback and for the link. The fact that my bite was closed so quickly with the elastics has been encouraging but I will be talking to my orthodontist about all of this at my next visit. In addition to the elastics, I have been working on proper tongue position since I was braced as my ortho mentioned that tongue position might be a factor in my case. I will check out that link as well though and see if there are more tips I can apply.

Imk wrote: Sorry for the delay in responding, I just saw your question now for some reason. As far as some regression I can say for me, yes. But just a little bit. My orthodontist said she likes to "over-correct" just a little because of that exact reason. So basically I just had to wear elastics for longer even though my bite was completely closed. Then she didn't want me to wear any elastics at the end of my treatment to make sure everything was stable before removing the braces. I just recently had my braces removed and that is when I noticed my bite wasn't as tight as it was with the braces on but I am still really happy with my bite and It is definitely closed. Also, I don't know if I had poor tongue posture before braces, I guess I never payed much attention to it but as I was reading causes of open bites I realized I was kinda a mouth breather and I read that can contribute to an open bite. So, during braces I've made some changes and made it a point to make sure I kept my mouth shut, breathed through my nose and had my tongue in the proper position. Now that I'm brace-free it's just natural for me and I don't even think twice about it.

Thanks so much Imk! This is really helpful and I am going to use it to guide my conversation with my ortho about her thoughts on over-correcting. I am glad to hear that the reversion has been minimal in you case.

testimony777 wrote:

jfriend33 wrote: Tads and elastics not being stable?

Sometimes closing an anterior open bite is enough to fix the problem, the tongue will go where it is supposed to. Other times, the poor tongue posture will make the open bite relapse.

Not everyone needs TADs that has an open bite. It all depends on the severity. But they seemed to help in my case. I guess we will have to wait a few years from now when my braces are off and see if things stay put.

To anyone with poor tongue posture aka tongue thrust I'd also check this out: http://www.iaom.com/pdf/memberDirectory.pdf and see if there are any professionals in your area. Many dentists, speech language pathologists, hygienists, and other professionals are trained in this field.

Thanks for this feedback and for the link. The fact that my bite was closed so quickly with the elastics has been encouraging but I will be talking to my orthodontist about all of this at my next visit. In addition to the elastics, I have been working on proper tongue position since I was braced as my ortho mentioned that tongue position might be a factor in my case. I will check out that link as well though and see if there are more tips I can apply.

Imk wrote: Sorry for the delay in responding, I just saw your question now for some reason. As far as some regression I can say for me, yes. But just a little bit. My orthodontist said she likes to "over-correct" just a little because of that exact reason. So basically I just had to wear elastics for longer even though my bite was completely closed. Then she didn't want me to wear any elastics at the end of my treatment to make sure everything was stable before removing the braces. I just recently had my braces removed and that is when I noticed my bite wasn't as tight as it was with the braces on but I am still really happy with my bite and It is definitely closed. Also, I don't know if I had poor tongue posture before braces, I guess I never payed much attention to it but as I was reading causes of open bites I realized I was kinda a mouth breather and I read that can contribute to an open bite. So, during braces I've made some changes and made it a point to make sure I kept my mouth shut, breathed through my nose and had my tongue in the proper position. Now that I'm brace-free it's just natural for me and I don't even think twice about it.

Thanks so much Imk! This is really helpful and I am going to use it to guide my conversation with my ortho about her thoughts on over-correcting. I am glad to hear that the reversion has been minimal in you case.

There are quite a few videos on youtube that show some myofunctional exercises. I would not say go and do them to just anyone, but I used them as a preview so I knew what to expect.

https://youtu.be/pdDsMCvDN5Q
https://youtu.be/4feUjLmwIsI
https://youtu.be/h2Ce7dlUG9c
https://youtu.be/8DPsRmqZ5Ss

Thanks for these Jfriend33! I hadn't come across these videos before, will definitely give them a go.

Jfriend33, thank you so much for sharing the videos! That is something I am going to read about and do. I really want my bite staying the way it is.