Patient who experience TMD pain and present with anterior open bite problems usually will have little to no over jet or over lap of their anterior teeth. Normally, the maxillary anterior incisors should overlap and be anterior to the lower anterior incisors. Excessive gingival to gingival relationships exist when patient closes their teeth together. A reversed occlusal plane and or smile line is presented.
When a normal anterior tooth relationship no longer exists the posterior teeth will often been in constant contact contributing to five regions of pain:
Temporal side of the head pain
Masseter (zyogomatic) facial pain and soreness
Cervical neck (sternocleidomastoid – SCM) pain
Pain at the lower border and corner of the mandible
These symptoms in this combination are occlusally related and have been shown to be effectively resolved when GNM principles have been implemented.
TMD patients who present with anterior open bites may also have high vault maxillary palates contributing to a narrowing of the maxillary arch from posterior to anterior. Underlying abnormal nose breathing restrictions are present accompanied with these conditions:
Possible anterior tongue thrust problems
Restricted oral pharyngeal space for the posterior regions of the tongue
Clenching – posterior teeth in constant contact contributing to hyper activity of muscles
Associated cervical neck pain
Resolving these problems with orthodontics to straighten an anterior open bite problems will not be proven successful unless the underlying abnormal aberrant tongue posturing problems is first addressed and resolved and the identification of a proper maxillary to mandibular jaw relationship is established.
Diagnosing Anterior Open Bite Tendency with Low Frequency Myomonitor TENS
An anterior open bite tendency is best diagnosed and recognized after muscle relaxation with involuntary low frequency Myomonitor TENS. A greater anterior vertical opening will be observed when the mandible relaxes with a lesser posterior opening when the teeth are resting apart. A GNM orthotics does not create an anterior open bite! 20% of most TMD cases have a tendency to show an anterior open bite tendency after TENsing and 80% of the TMD cases have shown a posterior vertical increase more than the anterior opening due to condylar decompression. With these anterior open bite tendency type cases (20% of TMD cases) the condyles and disc do not decompress as much – because of this the anterior region of their mouth and anterior incisor teeth separation increases vertical more than the posterior molar region.
Steep mandibular plane angled individuals seem to display this often hiding anterior open bite tendency more than those who have a flatter mandibular plane angle. If the dentist does not recognize thus underlying problem in his/her pre-treatment diagnostic work up it will become evidently clear, but this type of problem will end up challenging most dentists since most do not have a clear treatment understanding of this orthopedic/orthodontic problem.
Again the GNM orthotic does not open bites.
One should ask the underlying question whether there exists an orthopedic alignment problem when the mandible to the maxilla physiologically is in its relaxed position. One should not be afraid of getting the proper diagnosis via the TENS to learn if their case has an anterior open bite tendency or not (it should not be ignored in the diagnostic work up). When the TMD doctors do not properly identify these hidden type of problems that is when everyone gets into trouble – treating doctors begin to make excuses of why this problem was not identified prior to any restorative or orthodontic treatment. Lots of confusion occurs as to how does the mandible and joints properly relate to one another.
The GNM orthotic only gives support to those cases that have been diagnosed with an anterior open bite tendency and or supports those Class II div. 2 type decompression problems as well as supports the cervical dysfunction problems as well as supports the TMJ primary joint derangement problematic cases.