Open Bite in Children: Causes and Care

An open bite is a gap between the upper and lower teeth when your child bites all the way down — the back teeth touch, but the front teeth do not meet. You might notice it when your child smiles, or when they struggle to bite into foods like sandwiches or apples with their front teeth. In young children it is often related to habits; in older kids it can involve how the tongue rests and moves.

The most common causes I see

Prolonged thumb or finger sucking and extended pacifier use are the classic causes — the habit physically holds the front teeth apart while the jaws are growing. Another big one is tongue thrust: the tongue pushes forward against or between the front teeth every time the child swallows, which happens hundreds of times a day. Mouth breathing plays a role too, because it usually comes with low tongue posture.

It helps to know that not every gap between the front teeth is an open bite. Young children naturally have spacing between baby teeth — that is healthy and actually makes room for the bigger permanent teeth. A true open bite is different: the back teeth meet but the front teeth clearly do not, even when the child bites down hard. If you are unsure which one you are seeing, bring your child in and I will show you exactly what I see. At every exam I watch for these mouth breathing red flags and habit patterns, and I take radiographs only when they are clinically useful.

How I approach care

The first step is always the habit. If the thumb or pacifier habit stops early enough, a mild open bite in a young child can improve on its own as growth continues — the younger the child, the better the odds. When tongue posture is the driver, we work on retraining it: Myobrace, worn 1–2 hours a day plus overnight, helps correct mouth breathing, low tongue posture, and tongue-thrust swallowing while the jaws are still developing. For open bites that persist, Phase 1 orthodontic guidance may be recommended. The exact plan always comes from an in-person evaluation.

What parents can do now

Do not punish the habit — pressure and shame backfire. Instead, notice when it happens (tired? bored? anxious?) and offer alternatives, and praise the times your child does not do it. Then let me take a look: in our Tribeca office the pediatric dentist and orthodontist collaborate under one roof, so habit guidance and jaw development are handled as one plan. We are at 54 Warren St (Mon–Fri 8am–7pm, Sat–Sun 9am–4pm); call 212-561-5303.

Frequently Asked Questions

Will my child's open bite close on its own?

A mild one in a young child sometimes improves once the habit stops. The older the child and the longer the habit, the less likely it self-corrects.

When should a child stop using a pacifier?

Ideally well before age 3. The longer it continues, the more it can shape the bite and the jaws.

What is tongue thrust?

It is a swallowing pattern where the tongue pushes forward against the front teeth instead of resting on the palate — and it can hold an open bite open.

Does an open bite affect speech?

It can. Some children with open bites lisp or have trouble with certain sounds, which is another reason to have it evaluated.