Deep bite – detailed

Trauma to palatal mucosa

• A deep bite with significant eruption of the lower incisors can lead to a pathologic trauma to the palatal mucosa. If untreated, mucosa stripping and loss of incisors can result.
• Because of the damaging nature of this occlusion, early treatment is indicated.

Trauma to upper or lower incisors

• A deep bite can result with excessive occlusal forces on unfavourable incisor surfaces. This can lead to excessive dental wear and is indicated for treatment.
• Early treatment is indicated, particularly if a Class III incisor relationship is the cause of the deep bite trauma.

Trauma to palatal mucosa

• A deep bite with significant eruption of the lower incisors can lead to a pathologic trauma to the palatal mucosa. If untreated, mucosa stripping and loss of incisors can result.

Trauma to upper or lower incisors

• A deep bite can result with excessive occlusal forces on unfavourable incisor surfaces. This can lead to excessive dental wear and is indicated for treatment.

Aesthetic concerns of increased gingival display

• Excessive incisor eruption associated with a deep bite malocclusion can lead to increased gingival display. If this is the cause of the gingival display, deep bite correction via incisor intrusion is indicated.

Severity of the deep bite

• There is no strict guideline on the severity of a deep bite to treat/refer.
• IOTN (Brook and Shaw 1989) rates an overbite >3.5mm as mild to moderate need and an overbite with contact on the palatal tissues as a severe need of treatment/referral.

Associated problems requiring treatment

• Deep bites are often associated with a skeletal Class II malocclusion and a brachyfacial (short facial height), however it can be also associated with a lack of posterior eruption and/or over-eruption of incisors. These may require orthodontic treatment.