After Developing a Posterior Open Bite from Invisalign Treatment, the Doctor Recommended Doing Crowns, is This Correct?

Invisalign caused me to have a slight posterior open bite on both sides from my bicuspids to my molars. The doctor wants to charge me to do bonding on 12 teeth to stabilize the bite, and then do crowns on all 12 teeth. This seems drastic, and very costly. The bonding is 1100 and the crowns will cost me about 8000. Is this the most effective way to treat an open bite?

Doctor Answers 7

Posterior open bite after invisalign

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This can happen, especially in clenchers due to the thickness of the plastic between the back teeth.  The aligners should be cut behind the canines and allow the back teeth to re-erupt and settle.  Please do this with your dentist's supervision.  Do not have crowns placed to correct this.

Ontario Dentist

Absolutely do NOT do Crowns to correct open bite after Invisalign

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It is possible to develop a small posterior open bite after invisalign however you can correct this by doing a refinement with invisalgn to intrude the front teeth and tighten up the posterior bite. The refinement should be included in the intial invisalign treatmet.  If the open bite is not too big you can also cut off the back part of the aligner or retainer to allow the back teeth to erupt a bit. This may happen anyway once you are wearing your retainers only at night. You can also do a bite adjustment of the front teeth to get the back teeth to touch. You can do a combination of all these, but do NOT allow the dentist to grind on your teeth to make crowns on what I would assume are healthy teeth. If the teeth are broken down and need  crowns anyway, then that is a different story.

Your gut instinct is right, this is not only drastic but inapropiate and malpractice( based on the limited information given). I would seek another opinion. Your dentist is either incompetent or unethical.

Good luck

Dr. T


Mauricio C. Tijerino, DMD
Miami Beach Dentist

Teeth not touching on back teeth after Invisalign

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The thickness of the plastic that covers the teeth can cause your back teeth to push up (intrude) into the bone because your jaw is on a hinge and the back teeth will come together first when you are wearing Invisalign aligners.  This should not be corrected with crowns in my opinion.  It should be corrected by making an adjustment to the Invisalign first.  If that is not successful then I would recommend treatment with braces as an alternative but not crowns.  

John Budd, DDS, MS
Phoenix Orthodontist


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I just saw another posterior open bite from Invisalign last week. Patient is very unhappy with situation and seems to be contacting mainly just on upper left second molar.  Another office did the treatment for a front tooth that was displaced in a softball accident.  The treatment apparently  did not work entirely well, got rather long with more aligners, and now patient has a posterior open bite and can not chew properly.  I took a cone beam CT scan and bite is clearly open in front and back.  The condyles look OK with reduced joint space left.  Don't know how long it has been that way.  I suggested it may be possible posterior intrusion or a possible change of jaw/bite position due to lost neurologic sense of where to bite (engram) ??   I suggested that she stop wearing aligners and try to give teeth time to re-erupt  and/or for the bite to adapt but patient is seeking other opinions also. 

I would not recommend crowns as time and adaptive capacity might be able to improve the situation, I would at least try that before other interventions.

Clark L. Jones, DDS, MSD
Phoenix Orthodontist

Do NOT Get Crowns Placed for Posterior Open Bite

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 A Slight Posterior open bite may occur with invisalign, but should be easily corrected by relieving the final alignerer or retainer.  If the open bite is too large for this then something needs to be corrected orthodontically.  Cutting down healthy teeth to close and open bite is probably the last resort after all else fails. You should definitely question someone willing to place 12 crowns just to correct this.  Also $8000 for 12 crowns is VERY low which also sends a red flag.  Please seek the advice of a Board certified Orthodontist before you go through any other treatment, having crowns placed may cause serious issues with your bite and teeth which will haunt you for years to come.

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon

Crowns or braces will correct an open bite

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To fill the space, it can be done quickly with porcelain crowns or onlays, or braces (brackets and wires, NOT Invisalign).  


$8000 for 12 crowns is EXTREMELY low, so I would suggest a second opinion as well.

Invisalign and a Posterior Open Bite

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Invisalign is meant to improve your bite, not worsen it. I'm surprised you first developed the posterior open bite AFTER the Invisalign. You should see a dentist experienced in occlusion before going any further. A dentist that can do 12 crowns for $8000 is not going to be able to properly diagnose and treat your occlusion.

Jay Neuhaus, DDS
New York Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.