In this 2013 presentation, Dr. William M. Hang recounts a 1982–1983 clinical case of a teenage girl with a molar‑to‑molar open bite. Upon initial examination, Hang identified mouth breathing and large adenoids on radiograph as possible etiologic factors. He referred the patient to an ENT surgeon, who performed an adenoidectomy. Hang advised the mother to encourage the child to keep her lips together, promoting proper oral rest posture. Within a month after surgery, the open bite began to close, and by May 1983 the bite had resolved completely without any orthodontic appliances or jaw surgery. Hang followed the patient over the years, confirming that the bite closure was achieved solely through airway improvement and consistent lip‑seal posture. The case illustrates the potential for non‑surgical, posture‑based interventions to correct certain malocclusions, emphasizing the role of adenoids and oral rest posture in orthodontic treatment planning.
Chapters
Here then is a patient that I saw in 1982 when I— after I just learned where the adenoids were on an x-ray. Didn't know that. So I got back and I saw this girl. She's got a molar-to-molar open bite from here to here, and I said to the mom, gee, does she breathe through her mouth or through her nose? As if I— now I'd know when she walked in the door. I'm 16. Oh, she breathes through her mouth. Well, I've been to a course where they said that adenoids may have something to do with this. I took an x-ray, she had large adenoids. I then referred her to an ENT. He took the adenoids out, and I told the mother, she's gonna require jaw surgery. An open bite like this requires jaw surgery, but we don't do that till you're done growing. Fine. So, they went and did the adenoids, and about a month after that, in February of 1983, Her mom called and said, well, we'd like to go do the jaw surgery. And I said, well, wait, wait, sorry, you may not have understood. We don't do that until she's done with her growth. Well, could we at least meet the surgeon so we could plan for it? And I said, hey, great. So, I referred them to the surgeon. They went and met him, and this is like May, by the time that— May of that year when they got there. And the surgeon writes me a note and says, Bill, she doesn't have an open bite. And I— I thought, no, no, no. So, I had to get her in. So, she walks in, in May of 1983, and this has turned into this. And I've kept up with this girl. I never put her in braces, never did a darn thing. But I took some more pictures of her later on, and I said to her, so, tell me about it. I've had some patients who've had adenoids taken out, and we've had a nice improvement like you did, but a lot of them that didn't. And she said, well, I don't know. When I came to you, I couldn't keep my lips together. My mom was always on my case to keep my lips together, but I couldn't. After I had my adenoids out, my mom was telling me to keep my lips together, and I learned to do that. So, her bite closed from here to here, all by keeping her lips together. This then is what she went from there to there. No treatment, no surgery, except proper rest, oral posture.
