Overbites: When Braces Are Needed, Symptoms, and Treatment Options

How big does your overbite have to be to get braces?

There isn't a single, rigid measurement or "magic number" for an overbite that definitively dictates the need for braces; rather, the decision is based on a comprehensive evaluation of its severity, the presence of functional issues, and potential long-term health implications.

Understanding Overbites (Deep Bites)

An overbite, clinically known as a "deep bite," occurs when the upper front teeth significantly overlap the lower front teeth when the jaw is closed. It's important to distinguish between a normal, healthy overlap and an excessive overbite. In a healthy bite, the upper front teeth typically cover about 30-50% of the lower front teeth. This slight overlap is functional, helping to protect the lips and maintain proper chewing mechanics. An overbite becomes a concern when this vertical overlap is significantly greater, often exceeding 50%, or when the lower front teeth bite into the gum tissue behind the upper front teeth.

When is an Overbite Considered Significant? (The "Measurement" Aspect)

While there's no universal threshold, orthodontists often use the following general guidelines:

• Normal Overlap: Approximately 1-2 mm, or covering about 30-50% of the lower incisors.
• Excessive Overbite: When the upper teeth cover more than 50% of the lower teeth. In severe cases, the lower incisors may not be visible at all, or they may even make contact with the gum tissue on the roof of the mouth (palate).

However, this percentage is just one piece of the diagnostic puzzle. A skilled orthodontist will also assess:

• Skeletal Relationship: The underlying position and size of the upper and lower jaws.
• Dental Relationship: The alignment and position of the teeth within each jaw.
• Facial Esthetics: How the overbite affects the overall facial profile and symmetry.

Beyond Measurement: Functional and Health Considerations

The decision to recommend braces for an overbite goes far beyond a simple measurement. Orthodontists consider the functional impact and potential health risks associated with the malocclusion. Even a seemingly moderate overbite might warrant treatment if it's contributing to problems. Key considerations include:

• Occlusal Trauma: When the lower front teeth bite into the gum tissue behind the upper front teeth, causing irritation, recession, and potential damage to the gums and bone.
• Excessive Wear: Abnormal contact between teeth can lead to premature wear of the enamel, particularly on the chewing surfaces of molars and the incisal edges of front teeth. This can expose the sensitive dentin and lead to increased tooth sensitivity, fractures, or even tooth loss over time.
• Temporomandibular Joint (TMJ) Issues: An improper bite can place undue stress on the temporomandibular joints, which connect your jawbone to your skull. This can lead to jaw pain, clicking or popping sounds, headaches, and difficulty opening or closing the mouth.
• Speech Impairment: Severe overbites can sometimes affect articulation, leading to lisps or other speech difficulties.
• Chewing Efficiency: An improper bite can make it difficult to chew food properly, potentially affecting digestion.
• Esthetics and Self-Confidence: While not a direct health risk, a pronounced overbite can significantly impact a person's smile and facial appearance, affecting self-esteem and social interactions.

Symptoms and Complications of Untreated Overbites

Individuals with an overbite that requires correction may experience one or more of the following:

• Jaw pain or stiffness
• Headaches or migraines
• Difficulty chewing or biting
• Speech impediments
• Gum irritation or bleeding behind the upper front teeth
• Visible wear on the front teeth
• Receding gums or bone loss around the lower front teeth due to trauma
• Clicking or popping sounds in the jaw
• Difficulty maintaining proper oral hygiene in crowded areas

The Orthodontic Consultation: What to Expect

If you suspect you or a family member has an overbite, the first step is to schedule a consultation with a qualified orthodontist. During this visit, the orthodontist will:

• Conduct a thorough clinical examination: This includes assessing the bite, jaw alignment, and overall oral health.
• Take diagnostic records: This typically involves dental X-rays (panoramic and cephalometric), photographs of the face and teeth, and dental impressions or digital scans to create models of your teeth.
• Discuss your concerns: You'll have the opportunity to explain any symptoms you're experiencing or aesthetic concerns you have.
• Formulate a personalized treatment plan: Based on all the gathered information, the orthodontist will explain the diagnosis, discuss the potential benefits of treatment, outline the recommended treatment approach (e.g., type of braces, duration), and address any questions you may have.

Treatment Options for Overbites

The most common treatment for an overbite is orthodontic correction using braces or clear aligners. The specific approach depends on the severity of the overbite, the patient's age, and other dental considerations.

• Traditional Braces: Consist of brackets bonded to the teeth and connected by wires, which are adjusted periodically to gradually move teeth into proper alignment.
• Clear Aligners (e.g., Invisalign): A series of custom-made, removable clear plastic trays that incrementally shift teeth.
• Functional Appliances: Sometimes used in growing children to guide jaw development and correct skeletal discrepancies.
• Orthognathic Surgery (Jaw Surgery): In severe cases, especially in adults where the overbite is primarily due to a significant skeletal discrepancy between the upper and lower jaws, surgical intervention may be necessary in conjunction with orthodontics.

Conclusion: Consulting an Orthodontist is Key

Ultimately, the decision to get braces for an overbite is a professional medical judgment made by an orthodontist after a comprehensive assessment. There is no specific millimeter or percentage that serves as a universal cutoff. Instead, it's about evaluating the functional impairment, potential long-term damage, and the patient's overall oral health and well-being. If you have concerns about an overbite, seeking an expert opinion from an orthodontist is the most reliable way to determine if treatment is necessary and what the most effective course of action would be.