13 Anterior open bite
Gerald is 11 years old. He presents with no contact of his incisor teeth (Fig. 13.1). Identify the cause(s) and discuss the treatment options.
Gerald complains that his front teeth do not meet. This embarrasses him when eating as he cannot bite into food. His parents are also concerned by this and by lisping during speech, which they attribute to the position of his front teeth. They are anxious for treatment.
Gerald’s parents report that his primary incisors did not meet either, but the space between the upper and lower permanent incisors appears to have increased in the past year. His lisp has also become more noticeable. He has no history of thumb or digit sucking.
Gerald’s facial profile is shown in Figure 13.2. What do you notice?
What occlusal anomalies are associated with speech problems? Are the latter likely to resolve if any underlying malocclusion is treated?
Although speech problems are associated with incisor spacing, Class II division 1 malocclusion, Class III malocclusion and anterior open bite, they do not occur in all individuals with these occlusal anomalies. Furthermore, correction of these occlusal problems is no guarantee that the associated speech problem will resolve satisfactorily. Where sibilance is judged to be marked, referral to a speech therapist would be prudent, although treatment may do little to mitigate the defect.