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Open bite is a difficult orthodontic problem, and treatment with braces, dental extractions and even surgery may be required to correct open bite malocclusion. Open bite occurs when it is impossible to close all of the teeth together at once. It may occur on the back or front teeth, and may arise from an early age. It is caused by anomalous skeletal growth, digit sucking habits, a large tongue or postural positioning of a normal size tongue during speech or swallowing and occasionally as a result of pathological destruction of the jaw joints, or failure of teeth to grow normally. Treatment is undertaken in children and adults and invariably requires some type of orthodontic appliance but speech therapy may also be of value if a speech defect (lisp) is present.