Tongue Behavior in Anterior Open Bite-A Narrative Review

Background/Objectives: Multiple factors may contribute to the development of open bite malocclusion, including genetics and environmental factors. Anterior open bite is usually related to the interposition of the tongue between the dental arches during swallowing or at rest. But how important is the role of the tongue in the development of anterior open bite? And how does anterior open bite malocclusion influence tongue behavior? With this study, we would like to offer a better understanding on the importance of tongue function in the context of this malocclusion. Methods: In this narrative review, a comprehensive electronic search was conducted via PubMed, Google Scholar, and ScienceDirect. The inclusion criteria were original research articles published between 2014 and 2024 with full text access. The exclusion criteria were articles older than 10 years and articles with restricted access or without full text access. Results: Out of the initial 1231 articles, 9 articles were found to be eligible for the present study. The tongue is a part of the neutral zone of the oral cavity, together with the lips and cheek musculature, forming a corridor of equilibrium. If this neuromuscular balance is altered, the teeth will move out of the neutral zone, and various malocclusions may develop. Patients with anterior open bite experience difficulties in closing the anterior portion of the oral cavity during swallowing; therefore, adaptative changes occur in an attempt to compensate by changing the dynamics of the tongue. Conclusions: The cause-effect relationship between tongue malfunction and anterior open bite remains controversial. This review article mentions the possible role of the tongue in anterior open bite etiology, but evidence is still needed on this subject, as it is yet unclear whether the influence of the tongue is a primary cause, an influencing factor, or just a consequence of an already-existing vertical occlusal pathology.