Understanding Different Types of Bites in Children: What to Know About Orthodontics

"Dad, my teeth bump into each other in a funny way when I close my mouth."

These innocent observations often give us the first hint that our child might have a bite issue. As we track their height and development milestones, understanding how their teeth fit together is another important aspect of their growth journey.

A proper bite, how upper and lower teeth align when the mouth closes, affects far more than appearance. It influences how our children eat, speak, and even develop their facial structure. Early identification of bite issues can affect treatment simplicity and outcome.

Why Bite Alignment Matters

When teeth don't come together correctly, the effects can ripple through various aspects of your child's health and development:

Their teeth may wear unevenly, creating weak spots vulnerable to decay; chewing efficiency can decrease, affecting nutrition and digestion; speech development might be impacted, especially certain sounds, and jaw joints can experience unnecessary stress, potentially leading to discomfort. Not to mention, self-confidence may be affected as children become more aware of their appearance.

Let's explore the common bite patterns that dentists and orthodontists look for during checkups and what they mean for your child's dental future.

Overbite: The Most Common Variation

An overbite occurs when the upper front teeth extend too far beyond the lower teeth when biting down. While a slight overbite is perfectly normal (and even desirable!), an excessive one can create challenges.

Think of your child's teeth like book pages that should align neatly when closed. With a significant overbite, the top pages extend too far beyond the bottom ones.

Many children inherit overbites from their parents, while others develop them through habits like prolonged thumb-sucking or extended pacifier use. Beyond aesthetics, pronounced overbites can lead to excessive wear on lower teeth, increased risk of injury to protruding front teeth, and sometimes even gum irritation where lower teeth might contact the roof of the mouth.

Treatment typically begins in the elementary or early middle school years, often involving braces to guide teeth into better alignment. In some cases, special appliances help grow the jaw in favorable directions for growing children.

Underbite: When Lower Teeth Lead the Way

Unlike the common overbite, an underbite presents a more noticeable variation in which the lower jaw extends beyond the upper jaw, causing the lower front teeth to sit in front of the upper teeth when the mouth closes.

Children with underbites often have a distinctive facial profile and may experience challenges with certain speech sounds and biting through foods like sandwiches. This bite pattern frequently has a strong genetic component — if you or your partner had an underbite, your child might be more likely to develop one.

The good news is that early intervention can make a significant difference. Orthodontists often recommend evaluation around age 7-8 for children showing signs of an underbite. Early treatment might involve special appliances to guide jaw growth, while older children might require comprehensive orthodontics and, sometimes, surgical correction after growth is complete.

Crossbite: The Misaligned Bite

Imagine railroad tracks that should run parallel but instead cross over each other at certain points — that's what happens in a crossbite. Some upper teeth sit inside the lower teeth when biting down (rather than outside as usual).

A crossbite can affect just a single tooth or groups of teeth, and it often causes the jaw to shift slightly to one side when closing. This misalignment can lead to uneven jaw development, asymmetrical facial appearance, and uneven wear on the affected teeth.

Children with crossbites often benefit from early treatment, typically involving palatal expansion to widen the upper jaw. This creates the proper foundation for teeth to align correctly as they develop and erupt.

Open Bite: When Teeth Don't Meet

When back teeth are closed together, an open bite creates a gap between the upper and lower front teeth. It's as if an invisible barrier prevents the front teeth from meeting.

This condition frequently develops from:

• Extended thumb-sucking or pacifier habits
• Tongue thrusting (pushing the tongue against teeth when swallowing
• Airway issues that lead to mouth breathing

Children with open bites often struggle with biting through foods like sandwiches and may develop noticeable speech patterns, particularly with "s" and "th" sounds. Many parents first notice open bites when their child's speech development differs from that of peers.

Treatment approaches vary based on the underlying cause. Breaking habits like thumb-sucking is essential, sometimes with the help of special reminder appliances. Myofunctional therapy might help correct tongue placement and swallowing patterns, while orthodontic treatment addresses tooth positioning.

Severe Crowding: Too Many Teeth, Too Little Space

Unlike the other bite issues that involve how upper and lower teeth meet, crowding occurs when there simply isn't enough room in the jaw for all teeth to align correctly. Think of it as trying to park too many cars in too few parking spaces—some end up crooked, overlapped, or pushed out of line.

Crowding worsens as children grow, and their permanent teeth (larger than baby teeth) erupt into limited space. This can make brushing and flossing difficult, increasing the risk of cavities and gum problems.

Many children with crowding benefit from two-phase treatment:

1. Early intervention to create more space through expansion
2. Comprehensive orthodontics once most permanent teeth have erupted

In some cases, the strategic removal of certain teeth may be required to create adequate space for the proper alignment of the remaining teeth.

Deep Bite: The Excessive Overlap

A deep bite occurs when upper front teeth overlap the lower teeth excessively in the vertical dimension, sometimes so much that the lower teeth nearly disappear when biting down, potentially contacting the gum tissue behind the upper teeth.

Children with deep bites often show excessive wear on their front teeth over time. Since this bite pattern can place extra stress on jaw joints, they may also develop temporomandibular joint (TMJ) issues as they grow.

Correcting deep bites typically involves specialized orthodontic techniques that help intrude (push up) the front teeth and/or bring the back teeth into better contact. This rebalances the bite and reduces excessive pressure on the front teeth.

Additional Bite Considerations

Airway and Breathing Patterns: Growing awareness of how breathing affects dental development has revolutionized how we approach bite problems. Children who primarily breathe through their mouths (often due to allergies, enlarged tonsils, or nasal obstruction) frequently develop narrow upper jaws, high palates, and various bite issues.

If your child shows signs of chronic mouth breathing — sleeping with their mouth open, snoring, or always seeming to have their lips parted — consider this an orthodontic warning sign worthy of evaluation.

Jaw Growth Patterns: Sometimes, bite issues stem from discrepancies in how the upper and lower jaws grow together. Your orthodontist will evaluate whether your child's bite concerns relate primarily to tooth positioning or underlying skeletal patterns, as this distinction guides treatment approaches.

Finding the Right Time for Treatment

Orthodontists recommend an initial evaluation around age 7 when enough permanent teeth have come in to identify potential problems while growth can still be guided. However, the ideal treatment timing varies by condition:

• Crossbites and underbites often benefit from early intervention (ages 7-10)
• Overbites and crowding might be addressed in the mixed dentition phase (ages 9-12)
• Some conditions are best treated after most permanent teeth have erupted (ages 11-13)

Many children benefit from a two-phase approach:

1. Early intervention to address growth and development concerns
2. Comprehensive treatment once all permanent teeth are present

What Parents Can Watch For

You can be your child's first line of defense by watching for these potential warning signs:

• Difficulty biting through or chewing certain foods
• Teeth that look noticeably crowded, protruding, or misaligned

• Speech challenges that persist beyond the age when sounds typically develop

• Mouth breathing or snoring
• Jaw shifting, clicking, or discomfort when chewing
• Early or late loss of baby teeth
• Thumb-sucking or pacifier use beyond age 4

The Journey to a Balanced Bite

Understanding your child's unique bite pattern is the first step toward ensuring they develop a healthy, functional smile. Today's orthodontic approaches focus on straight teeth AND creating proper bite relationships that support the overall smile, comfortable function, and long-term dental health.

The journey from identifying a bite concern to achieving optimal alignment might span several years and stages of treatment. Still, the investment pays lifelong dividends in dental health, function, and confidence.

If you've noticed potential bite issues in your child, an evaluation with an orthodontist can clarify what's happening and whether intervention would be beneficial. With today's diverse treatment options — from traditional braces to clear aligners and growth modification appliances — orthodontic care can be tailored to your child's specific needs and lifestyle.