Dental overbites occur when the upper teeth protrude over the lower teeth by 30 to 50 percent. Medically, an overbite is referred to as a class II malocclusion.
There are two types of overbite:
While an overbite is either vertical or horizontal, some patients display signs of both. Overbites can also be defined as either dental or skeletal.
A dental overbite forms due to childhood habits that involve pushing the tongue against the back of the teeth.
A skeletal overbite is caused by irregularly shaped jaws and/or teeth, and is typically genetic. Skeletal overbites are often hereditary. Some people are born with malformed jaws that develop unevenly.
The most common cause of an overbite is the shape or size of the jaw and/or teeth. This may lead to little room in the jaw area or too little space to fit a person’s teeth. If left untreated, an overbite can lead to teeth crowding. Or, the teeth can grow crooked if there’s not enough room in the mouth. The teeth may also form gaps if the jaw is too wide.
In infants and children, habits like thumb-sucking, consistent pacifier use, and the overuse of drinking from a bottle may cause the tongue to push against the back of the teeth. This can lead to an overbite.
Habits such as chronic nail-biting and the chewing of writing utensils, like pencils or other objects, may also cause an overbite. These habits can be common in teenagers and adults.
Clear aligners are a safe and effective treatment for crowded teeth, gapped teeth, and some cases of overbites and underbites.
Losing teeth without a quick repair may also cause an overbite. Other causes include grinding and chewing of the teeth and temporomandibular joint dysfunction (TMD).
There are several overbite orthodontic treatment options available:
Braces are a popular treatment option for correcting an overbite. As part of the assessment stage, x-rays identify the overbite type and the relationship between the teeth and jaw.
The process involves fixing metal brackets to the teeth. The brackets then connect with wire to straighten teeth that are misaligned or crowded. A mouth is overcrowded when the teeth overlap significantly.
Once the teeth are straight, overbite treatment begins. Springs, coils, and rubber bands are set to the braces to help move the jaw with extra strength.
The elastic bands are removed before eating, drinking, and brushing your teeth. The bands must be worn at all times to ensure constant pressure is applied. Wearing the bands inconsistently can cause the teeth and jaw to ache more often.
During the final stage of treatment, a patient must wear a retainer or use a permanent wire to keep the teeth in place.
An overbite correction with braces can take anywhere from six months to two years. Most patients who undergo overbite correction with braces are children and teenagers. However, traditional braces are used for adults too.
The cost of braces usually depends on the type, treatment time, and the patient’s needs.
A braces overbite consultation usually costs between $275 to $300. Traditional metal braces can cost anything between $2,500 to $7,000. Ceramic braces are more expensive, costing between $4,000 to $8,000.
Dental insurance for orthodontic braces is required for children in certain states. However, insurance may only cover some of the fees for adults.
Coverage doesn’t consider whether the need for braces is for aesthetics or not. Most insurance companies cover treatment if the plan includes orthodontic benefits. However, they won’t pay for braces treatment if the coverage doesn’t have orthodontic benefits.
Clear aligners may fix overbites by applying constant pressure to the teeth. This power gradually moves the teeth into a better position, which also helps with the teeth' straightening.
Clear aligners can help mild to moderate overbites.
Individuals using clear aligners must wear their aligners for at least 22 hours a day. Trays must be worn during sleeping. They can only be removed for eating and oral health practices like brushing and flossing the teeth.
Patients receive new sets of aligner trays every few weeks. Each tray is worn for around two weeks to shift the teeth a small amount. After two weeks, patients must switch to the next tray in the treatment. The entire procedure can involve up to 26 trays, depending on the severity of the overbite. This would include one tray every two weeks for 12 months.
The cost of aligners depends on the brand chosen, treatment time, and how many trays are required. Many companies offer a payment plan option. This treatment plan allows patients to pay a deposit up-front, followed by smaller monthly payments.
Invisalign is one of the most popular brands that sells clear aligners. The cost of Invisalign is between $3,000 and $8,000. Invisalign is also usually the most expensive brand for clear aligners.
Smile Direct Club offers a more affordable option. These aligners cost $1,950 if paid in full. Smile Direct Club does not use direct dentist supervision, so it is not recommended for complex orthodontic cases like overbites.
If there’s a skeletal overbite, some extreme cases may require surgery. This surgery would reposition the jaw when braces or clear aligners are not enough to correct it.
Read our clear aligners vs braces comparison to learn which treatment is better for you.
Jaw surgery is otherwise known as orthognathic surgery. It corrects the relationship between the upper and lower jawbones. It also realigns the jaws and teeth to improve how they work. These corrections may also improve facial appearance.
Severe overbite correction surgery is often for adults. This is because their jaws are no longer developing or as flexible as children's jaws. Jaw surgery is not usually recommended for females under 16 years old or males under 21 years old.
In most cases of severe overbite surgery, patients wear braces on their teeth before and after the procedure. These braces cannot be removed until healing and alignment are complete.
Typically, an orthodontist works with an oral, jaw, and face (maxillofacial) surgeon for treatment.
Overbite surgery costs usually range between $20,000 to $40,000. Surgery for temporomandibular joint dysfunction can cost up to $50,000.
Patients with health insurance may have orthognathic surgery covered in some cases. Some insurance companies determine jaw surgeries to be medically necessary if the skeletal issues lead to sleep apnea, breathing difficulties, or severe speech impediments.
If the orthognathic surgery only improves a patient’s facial appearance or isn’t medically urgent, it is considered cosmetic.
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Khechoyan, David Y. “Orthognathic surgery: general considerations.” Seminars in plastic surgery vol. 27,3 (2013): 133-6, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805731/
Millett, Declan T et al. “Orthodontic treatment for deep bite and retroclined upper front teeth in children.” The Cochrane database of systematic reviews vol. 2,2 CD005972. 1 Feb. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491166/