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TMJ, deep overbite, recessed side profile, seeking advice  

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retroclined_incisors
New Member

I'm a 24 year old male who is suffering from TMJ disorder and a bad bite. I've had a deep overbite for as long as I can remember, and my side profile is recessed. I have no history of orthodontic work. I had 4 wisdom teeth removed 4 years ago at the age of 20. No sleep apnea symptoms. My default head posture has been tilted slightly back; I've had poor posture all of my life that I'm currently trying to fix. I didn't even realize that my jaw was so recessed until I adopted proper head posture and tilted my head forward. I've been tilting my head back and jutting my thus jutting my jaw out, hiding my recession.

I would like to correct my TMJ disorder and bad bite without surgery as I feel it is unnecessary for my case. I would also like to bring my jaw forward slightly so that my side profile is more attractive. I'll add in some images here of my teeth and x-rays of my mouth here that were taken very recently.

 

 

I have retroclined incisors that trap my mandible in the back of my mouth. When I bite down, I feel that my lower jaw is being forced back and upwards into my mouth as a result of these teeth. I feel that simply rotating these teeth outward would provide me a decent amount of relief. The teeth on the left side of my mouth appear to be in a class 1 relationship, while the teeth on my right side are in more of a class 2 relationship. My mandible is being pushed back on the right side, and most of my TMJ pain is on that side. I have a deviated midline on my upper teeth. Is a deviated midline indicative of insufficient maxilla growth?

Lately I have been letting my lower jaw hang forward, as far as my retroclined incisors will allow, with my front teeth lightly touching, lower incisors behind upper incisors, molars 2-3 mm apart. I believe that this is a better position for my jaw to sit as it takes pressure off of my TMJ, and is closer to where I would like my jaw to sit in the future. It is a comfortable position.

The orthodontist who I met with, where these images were taken, told me that I have well-developed arches. Looking at the images of my mouth I think I agree with her, but this makes me question why I am dealing with a recessed jaw in the first place then. I thought that small arches were the root cause of craniofacial issues? The orthodontist's plan of action is to use braces to bring my upper incisors up and forward, and lower incisors down and forward as well, and this would allow my jaw to slide forward into a more ideal position. While this sounds good in theory, I'm hesitant of this treatment plan because everything I've read has told me that braces aren't a treatment for TMJ. I am also hesitant because they insisted on placing some sort of object behind my upper incisors that my lower incisors would bite down on, and I wouldn't be closing my jaw fully. I'm still unsure exactly what they meant, the orthodontist drew the squares on the image of my upper arch; these are the object I'm referring to. I've read that braces can only retract your arches, so that's why I'm hesitant of the plan. When I brought up palate expanders to this orthodontist she said that they don't use them on patients over the age of 10. While this orthodontist has a good reputation, it seems like the type that slaps everyone in either invisalign or braces.

I have a couple more orthodontist consultations scheduled, particularly with ones who specialize in TMJ issues. I'm going to schedule an appointment with a provider of the DNA appliance as well. The DNA appliance has interested me greatly, and I really want to explore this appliance. The main reason I am so interested in the appliance is because it is a 3-way expander that supposedly ushers in forward expansion of the palate. If this appliance could expand the front of my palate and tip my incisors outward then I think it would work well. My reservations though are that my arches seem well developed, so I don't know how much use a palate expander would be to me. And if a palate expander will be of minimal benefit to me, then what options do I have? 

Sorry if this post is a bit messy, I'm trying to organize a lot of different thoughts that I have going on with this issue. I appreciate any advice, and all criticism of my assumptions, thoughts, diction, etc is welcome. Please inform me if I'm using any terms incorrectly. I'm here to learn from the knowledgeable people on this forum, and I'm very thankful that I found this community. I'll gladly answer any questions and I appreciate the help of everyone here. Thank you!

Quote
Posted : 13/09/2020 6:14 pm
Limebike
Active Member

@retroclined_incisors 

You seem to have somewhat of a Class 2 division 2 malocclusion. As is typically the case, this goes hand in hand with a deep bite.

Lately I have been letting my lower jaw hang forward, as far as my retroclined incisors will allow, with my front teeth lightly touching, lower incisors behind upper incisors, molars 2-3 mm apart. I believe that this is a better position for my jaw to sit as it takes pressure off of my TMJ, and is closer to where I would like my jaw to sit in the future. It is a comfortable position.

So what you are saying is that you are currently overclosing your jaw joint? If this is really the case, then instead of opening the deep bite of your incisors by intruding the upper central incisors, you will need extrusion of your upper posterior segment. I also noticed that you have a flat occlusal plane. In other words, you perhaps need a steeper curve of Spee on the upper.

What your dentist suggested are bite turbos.

This results in your lower incisors biting into these bite turbos and intruding your upper incisors over time.

 

ReplyQuote
Posted : 13/09/2020 7:24 pm
retroclined_incisors
New Member

 

@Limebike

 

So what you are saying is that you are currently overclosing your jaw joint? If this is really the case, then instead of opening the deep bite of your incisors by intruding the upper central incisors, you will need extrusion of your upper posterior segment. I also noticed that you have a flat occlusal plane. In other words, you perhaps need a steeper curve of Spee on the upper.

 

I couldn't tell you exactly how I think my bite needs to change, but in its current form it isn't correct. I know that my incisors need to be rotated at the very least, maybe not intruded. But my lower incisors form a shelf, so I think that they would need to be rotated and intruded. I think the flat occlusal plane is a slight illusion; I believe that I'm tipping my head back slightly which is causing that.

 

 

ReplyQuote
Posted : 13/09/2020 8:45 pm
Roflcopters
Trusted Member
Posted by: @retroclined_incisors

 

@Limebike

 

So what you are saying is that you are currently overclosing your jaw joint? If this is really the case, then instead of opening the deep bite of your incisors by intruding the upper central incisors, you will need extrusion of your upper posterior segment. I also noticed that you have a flat occlusal plane. In other words, you perhaps need a steeper curve of Spee on the upper.

 

I couldn't tell you exactly how I think my bite needs to change, but in its current form it isn't correct. I know that my incisors need to be rotated at the very least, maybe not intruded. But my lower incisors form a shelf, so I think that they would need to be rotated and intruded. I think the flat occlusal plane is a slight illusion; I believe that I'm tipping my head back slightly which is causing that.

 

 

Do "melting heart" yoga pose. 3 minutes each 3 rounds. You should feel a deep stretch on you upper back/shoulders and traps. If you don't, you're probably too stiff.

Unfocus from mewing and relax while your doing it.

Come back here and tell me how your mandible and occlusion feels after that.

Ive comented here on this site previously saying that alot of people who focus on "hard mewing" develop "fake deep bites" and "fake class 1s". Hard mewing and heavy chin tucking will vault your palate and push your molars up because you can't hard mew naturally. Also it will create more TMJ problems.

Most people here chin tucking actually cheat because your thoracic spine and your chest shouldn't move when you chin tuck, it defeats the whole purpose. IF, when you think you're chin tucking, your chest and upper back moves you're over mewing and your cervical/upper back muscles are stiff as a board.

Same goes for mewing. If, when your trying toflatten the back of the tongue on the back palate, your chest and cervical areas move, you're just stiff and you're not mewing correctly.

Relax.

 

 

ReplyQuote
Posted : 14/09/2020 5:54 pm
Progress
Member Moderator
Posted by: @roflcopters

Come back here and tell me how your mandible and occlusion feels after that.

Can you elaborate on this? Do you see it as a solution to deep bite? I have observed that when I rotate my neck backward all the way into hyperextension and keep it there for a while, afterwards my maxillary molars will feel as if they have come down a bit. I can't seem to make the effect permanent though.

ReplyQuote
Posted : 15/09/2020 6:27 am
Roflcopters
Trusted Member
Posted by: @progress
Posted by: @roflcopters

Come back here and tell me how your mandible and occlusion feels after that.

Can you elaborate on this? Do you see it as a solution to deep bite? I have observed that when I rotate my neck backward all the way into hyperextension and keep it there for a while, afterwards my maxillary molars will feel as if they have come down a bit. I can't seem to make the effect permanent though.

Well its hard to put certain things in to words when you lack specific and medical terms but ill try. 

I doubt your molars would move down off of a single stretch. Most likely what you feel is an involuntary Change of lingual posture due to the stretch. Which is good. 

I think Mike mew failed when he Said that the tongue shoudnt Touch the teeth. Im nota saying it should actively put pressure on teeth but id say it naturally wants to very gently Touch certain parts of the teeth on more under developed cases and inward tipping. The way he explained mewing oNLY works for decently developed upper arches, especially sagitally.

What im trying to say is that his bite may be deep NOT because his mandible is too short but because hes continually forcing it by wrong/hard mewing and or possibly fake chin tucking.

Ir youre underdeveloped sagitally on both arches and you hard Mew youre inevitabily going to BE pushing your mandible back. That Alone Will create unhealthy and unnatural breathing pattens that Will put heavy amounts of tension on your upper back because you cant hard Mew and breathe from your belly without forcing body posture, which ceeates leverage on the uper back.

Theres a relaxation aspect ive dwelved into since i started doing yoga few months back which i completely skipped when i got into mewing.

Diaphgram breathing and a relaxed mandible are Paramount for body posture. You achieve a natural diaphgram breathing pattern by stretching and doing yoga and i guarantee you your mandible Will Come down andrand forward. Regardless of your current occlusion.

Dos it make sense ir os too bro sciency?

ReplyQuote
Posted : 15/09/2020 11:05 am
Roflcopters
Trusted Member

Also Im not saying youre supposed to jut your mandible.

Im saying you should spend a month doing yoga and active isolation stretches and unwind a bit from mewing.

An effortless and relaxed lip Seal in combination with a well behaved body posture Will be enough to achieve the right mewing and breathing patterns for correct growth.

Tension Will oNLY disapeer when you allow your body to do its thing.

So id say that dropping bad habits and focusing on body posture os more important and Will Grant morr results thn isolation tongue exercises.

And when i say work on your posture i dont mean "tense" up, Mew and force it. I mean, stretch, stretch stretch and breaaaathe.

ReplyQuote
Posted : 15/09/2020 11:14 am
Progress
Member Moderator

@roflcopters To clarify, I could sense that the molars had come down based on how my occlusion had changed during the stretch. Since the effect was temporary, I think it relates to the craniosacral flexion/extension pattern which is a natural movement of the cranium that is associated with breathing.

I agree that the diaphragm must innately have the highest postural priority, since lack of air kills us faster than lack of anything else does. As such the whole postural anatomy must've been designed around the diaphragm. And so it seems that when the body is postured so that the diaphragm behaves as it should behave, correct posture, including oral, naturally emerges.

Would you then say that some forms of CFD may be a manifestation of excessive chronic tension, rather than a direct lack of supporting baseline tension? For long we've been operating under the axiom that gravity has been melting our faces due to lack of countering tension from the musculature -- which may be true for some -- but for the rest of us, could it be that our skulls are deformed because of too much tension?

ReplyQuote
Posted : 15/09/2020 12:50 pm
Sergio-OMS
Trusted Member
Posted by: @retroclined_incisors

I'm a 24 year old male who is suffering from TMJ disorder and a bad bite. I've had a deep overbite for as long as I can remember, and my side profile is recessed. I have no history of orthodontic work. I had 4 wisdom teeth removed 4 years ago at the age of 20. No sleep apnea symptoms. My default head posture has been tilted slightly back; I've had poor posture all of my life that I'm currently trying to fix. I didn't even realize that my jaw was so recessed until I adopted proper head posture and tilted my head forward. I've been tilting my head back and jutting my thus jutting my jaw out, hiding my recession.

I would like to correct my TMJ disorder and bad bite without surgery as I feel it is unnecessary for my case. I would also like to bring my jaw forward slightly so that my side profile is more attractive. I'll add in some images here of my teeth and x-rays of my mouth here that were taken very recently.

 

 

I have retroclined incisors that trap my mandible in the back of my mouth. When I bite down, I feel that my lower jaw is being forced back and upwards into my mouth as a result of these teeth. I feel that simply rotating these teeth outward would provide me a decent amount of relief. The teeth on the left side of my mouth appear to be in a class 1 relationship, while the teeth on my right side are in more of a class 2 relationship. My mandible is being pushed back on the right side, and most of my TMJ pain is on that side. I have a deviated midline on my upper teeth. Is a deviated midline indicative of insufficient maxilla growth?

Lately I have been letting my lower jaw hang forward, as far as my retroclined incisors will allow, with my front teeth lightly touching, lower incisors behind upper incisors, molars 2-3 mm apart. I believe that this is a better position for my jaw to sit as it takes pressure off of my TMJ, and is closer to where I would like my jaw to sit in the future. It is a comfortable position.

The orthodontist who I met with, where these images were taken, told me that I have well-developed arches. Looking at the images of my mouth I think I agree with her, but this makes me question why I am dealing with a recessed jaw in the first place then. I thought that small arches were the root cause of craniofacial issues? The orthodontist's plan of action is to use braces to bring my upper incisors up and forward, and lower incisors down and forward as well, and this would allow my jaw to slide forward into a more ideal position. While this sounds good in theory, I'm hesitant of this treatment plan because everything I've read has told me that braces aren't a treatment for TMJ. I am also hesitant because they insisted on placing some sort of object behind my upper incisors that my lower incisors would bite down on, and I wouldn't be closing my jaw fully. I'm still unsure exactly what they meant, the orthodontist drew the squares on the image of my upper arch; these are the object I'm referring to. I've read that braces can only retract your arches, so that's why I'm hesitant of the plan. When I brought up palate expanders to this orthodontist she said that they don't use them on patients over the age of 10. While this orthodontist has a good reputation, it seems like the type that slaps everyone in either invisalign or braces.

I have a couple more orthodontist consultations scheduled, particularly with ones who specialize in TMJ issues. I'm going to schedule an appointment with a provider of the DNA appliance as well. The DNA appliance has interested me greatly, and I really want to explore this appliance. The main reason I am so interested in the appliance is because it is a 3-way expander that supposedly ushers in forward expansion of the palate. If this appliance could expand the front of my palate and tip my incisors outward then I think it would work well. My reservations though are that my arches seem well developed, so I don't know how much use a palate expander would be to me. And if a palate expander will be of minimal benefit to me, then what options do I have? 

Sorry if this post is a bit messy, I'm trying to organize a lot of different thoughts that I have going on with this issue. I appreciate any advice, and all criticism of my assumptions, thoughts, diction, etc is welcome. Please inform me if I'm using any terms incorrectly. I'm here to learn from the knowledgeable people on this forum, and I'm very thankful that I found this community. I'll gladly answer any questions and I appreciate the help of everyone here. Thank you!

To me, your mandible seems to be blocked. You should probably start by consulting with an orthodontist that knows about TMJ issues. Starting with a Roth deprogramming splint 24/7 would be a very good thing to do, so you could have a good diagnostic.

ReplyQuote
Posted : 16/09/2020 12:50 am
Roflcopters
Trusted Member
Posted by: @progress

@roflcopters To clarify, I could sense that the molars had come down based on how my occlusion had changed during the stretch. Since the effect was temporary, I think it relates to the craniosacral flexion/extension pattern which is a natural movement of the cranium that is associated with breathing.

I agree that the diaphragm must innately have the highest postural priority, since lack of air kills us faster than lack of anything else does. As such the whole postural anatomy must've been designed around the diaphragm. And so it seems that when the body is postured so that the diaphragm behaves as it should behave, correct posture, including oral, naturally emerges.

Would you then say that some forms of CFD may be a manifestation of excessive chronic tension, rather than a direct lack of supporting baseline tension? For long we've been operating under the axiom that gravity has been melting our faces due to lack of countering tension from the musculature -- which may be true for some -- but for the rest of us, could it be that our skulls are deformed because of too much tension?

Would you then say that some forms of CFD may be a manifestation of excessive chronic tension, rather than a direct lack of supporting baseline tension?

Oui. Clenching for example. A more appealing face aesthetically may not always be a healthier and more functional one than a face with some downward growth. Thats why i dont support hard mewing.

I think that the direct lack of CORRECT supporting tension to grow healthy is the cause both for too much tension or no tension at all(which would be mouth breathing).

CFD "starts young" and thn theres 2 types of people: People that mouth breathe and relax and let go too much and people that nose breathe underoxygenated and hold to the tension without being able to relax. Both of these result in different CFD, faces and problems.

CFD is related to fidgeting, nail biting, anxiety etc..

For me, the supporting baseline tension isn't just mewing. It's body posture, proper breathing patterns and relaxation. Which can be developed regardless of occlusion and CFD case.

I consider mewing more of a "hack" than a solution.

I see people here advocating mewing while slouching and saying body posture doesn't matter. But you can't mew correctly if you're slouching. If you're mewing while slouched you're pulling the base of your head backwards and your mandible too. That's incorrect growth and it will most likely develop into undesirable results.

Obviously because you're hard mewing it is something you're doing consciously but there is alot of cases where clenching/tension happens unconsciously yeah..

 

ReplyQuote
Posted : 16/09/2020 10:15 am