Correction of open bite in adults. What is an open bite: types, symptoms, treatment of a defect. Depending on location

The correct bite is very important for a person, because in case of pathology, the load on the most “loaded” teeth increases significantly, which is fraught with loss of teeth. In addition, malocclusion changes the appearance of the face, it can even interfere with the child's normal chewing and speaking. It is worthwhile to understand in more detail the methods of correcting the wrong taste in a child.

Development periods

Pathology does not develop immediately, it is formed in several stages:

• Newborn. This period of time is characterized complete absence teeth in an infant, but an experienced orthodontist is already able to determine how the incisors and molars will be located. The lower jaw of a newborn is slightly behind, and this is quite normal.
• The appearance of the first milk teeth. As soon as the first teeth begin to appear in the baby, the lower jaw noticeably levels out. A little later, the teeth from above (most often the incisors) begin to cover themselves lower teeth almost half.
• Alignment of milk teeth. At this stage, it is considered quite normal if the baby has gaps between the unstable teeth, and the tubercles are erased. This process is smooth, gradual and is usually considered complete by the age of six. By this age, the bite becomes almost straight (the upper teeth no longer cover the lower jaw).
• Change dairy to indigenous. This process in all children proceeds with different intensity, but usually it lasts up to 11-12 years. During this time, milk teeth fall out, instead of them, permanent, molars grow. Fine upper teeth begin to cover the lower ones, but not more than one third of the size of the crown. Cracks and gaps between the teeth should not be observed normally.

Causes of violations

Formation pathological bite- this is usually a whole set of reasons why there was no proper development. Most often, experts talk about the hereditary factor - if one of the parents has a bite that is far from ideal, then the child has every chance to face the same problem.

An incorrect bite can be due to the fact that milk teeth for some reason (for example, due to dental disease) was removed ahead of schedule. Belated, late teething is also a cause for concern. It may well cause the formation of a pathological bite.

Incorrect bite may be in a child who is fed mashed soft food for too long, in a baby suffering from frequent illnesses ENT organs (for example, with adenoids, the bite changes significantly). The reason may be too long sucking on the pacifier. The cause of the pathology may also be bad habit suck your fingers.

Many orthodontists tend to believe that bite problems in a child begin in the womb, because the formation of the jaw and all its components occurs long before birth. It is believed that anemia future mother, metabolic disorders in her body, acute viral infections in the first trimester of pregnancy are considered those factors that adversely affect the formation of the jaw bone skeleton of the fetus.

The role of proper nutrition - if there is not enough calcium and fluorine in the body of a newborn, the baby, then the risk of developing bite pathologies increases tenfold.

The condition of the oral cavity also affects the bite - in a child who regularly suffers from gum disease, stomatitis and other problems inflammatory nature in the mouth, the risk of malocclusion is much higher.

Effects

cosmetic defect, which to one degree or another becomes noticeable if the child does not correct bite- just the tip of the iceberg. More serious consequences pathologies lie in the fact that the main function of the teeth is disturbed. The child begins to chew food incorrectly, which quite often leads to diseases of the stomach, liver, pancreas, and intestines already at a very early age.

Bite affects the clarity and quality of speech. With pathology, the child may begin to suffer from speech defects, and this will prevent him from communicating normally with his peers. From here grow the roots of heavy psychological problems in elementary school or older school age.

In children with malocclusion, the risk of developing periodontal disease increases, their teeth are more vulnerable, children lose many units due to excessive wear and improper load very early - implantation is required.

The most serious consequences concern changes in the temporomandibular joints. Such pathologies can cause persistent excruciating headaches, hearing loss, and breathing problems (especially at night).

Norms and deviations

It is customary to assess the final state of the bite after the change of non-permanent milk teeth to molars. Normally, the upper jaw protrudes slightly forward (one third of the length of the crown, no more), the teeth on top have close contact with the lower ones. There are no large gaps and crevices between the teeth; there should not be extra and unpaired teeth either.

A correct and healthy bite has several varieties, all of which are considered normal options. Incorrect bite is more diverse in manifestations:

• Distal. This is the most common malocclusion, which is diagnosed in babies with unstable teeth, and in children with molars. The upper jaw protrudes significantly forward, the ratio of all teeth is disturbed. At the same time, the upper jaw itself can often be developed to a greater extent than the lower one.
• Mesial. With this pathology, the lower jaw moves forward. It is usually developed stronger than the upper one. A child with such an overbite looks somewhat belligerent - the chin is pushed forward, upper lip sinks slightly.
• Open. With such a pathological bite, the teeth close completely. This is considered the most complex pathology.
• Deep. Due to the development of such a pathology, the upper incisors cover the lower teeth by more than a third of the size of the crown. This is a very common type of pathological bite among children.
• Cross. They say about such a bite when the upper and lower jaws are horizontally displaced relative to each other. The face of a child with such a pathology looks asymmetrical, the problem needs a long-term correction from the very beginning. early age.

Diagnostics

An experienced orthodontist can even tell you if there is a risk of malocclusion, check the condition of the upper and lower jaws in newborns. However, in practice this is usually not necessary. Therefore, many parents turn to this specialist in the direction of a dentist, who, during a routine or unscheduled examination, discovers one or another malocclusion in a child.

The orthodontist conducts an anthropometric study and finds out if there is asymmetry of the face. After that, the doctor makes casts from each jaw, and plaster models are cast on them in the laboratory. According to them, the doctor can tell with great accuracy (up to a millimeter) which teeth are displaced and how, whether there is twisting, where the most problematic places are located.

An x-ray makes it possible to find out what is inside the gums - how the teeth are formed, how the root canals are located. Only then does the doctor check how chewing is developed in a small patient, how the pathology affects speech, and whether the bite interferes with free breathing.

A separate discussion is worthy of the question of at what age a child should be taken to an orthodontist. Some say that it is better to do this at 5-6 years old, when the teeth begin to change to permanent ones. However, experts warn that noticeable malocclusion in a child of an earlier age is not a reason not to go to the doctor. The sooner the correction starts, the better: as long as active growth, the problem is corrected much faster and more efficiently.

Methods

Bite correction is usually a rather lengthy and laborious task. In modern medicine, several basic methods are used to cope with the problem:

• hardware treatment;
• Maxillofacial Surgery;
• myotherapy;
• combined methods (when using several methods at once - for example, the use of devices after surgery);
• non-invasive treatment.

Which method to choose is decided by the orthodontist (based on the results of the examination). About what the essence of these methods is, it is worth telling in more detail:

Hardware treatment

Special devices well help to cope with malocclusion in childhood. Such devices can be removable and non-removable, as well as mechanical, guiding and operating. Mechanical - this is the Angle apparatus and any bracket system. Guide vanes are mouthguards and overlays through which biting occurs. The existing devices, with the help of artificial obstacles, protect the teeth from pressure on them by the muscles of the cheeks. These include Shonher's records.

Removable plates are usually used to make the teeth grow straighter under the pressure of the temples, however we are talking only about the correction of the position of the jaws in relation to each other. The plates do not have a pronounced effect on the inclination of the teeth.

When the teeth of the little one are twisted, then instead of the plates, the orthodontist will offer to install a bracket system. When pain or changes occur in the temporomandibular joint, a special silicone splint is recommended for the baby, which fits snugly on the dentition and fixes them in a more or less normal position from a physiological point of view. The tire allows all nearby muscles and ligaments to "rest", relaxes them. From point of view modern medicine- the most effective are just such dental trainers (silicone removable devices).

Whatever device is prescribed to the child, parents should be prepared for the fact that the treatment will be long. For example, braces are worn for at least 1.5-2 years, and removable plates and mouth guards need to be worn not only during the day for a couple of hours, as many do. You will have to wear them almost all the time. Only such a responsible and consistent approach to therapy (as well as a patient attitude towards the treatment process) will help to cope with the problem of malocclusion once and for all.

Myotherapy

This is a very popular method of correction of pathological bite in the practice of orthodontists. It is a technique of specific gymnastics, which is aimed at the activation and development of certain jaw- facial muscles and muscle groups involved in articulation, chewing, making facial movements.

This method is usually used for babies with unstable teeth - from 3 to 6 years. At an older age, myotherapy does not show the desired effectiveness as an independent method.

If she is appointed, then only as helper method– while wearing the device or after surgery.

To each little patient the orthodontist prescribes an individual set of exercises, which directly depends on the type and degree of pathology. The most commonly practiced exercises are clenching the teeth in turn (upper jaw forward, lower jaw backward, then vice versa), strong clenching of the two jaws, tight clenching of the lips, holding a light flat object with the help of the lips - a ruler or sheet of paper. There is also a set of exercises for the tongue and cheeks.

Myotherapy will also require great patience and diligence from parents and the child, because the exercises will need to be performed systematically, as the muscles get used to the load, increasing this load and the duration of such “charging” to the feeling of muscle fatigue in the masticatory and facial muscles.

Surgical correction

Surgery to correct the bite in children is not required so often, but sometimes (especially in cases of complex congenital anomalies) you can’t do without a surgeon’s scalpel. Operations are aimed at shortening the arches or lengthening them, and sometimes even changing the size of the chin.

Surgical intervention is usually indicated only for adolescents who have not been helped by other methods (braces, plates, mouthguards). Children at the age of 2-3 try not to do surgery - injuries can occur due to such intervention.

Rehabilitation after such an operation is long and rather painful for the child, the risk of infection is high, which is why surgical correction they try to abandon in favor of longer, but more gentle methods of correction.

After surgery, the patient goes back under the control of an orthopedist, who will help to level the bite for a long time by using devices.

Correction of distal occlusion

Correction distal occlusion very long. It may take several years. At the same time, such a pathology is often complicated - signs of a deep bite are added to it. I am glad that the treatment started in childhood usually proceeds faster and brings the desired effect. The most common method is the installation of removable devices and simultaneous myotherapy.

Deep bite correction

To correct this pathology in children under 6 years of age, a large amount of solid food is prescribed. It is hard green apples and crackers that help the dentition get closer to normal. There is no other treatment until the age of six.

When the child turns six, if crackers and drying did not help, the doctor selects the necessary apparatus for the child (removable mouthguards, hard or soft plates, silicone trainers).

After 12 years, if the problem is not solved, the doctor puts fixed devices on the child. Simultaneously with treatment for all age categories a visit to a speech therapist and the use of myotherapeutic gymnastics techniques are shown.

Correction of the mesial occlusion

If such a pathological bite is detected in childhood, the child is prescribed to wear a mouth guard or a silicone trainer. If the degree of pathology is significant, then the child may be prescribed the wearing of special orthodontic caps with support for the chin. If these methods fail, the baby may have several lower teeth.

In the same way as with other pathologies of the maxillofacial apparatus, myotherapy exercises are prescribed.

To make the exercises easier for the child, dentists come to the rescue, who polish the prominent tubercles of the fangs.

The devices are usually worn up to 12-13 years. After this age, the orthodontist evaluates the result and decides on the need further treatment. If there is such a need, you can put on non-removable devices.

Prevention

• Even if the child does not visible problems with teeth It is advisable to visit the dentist at least once a year, beginning with one year old. This will help not only to eliminate all emerging inflammatory foci, but also in a timely manner to identify incipient malocclusion and proceed to their correction. The sooner this happens, the more effective the treatment will be.
• Everything should be treated in time respiratory diseases that lead to impaired nasal breathing - treat or remove adenoids, prevent chronic rhinitis. The habit of breathing through the mouth not only contributes to SARS, but also leads to the formation of a pathological bite.
• Young children must, according to the doctor's testimony, be sure give vitamin D, since rickets, which can develop due to a lack of this vitamin in the body, affects the condition of the jaw facial bones.
• timely need refuse pacifiers and bottle feeding. If the baby already has milk teeth, he does not need a nipple. Ideally, after a year, the child should drink from a cup, and at a year and a half, you should completely part with the pacifier. This will significantly reduce the risk of developing malocclusion.
• It is important to ensure that the child during the growth period has adequate levels of calcium in the body. In case of deficiency, you should definitely consult a pediatrician and start taking calcium supplements.

  About how to fix malocclusion see the next video.

Anomalies in the development of the jaw and facial bones are rare, but are among the pathologies that are difficult to correct. Open bite occurs in less than 5% of the population. It has a characteristic severe symptoms and develops in infancy and adulthood. Treatment of open bite in children and adults has a very good prognosis. The sooner signs of an open bite are detected, the easier and faster will be treated this disease.

The article will tell you how the anomaly is classified, what are the causes of its occurrence, give a list of signs of the disease for self-identification, and also tell you whether it is possible to correct an open bite in children and older patients. You will receive an answer to the question - how long will it take, which of the doctors treat open bite and how to effectively prevent the development of pathology and avoid serious complications.

What is an open bite?

An open bite is a vertical pathology of the development of the dentition, in which the jaw does not close completely in the area of ​​​​the anterior and lateral teeth. This type of bite interferes with the closing of the lips, which is why the mouth of a person with such an anomaly is always ajar. The anomaly affects not only appearance person, but also on his health. Improper development of the jaw and intermaxillary bones affects the quality of breathing, chewing food and swallowing.

Photo 1. Open malocclusion.

There is an open bite in adults and children, but only one that occurs due to rickets suffered in childhood is called true. All others are considered false or traumatic.

Open bite is classified according to several parameters:

The table shows various classifications malocclusion open type and their brief descriptions.

The main signs of an open bite

The most noticeable signs include severe deformation of facial features, asymmetry of the jaws, articulated movements, chewing disorders. Sometimes, in an effort to hide defects, patients tightly close their lips, but even despite these actions, upper edge teeth. The dental arches themselves narrow, making the face oval, elongated, especially in its lower third. Tooth enamel is often affected by caries.

Photo 2. Open bite compared to a physiologically correct bite.

When chewing food, the main work is done by the tongue, which contributes to the swallowing of chewed food, since the jaws themselves, especially with insufficient closure, are not able to chop food well. Swallowing also changes, becoming abnormal - infantile or infantile.

Sound pronunciation is disturbed, especially for deaf and hissing consonants, lip and lingo-labial sounds. In addition to speech disorders, there may also be respiratory disorders, which become oral. This causes irritation and dryness of the mucous membranes, and also contributes to the penetration of viruses and bacteria into the body.

Photo 3. Contacting an orthodontist will help to diagnose an open bite in time and start its treatment.

Only specialists - an orthodontist and a dentist - as a result of X-ray cephalometric analysis and orthopantomography, can correctly identify a developmental anomaly and make a diagnosis of "open bite". Doctors take a picture of the jaws and damaged soft tissues of the face, after studying which, the final verdict is made.

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Reasons for the formation of an open bite

Jaw deformity can occur for many reasons. It can be both congenital and acquired. Be the result of an injury or illness. The reasons for the formation of an open bite include external (exogenous) and internal (endogenous).

External causes

• constant same-type movements of the tongue, laying the tongue between the rows of front teeth;
• jaw trauma;
• thumb sucking and pacifiers that press on the oaks, deforming them and the jaw bones;
• irregular shape of the nipple;
• early loss of front or side teeth (less often - loss of teeth in adulthood);
• chronic mouth breathing.

Photo 4. The formation of bite and its correction makes sense to start in childhood.

Internal causes

• hereditary factors (if the family had cases of the formation of an open bite in parents, then this increases the chances of developing an anomaly in a child);
• maternal illness during pregnancy can adversely affect the formation of the fetus;
• atypical arrangement of the rudiments of the anterior or lateral teeth, which, growing, put pressure on the jaw bones and bend them;
• metabolic disorder, pathology hormonal system;
• underdevelopment of the intermaxillary bone due to rickets (it is this open bite that is called true);
• cleft in the alveolar process of the palate, distorting upper jaw and interfering normal growth teeth.;
• macroglossia (abnormal enlargement of the tongue that presses on the bones and teeth).

Open bite treatment methods

Correction of an open bite takes place in several stages and can take more than one year. Therefore, doctors strongly recommend preventing the formation of this anomaly, as well as conducting regular examinations and preventive actions in patients at risk. There are two methods: conservative therapy and surgical intervention. However, doctors make their choice in favor of combined treatment.

Photo 5. Bracket systems are effectively used in the treatment of open bite.

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Conservative treatment of open bite

The best thing conservative methods open bite treated early stages development and in childhood. So to get rid of bad habits, children are prescribed to wear special removable mouth guards, trainers and devices that help to correctly position the tongue in oral cavity. These pads also help adult patients with initial stage development of an open bite.

Photo 6. Removable devices can be chosen for the treatment of malocclusion.

Mimic exercises stimulate the development of facial muscles and allow for short term eliminate most functional disorders. Myogymnastics is also used in recovery period after the completion of bite correction. Exercise helps you get used to new form oral cavity, develop correct breathing and speech. And eating a large number solid foods that put stress on the jaw, increase muscle strength and form a correct bite.

Photo 7. There are various myotherapy exercises aimed at correcting an open bite.

Also, electrical muscle stimulation is often used both during and after treatment to correct facial signs of open bite.

Open bite correction in adults

Earlier treatment open bite in older patients required mandatory surgical intervention. Now the correction of this pathology does not always lead to surgical intervention. For the treatment of adult patients, non-removable devices are used, such as: braces, plates with flaps for teeth, Andresen-Goipl and Frenkel devices.

People who refuse treatment are expected to be very backfire. Due to open disocclusion, the symmetry of the face, the functioning of the muscles and the temporo-temporo- mandibular joint. Moreover, the owner of an open bite cannot breathe normally, swallow, close his mouth and chew food, as well as clearly pronounce words with large quantity hissing and voiceless consonants. Leaving everything as it is in this situation will be a big mistake, an open bite can and should be corrected!

Surgical treatment of open bite

Surgery applies only in case serious injury jaws and facial bones, complex pathologies and pronounced facial asymmetry.

Photo 8. Correction of an open bite surgically requires careful preparation.

First, orthodontists align the bite (install special plates that eventually turn the teeth in the right direction), cut the frenulum and remove extra teeth. After removing the braces, the result is fixed, and compact osteotomy is also performed - a small surgical procedure to breach the integrity alveolar processes teeth. This is necessary in order to weaken the resistance of the bone and simplify the procedure.

After surgical correction and complete healing, the patient undergoes a period of rehabilitation, which includes: speech therapy correction, restoration of functions chewing muscles, development and training of the jaw ligaments.

What is an open bite?

The simplest definition of an open bite is the presence of a gap between the upper and lower dentition with closed jaws. Another term that characterizes this condition is called disocclusion, in other words, non-completion of the upper and lower teeth. Depending on the area of ​​the dentition in which disocclusion is observed, there are distinguished: anterior, lateral, bilateral or unilateral open and malocclusion.

Depending on the main cause of this pathology, there are:

1) true disocclusion

• it occurs when the development of the jaws is disturbed.

2) false disocclusion

• it occurs when the dentition is deformed, but the size and position of the jaws is normal

Anterior open bite, photo

Causes of open bite

The main causes of open bite are, first of all, violations of the formation dental system in childhood, namely:

1. Sagittal (lateral) disocclusion is formed with an untimely change of the milk bite to a permanent one in the region of the lateral chewing teeth. There are gaps in which children stick their tongue and further displace the dentition.
2. Anterior (frontal) open bite occurs with prolonged thumb sucking or after an irregularly shaped nipple.
3. The increased size of the tongue shifts the dentition and prevents the upper and lower teeth from closing, which also separates the bite.
4. With problems with nasal breathing, the child has to move the tongue, and as a result, there is no closure of the upper and lower dentition.
5. With underdevelopment of the jaws in childhood, which occurs due to rickets, a true, jaw open bite is formed, which is very difficult to correct.

Lateral open bite, photo

Treatment of open bite in children

The tactics of treating open bite in children takes into account such parameters as age, the manifestation of anomalies, the presence of bad habits.

If the pathology of the bite is caused by rickets, then the correction and alignment of the dentition begins after the treatment of the underlying disease. After that, the child's personal oral hygiene is normalized and he is weaned from bad habits, especially from sucking fingers and pacifiers.

At the age of 4 to 7 years, an individual complex of facial myogymnastics is developed for the child, as well as physiotherapy is selected, in particular laser and magnetotherapy. Already at this age, when a changeable bite begins, activated plate devices with bite pads are used to inhibit the displacement of the front teeth outward. In particular severe cases use extra-oral appliances, with elastic traction to stimulate or inhibit jaw growth.

After the completion of the interchangeable bite - permanent bite, by the age of 14 - 15, braces are used to treat disocclusion. The most active this pathology treat external, metal braces.

In some cases, to correct this kind of pathology, the use of orthodontic aligners is acceptable. This is a more convenient method of treatment, but longer than using braces.

Open bite treatment in adults

In cases of false disocclusion, which occurs due to deformation of the alveolar processes and dentition, brect systems or aligners are actively used to treat adult patients. Depending on the specific clinical case Teeth straightening can start with braces and end with aligners. As a rule, a false open bite responds well to orthodontic treatment methods.

If the patient has a true open bite caused by jaw deformity, combined treatment is carried out using orthodontic surgery and a bracket system. This is required because the displacement of teeth with braces is limited and cannot always provide the desired result with a significant change in the size of deformed jaws.

How much does it cost to cure (correct) an open bite for an adult patient?

The cost (price) of open bite treatment on a turnkey basis in Moscow starts from 140,000 rubles for a bracket system. Under the promotion with a discount, prices for the correction of an open bite can be lower by 15-30%, depending on the volume of treatment.

What if open bite is not treated?

In order to evaluate possible consequences if you do not want to treat an open bite, you need to familiarize yourself with the list below:

1. With the existence of this pathology for 10 years or more, pathologies of the temporal mandibular joint develop, leading to clicking and pain when chewing and swallowing food, and subsequently to the inability to open the mouth.
2. The balance and tone of the masticatory muscles are disturbed, which leads to myalgia and provokes neuralgia of the facial nerve.
3. Phonetics is disturbed, lisping and slurred senile speech develop.
4. The aesthetics of the face is broken, an eternally surprised smiling face appears, like the movie characters of the actor Savely Kramorov.

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