10 year old girl patient presents to the clinic with concern for the outward appearance of teeth. Her mother mentions that  she had been indulged in thumb sucking till the last year. On clinical examination, protrusion of maxillary incisors and spacing between maxillary anterior teeth. All of the following features will be seen, EXCEPT
The anterior open bite associated with thumb-sucking arises by a combination of interference with normal eruption of incisors and excessive eruption of posterior teeth. When a thumb or finger is placed between the anterior teeth, the mandible must be positioned downward to accommodate it. The interposed thumb directly impedes incisor eruption. At the same time, the separation of the jaws alters the vertical equilibrium on the posterior teeth, and as a result, there is more eruption of posterior teeth than might otherwise have occurred. Because of the geometry of the jaws, 1 mm of elongation posteriorly opens the bite about 2 mm anteriorly, so this can be a powerful contributor to the development of anterior open bite.
The child with a persistent digit-sucking habit that results in an open bite typically exhibits a convex profile with hypotonic upper lip, lower lip hypertonicity with marked mentalis muscle activity, and tongue-thrusting. These patterns maintain and possibly intensify the developing anterior open bite and overjet discrepancy.
NOTE: The hyperactive mentalis activity produces puckering effect in chin termed as “Golf ball appearance of chin”.
Anterior open bite
Excessive eruption of posterior teeth
Normal eruption of central incisors
Golf ball appearance of chin