The Mystery Around Posterior Open Bites

I'll talk about why they happen. Are they good or bad? And how to fix them?

Ok so I’ve been asked by many folks over the years “what do I do about my posterior open bite?”

Many of these folks were from the Starecta group and had seen old posts of mine from 2015-16. That was my Facebook group ‘golden period’ where I was posting almost daily hahaha.

So in this post i’m gonna give the low down on posterior open bites.

What is a ‘Posterior open bite’?

A posterior open bite is when your front teeth (incisors) touch but your back teeth do not. As in the picture above.

In a completely healthy mouth all teeth should ideally touch, but this doesn’t mean that it is absolutely necessary to have all teeth touching to be healthy.

I’ve had an open posterior bite for many years and for the past few years I’m improving very rapidly despite walking around with this open bite the whole day.

Why? Because I wear a myobrace at night that puts distance between my upper and lower teeth, thus keeping things in a stretch.

How do they occur?

In my experience posterior open bites occur pretty much anytime you wear an appliance between your teeth for an extended period of time.

It could be something like a dental splint, a nightguard, or perhaps you put composite on your teeth.

All of these things will create posterior open bites given enough time.

Is it good or bad?

I do not consider a posterior bite either good or bad.

They are a necessity as you improve.

Think about it.. if you’re like most people… your teeth should have perhaps extruded another 4-5mm in total. Like in this skull below.

And the rest of the body was biomechanically programmed to work optimally if that extrusion had occurred.

So if you want to stretch the entire body and skull out ‘as if’ you had the additional 4-5mm of dental height, than you’re going to have to have a gap between your teeth as you start to achieve it.

Because at this point your teeth are not going to grow that long.

Some folks think you absolutely need contact on the back teeth. For example Starecta believes in a ‘molar lever’.

I can say without hesitation that I think this is wrong.

NTI splints put contact on the front teeth

I used a splint with only frontal contact (like the NTI splint I show above) a couple years ago for months and I found that it stretched things out just like putting contact on the back.

There was absolutely no difference.

The key is in putting space between the upper and lower teeth without locking an occlusion.

Do you need to ‘fix’ it?

So this is a tricky question because my answer is yes and no.

So in my view you do not need to permanently fix an open posterior bite till you are at the end of your journey and are happy with your results.

Before that you just need to wear a nightguard or myobrace at night to give you support.

But you also should not sleep without supporting the open bite with something. ie. you should never try to let a posterior open bite close ‘naturally’.

If you do than your body and skull will accelerate through the natural collapse process that we like to call aging.

I’ve tested and observed this many times over the years. Latest one being when i slept with an open posterior bite for like 9 months in 2020 without wearing any appliance.

I would estimate that I aged at somewhere between 5-10x the normal rate. I looked HORRIBLE by the end of 2020 and functioned horribly too.

I was probably at the functional age of like 60 yrs old because i just couldn’t concentrate at all.

How do you fix it?

So when you want to permanently fix your posterior open bite, the best and easiest way to do it is to have a dentist put composite on your last lower molar on either side.

He should add enough so that you have a couple millimeters of gap between your front teeth with the only contact being in the back.

Also the composite should be flat. You do not want to lock an occlusion (ie. the upper and lower teeth should not come together in a fixed position).

Why? Because you want to continue to improve and thus your occlusion will continue to evolve.

I have used this same exact technique of flat composite height on my son’s teeth for over three years now. So i’m not talking from ‘theory’… i’m talking from the perspective of someone who was confident enough in how this works to use it on his now 10-year old son.

And my son has done amazing these past few years. Got rid of mouthbreathing, sleeps better, spacing between his teeth has increased considerably and his entire skull development has accelerated nicely.

But beyond me.. you have dentists using this type of flat composite on kids for decades now with consistently great results. For more information on that you should look up ‘Planas tracks’ and read the research around it like this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789147/

See yaaaaaaaaaa!