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The Initial Challenge: An Open Bite and Muscular Hurdles
The patient first discovered our Dublin clinic through a Google search, presenting with her mother. She was deeply unhappy with a large 3mm median diastema (front tooth gap) and the fact that her upper and lower front teeth did not meet when she bit down.
A thorough specialist examination by Orthodontist Claire O’Sullivan revealed several significant clinical hurdles:
- Anterior Open Bite (AOB): A distinct gap between the upper and lower front teeth when the back teeth were closed.
- Tongue Thrust Habit: The patient had a myofunctional habit where the tongue involuntarily pushed forward against the front teeth during swallowing, which was the primary anatomical cause of the open bite and presented a high risk of orthodontic relapse if left unmanaged.
- Complex Occlusion: A localised crossbite on the upper right first molar and a scissors bite on the lower left quadrant.
- Congenitally Missing Tooth: A missing lower left second premolar (tooth 35) with a naturally resorbing baby tooth still in place.
To close the front gaps and ensure the teeth remained stable long-term, Dr Claire O’Sullivan designed and engineered a highly customised treatment strategy.
1. Correcting the Bite & Myofunctional Coaching (2020 – 2022)
We began by bonding fixed metal braces to both arches to align the teeth and systematically close the front spacing.
- Managing Habits: The patient and her mother were extensively coached on tongue posturing and myofunctional awareness. By training the tongue to sit away from the front teeth, we removed the forward pressure, allowing the bite to close naturally.
- Complex Bite Correction: To correct the crossbites and scissors bites, our team utilised precise structural adjustments, including specialised secondary wire bends, intermaxillary cross elastics, and box elastics to safely coordinate the upper and lower arches.
2. Artful Incisal Edge Contouring (Late 2022)
In the final stages of active alignment, the patient shared that she wanted her teeth to look completely even and flat along the biting edges. She was particularly unhappy with the prominent appearance of her natural mamelons (the ridges naturally present on the edges of newly erupted incisors).
To deliver an elite aesthetic finish, Dr Claire O’Sullivan used smooth Soft-Lex polishing discs to gently and painlessly contour the incisal edges of both the upper and lower front teeth. This artful sculpting trimmed away the uneven ridges, instantly giving the teeth a perfectly symmetrical, mature appearance. The teeth were beautifully de-bonded in late 2022.
3. Bespoke Dual-Retention Strategy
Because a tongue thrust habit carries an inherently high risk of relapse, our team implemented a robust, customised dual-retention system to protect her investment:
- The Upper Arch: A custom-made, durable Hawley retainer was paired with a fixed Nance appliance to hold the upper arch width and provide a physical reminder to help train the tongue position.
- The Lower Arch: A clear, custom-moulded Essix retainer was delivered to lock the lower alignment into place.
Real-World Success: Long-Term Stability in 2024
Orthodontic care requires vigilant long-term monitoring. In August 2024, after both of her retainers accidentally cracked, the patient promptly returned to our clinic. Ortho Laura Herbsta acted swiftly, taking fresh digital scans to manufacture a brand-new set of highly durable upper and lower clear Essix retainers, completely preventing any structural shifting.
In December 2024, the patient attended her routine retainer check-up and a preventative scale and polish with our hygienist, Estelle Farrelly. The clinical team confirmed perfectly stable orthodontic alignment, a beautifully closed bite, and healthy gums. With her treatment officially concluded, the patient happily signed our consent form to allow us to share her incredible transformation on Instagram!
The Specialist Advantage: Open bites caused by tongue thrusting are notoriously difficult to treat and stabilise. By combining precise fixed appliance mechanics, lifestyle coaching, artful cosmetic contouring, and a high-security dual-retention strategy, Dublin Orthodontist achieved a stable, beautiful outcome that standard alignment alone could not deliver.
Real-World Success: Long-Term Stability in 2024
Are you or your child struggling with gaps, an open bite, or specialized chewing difficulties? Our specialist-led Dublin team possesses the advanced training needed to correct complex structural issues and deliver radiant, lasting confidence.
