What is reverse bite? Causes and treatments

Backbite is a malocclusion that affects aesthetics and function. In severe cases, backbites can cause sunken cheeks, with a face pattern known as a “bulldog face”. Not only does it affect the appearance, it is also one of the “most serious” conditions that can occur in the jaw, teeth and face. An underbite is known as a “bad bite” because it can be harmful not only to your oral health but also to your overall health. Backbiting can cause many serious dental complications. It is therefore most important to treat this condition as soon as possible. The examination and appropriate treatment options need to be discussed carefully with the dentist.


1. What is a reverse bite?

Overbite is a malocclusion that often occurs in class III malocclusions. People with an overbite have the lower jaw protruding first. The lower incisors are in front of the upper front teeth. In a normal bite, the upper incisors should overlap the lower teeth slightly. 

What is reverse bite?  Causes and treatments

Backbiting causes the facial structure to change. Chin protrudes more forward. Usually people refer to this condition as “swallowing”.

What is reverse bite?  Causes and treatments

Overbite (left) versus normal bite (right)

2. Classification 

There are two types of backbites:

  • Due to teeth 

A backbite is caused by a tooth formed due to a misaligned tooth. This condition is usually caused by a cross bite. A cross bite occurs when some of the lower teeth are outside the upper teeth when the jaws are closed.

Crossbites are more common in the anterior teeth than in the posterior teeth. Anterior crossbite occurs when several teeth are tilted slightly forward. But the entire lower jaw is not forward (outward).

  • Due to bone

A bony backbite is caused by an abnormality of the jawbone. This type of malocclusion is often hereditary (present at birth). In some cases, the cause of a backbite may be jaw deformity (bone), misalignment (tooth) or both.

3. Causes of backbite

The main causes of backbite include:

  • Heredity (main cause)
  • Tongue push
  • Thumb sucking as a child
  • Baby pacifiers (suck on more often and longer than usual)
  • Long-term bottle feeding (infant)
  • Face and jaw trauma
  • Jaw bone tumor

3.1 Genetic factors

Heredity is a factor that can affect the structure and development of the jawbone as well as the arrangement of teeth. Children can inherit traits such as long lower jaw, short upper jaw or misaligned teeth. This can lead to backbite from an early age.

Other genetic conditions can cause a backbite, such as:

  • Treacher Collins Syndrome
  • nevoid . basal cell carcinoma
  • Big head
  • Severe Binder Syndrome
  • Geroderma osteodysplastica
  • Rabson-Mendenhall . syndrome

3.2 Habits of childhood

Certain habits in childhood can increase a child's chance of developing an overbite later in life, such as:

  • Thumb sucking
  • Using a pacifier after the age of 3
  • Extended bottle feeding
  • Tongue push

3.3 Physical trauma

A fractured jawbone with improper healing can lead to a backbite. Even if the broken jaw has been operated on; if the recovery fails can also lead to this condition.

3.4 Tumors

A cancerous or benign tumor, including those caused by nevoid basal cell carcinoma, can cause the jaw to protrude.

3.5 Cleft lip or palate

People born with a cleft lip or palate often develop a backbite.

4. Overbite versus backbite

Overbites occur when the upper incisors protrude too far relative to the lower incisors. This is the opposite of a reverse bite. Common in class II malocclusion. Although this type of malocclusion is common, it is less common than in Class I malocclusion (crowded teeth).

5. Complications of untreated backbite

If left untreated, a backbite can lead to jaw and dental problems over time. Even causing severe pain. Common complications of untreated backbite include:

  • Increased risk of tooth decay

Backbiting increases the risk of enamel damage due to the severity of the misalignment. Misaligned teeth increase the likelihood of causing grinding, causing tooth enamel to wear away. In addition, the ability to maintain oral hygiene is also reduced. Therefore tooth decay is more likely to develop.

  • Sleep apnea, mouth breathing and increased snoring

Uncorrected backbite can lead to sleep apnea, mouth breathing, and excessive snoring. Obstruction in the upper airway during sleep causes disturbances, resulting in intermittent breathing that stops and continues during sleep.

This condition is more common in deep bites than in reverse bites. However, they can occur in an open bite if the cause of the open bite is an abnormally small upper jaw and narrow airway.

  • Temporomandibular disorder (TMD)

If left untreated, backbite can lead to temporomandibular joint and muscle disorders (TMJD). Temporomandibular disorders lead to musculoskeletal dysfunction related to the functioning of the masticatory system and cause pain sensation. People with TMJ disorders experience different types of pain. Such as headaches, ear pain, and discomfort when opening or closing the jaw.

What is reverse bite?  Causes and treatments

Backbiting causes temporomandibular disorders, which can be painful

Other complications of untreated backbite include:

  • Difficulty speaking (slurred speech and stuttering), chewing food, and swallowing.
  • Increased risk of developing gum disease.
  • The structure of the mouth and smile changes.
  • Uneven or crooked teeth.
  • Bad breath, even after brushing or rinsing with mouthwash.
  • Poor mental health and low self-esteem.
  • Increasing demand for invasive jaw surgery.

6. Reverse bite treatment

Backbites are common in children and adolescents. Although, the misalignment usually resolves once the permanent teeth have fully erupted. If you are concerned that your child may have a true backbite, take him or her to the dentist to see if treatment is necessary.

Treatment for backbite depends on the age of the patient and the severity of the deviation:

  • Reverse bite in infants compared with children and adults

If a child is born with a severe backbite, a growth regulator helps to position the child's jaw accurately early on. Some deviations form due to birth defects, such as cleft lip and cleft palate. In this case, the sooner the treatment is given, the less likely surgery is to be required later.

If the condition is not too severe or does not appear at birth, orthodontists recommend waiting until the child is seven years old to seek treatment. Around this age, baby teeth fall out and permanent teeth begin to erupt.

If the bite is not corrected in childhood, it is likely that other dental problems and jaw problems will develop in adulthood.

Adults can still have treatment, but options are limited because the jaws and teeth are fully developed. Depending on the patient, surgery is often necessary in adulthood.

Common treatment options include:

  • Tooth extraction

Extracting baby teeth is a popular treatment option for infants and children. Extract the tooth early to make room for the permanent teeth to align. Orthodontists try to avoid extracting adult permanent teeth. But in severe cases, treatment may be needed to give the teeth enough room to move.

  • Braces

Braces are often the best treatment option for young children, adolescents, and some adults. Braces help achieve both aesthetics and function, not only helping to correct your smile but also helping to realign your molars. Braces last from 18 months to three years.

See more Braces - Learn about today's popular orthodontic methods

  • Recover

In cases where the degree of backbite is mild and the cause is dental, a treatment that reconstructs the right shape and position to create a better bite for the patient is applied. The mandibular incisors will be restored to their new position by suitable restorations.

  • Surgery

Jaw surgery (orthopedic surgery) is a treatment option that may be required for backbites in older patients or those with severe backbites. Usually, maxillofacial surgery is applied in combination with orthodontic treatment. Jaw surgery can reposition your upper and lower jaws and create appropriate occlusal patterns in severe cases of protrusion. Each surgery is different and tailored to each patient. The typical recovery time for cleft palate surgery is 10-12 weeks.

7.Frequently Asked Questions

  • What is the best age for reverse bite treatment?

The short answer is: the sooner the better. As soon as you receive oral development abnormalities in your child, consult your dentist. This early intervention can prevent the need for orthodontic treatment or surgery. Otherwise, traditional treatments are most effective between the ages of 5-10.

  • Can backbite be treated even as an adult?

It is never too late to treat this condition. Treatment can reverse many painful complications and low self-esteem in life. Treatment in adults has been shown to be successful in many cases.

As noted above, a backbite is a serious malocclusion. It not only affects oral health, whole body health; It even makes you feel self-deprecating and guilty because of your appearance. Treating a backbite is essential. Ideally, the child should be treated as soon as possible. However, it is never too late to fix this situation. Although the treatment in adults is more complicated and difficult, it will definitely help you improve your life a lot. Visit your dentist immediately for advice and understanding of the condition; as well as choosing the right treatment for your backbite.

Doctor Truong My Linh