Hello all of my wonderful TMJoiners! I’m Priya Mistry the TMJ doc and today I’m going to talk
to you guys about an anterior open bite. What is an anterior open bite? What are the most common
causes for anterior open bites? And what does an anterior open bite have to do with TMJ Disorders?
Watch this video until the end for the answers to these questions and more!
That being said, if you’re looking for more information on TMJ Disorders for yourself or for
a loved one, then this is the YouTube channel for you. Be sure to hit that Subscribe button
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out! I post a new informational video every Friday for people who are suffering from TMJ Disorders
or just for people who are looking for more information in general.
If you don't know who I am, I’m a general dentist with a practice in Vancouver,
Washington where we are dedicated to taking care of patients with TMJ disorders.
So let’s get right into it! Let’s start by defining an anterior open bite. "Anterior"
means forward or “near the front” - so in this case, it’s referring to the front teeth.
"Open bite" means that the upper and lower teeth are not
touching. So an anterior open bite means that the teeth in the front are not touching, while
the teeth in the back are touching or meeting each other. In an ideal bite, all the teeth front and
back should touch each other to distribute the forces of speaking and chewing evenly.
What causes an anterior open bite? Well, there are two main causes so let's start by talking about
the first one . The first main cause is a tongue thrust. What is a tongue thrust? A tongue thrust
is when you push your tongue between your top front teeth and your bottom front teeth
when you go to swallow [OR AT REST]. If you have a tongue thrust or if you swallow that way,
you may be thinking “well, doesn’t everyone swallow that way?” And the answer is NO! There
is a correct way to swallow, a correct swallow pattern. The correct way to swallow is with the
tongue up against the roof of your mouth, and as the food is pushed further back towards the
esophagus, the tongue moves up against the roof of the mouth in a wave-like motion,
with the tongue making contact ONLY with the roof of the mouth throughout the entire swallow. So go
ahead and gather up your saliva, dear watchers, and before you swallow tell yourself to really
observe and be aware what your tongue is doing when you swallow. Does it thrust forward?
Does it go up against the roof of the mouth? Now go ahead and swallow and I'll do the same thing.
When when I swallow, the tip of my tongue touches the soft tissue behind my front two teeth,
and as the saliva goes further back into my mouth - as I continue to swallow - the
rest of my tongue - the middle of my tongue and the back of the tongue - then also make contact
one after another with the roof of my mouth. The point here is that my tongue NEVER comes forward.
Does yours? If so, you may have a tongue thrust, which is not ideal because thrusting the tongue
forward 1000 times a day when we swallow - and yes, we swallow at least 1000 times a day - can
actually create an anterior open bite over time. How does that happen, you ask? Because that
forward thrusting motion of the tongue is actually quite powerful and muscle will always “win”
over bone. The tongue is an organ supported by a lot of really, really strong muscles and teeth are
essentially bone - they're actually stronger than bone. Bones or teeth can actually bend or change
shape or change orientation over time with the powerful forces that muscles can exert. Therefore,
the forward thrusting of the tongue can actually lead to a separation of the top and
bottom teeth. I’ve seen it time and again with my patients. So how do you correct this? Well,
if you already have an anterior open bite due to a tongue thrusting habit, the first step is to
actually correct that tongue thrusting habit. And the way to do that is to find a provider
who is skilled and trained in providing myofunctional therapy. Do NOT attempt to
correct that tongue thrusting habit on your own - you can strain muscles and that can lead to pain.
For more information on myofunctional therapy, please watch my videos “What is
Myofunctional Therapy” and “Tongue Posture Dos and Don’ts”. I’ve linked both of them above.
Now let’s get into the second most common cause for an anterior open
bite or just bite changes in general - and that is degeneration within the jaw joints.
This is much LESS common than tongue thrust and it is much more difficult to treat!
Our jaw bone is part of the jaw joint (obviously) and it also houses all of these lower teeth.
If that jaw joint starts to degenerate, it's going to affect the bite. It's going to change
the orientation of the jaw in three dimensional space, which will then change where the teeth are
in three dimensional space. If the lower teeth are literally sitting in a different position,
they will be hitting the upper teeth in a different way.
So that will be perceived as a change in the bite. Again, this is NOT common as a tongue
thrusting habit being the cause of an anterior open bite, but it can certainly happen. So what
do you do about it? Well, the first step is to see a good TMJ dentist in your area!
That leads us to the question: what does an anterior open bite have to do with TMJD? So
why am I talking about this. As I’ve mentioned in previous videos - the two jaw joints and the
way the teeth fit together like cogs on a gear - that is like a “tripod-like” relationship. What
happens if you cut off one leg of a tripod? Well, he whole system goes out of balance!
Well, apply that analogy here - what happens if the bite changes? It can definitely impact
the jaw joints. It can negatively impact the jaw joints. It can cause clicking, popping,
or episodes of the jaw locking. Additionally, the muscles of the head, neck, and jaw are ALSO
affected when the bite changes. The muscles of mastication - the chewing muscles - as well
as the muscles of just this complex can become dysfunctional if the bite changes drastically.
And that typically manifests as pain - headaches, jaw pain, neck pain, ear pain and more. If you’re
experiencing any of this, see a TMJ Dentist or a TMJ Physical Therapist in your local area.
So that’s really it my friends. I hope you learned something new and like what you heard and if so,
click “Like” below, Subscribe to my channel, do all the things! As always,
questions and comments are welcome. And remember, you can never have TMI about TMJ! Thank you!