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FAQ:  Open Bite

Braces Removed - Open Bite Returns: I had braces as a child, had them taken off at 14 and everything was fine initially.

I'm 28 now and my open bite is back and what's worse I have awful pain in my jaw from grinding. I now see a doctor who is an expert in orofacial pain and he gave me a mouth splint to wear (at night).

I've been wearing and getting this splint adjusted for 1 year now but I'm still in alot of pain....continually. I also fear that my bite will continue to deteriorate.

I had a CT scan and it didn't show up any serious problems with my TMJs. Any advice? ...Visitor from NY

Open bites can come from many different reasons and some of the causes can be determined with a proper examination. Since we cannot examine you by internet (as of yet), I will just give you some common reasons for open bites that may give you insight to your particular concern. This is not meant to be a diagnosis.

An open bite is often considered to exist when the anterior teeth do not touch or have the top teeth overlap the bottom teeth and a person sees space between the teeth when they smile with the back teeth touching.

In a normal healthy occlusion (bite) the front 6 teeth do not touch when the back teeth touch (there is not a lot of space between them and the upper teeth overlap the bottom) when the lower jaw is moved forwards the front teeth touch and the back teeth do not (this is called anterior or lateral excursions depending upon the direction of the movement).

Causes of this type of open bite range from a shift in the teeth caused by:

1) A habit of tongue thrusting, thumb sucking, or biting on something that pushes the teeth out

2) Gum disease and bone loss (periodontal disease) which is a bacterial infection that causes the gums to get inflamed and the supporting bone to shrink away, eventually resulting in tooth loss. (this is the most common cause)

3) The teeth were naturally in that position and the results of the braces placed the teeth in an incompatible position for the lips and tongue, resulting in a relapse of the open bite. This is often a boney jaw misalignment and often is corrected with a surgical procedure.

Another concern may be that there is something happening in the jaw joint (TMJ) which is causing the Condlye (the lower jaws part of the joint near the ear) to shrink and get shorter. this can occur in fractures or other pathological conditions.

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