Developing Open Bite

[u/Full_Grapefruit_9972]

Im a 31yr old F who has had a normal bite and healthy teeth my entire life without ever needing braces. However, over the course of approx. one year, I gradually developed an open bite. I do clench my teeth, although I have not noticed myself clenching for at least the past 5 months since becoming more aware of the habit. I have been attending physical therapy for 3 months in hopes of potentially correcting the open bite, but I am unsure whether this is possible. I have consulted multiple oral and maxillofacial surgeons, but I have not yet received a clear explanation for why this is happening. One particularly unusual pattern I have noticed is that when I take a muscle relaxer at night, my teeth are almost perfectly aligned when I wake up, and my bite appears nearly normal. However, as the day progresses, my open bite gradually becomes more pronounced.
I have attached my MRI results for reference. Has anyone experienced something similar or have any insight into what might cause a progressively worsening open bite in adulthood? I would greatly appreciate any advice or recommendations for further evaluation.

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[u/anonymous_opinions]

Yeah: https://www.condylarresorption.org/

Many unknown or known to them have underlying conditions like Ehlers-Danlos, J(RA) or other autoimmune conditions. Sometimes it's just hormones (pregnancy, peri/menopause triggers it) - and trauma which could be constant grinding/clenching.

[u/Chumbawumbah]

As someone already wrote, it could be as severe as idiopathic condylar resorption. That is when the bone in your condyle resorbs. There is a really helpful (and probably scary at first) Facebook group where you can learn more and find a surgeon to speak with who’s familiar with it and learn more.  What can also happen is what happened to me, disc issues - I had a subluxation of a disc and it threw my bite off. Yours look like they aren’t in great shape in the report. I noticed what you do too, where when I woke up my bite felt better than as the day went on, because my pterygoid or masseter muscles would tighten and pull my lower jaw. The difference was millimeters Im sure but you feel millimeter differences when your teeth no longer fit!  In my opinion, having watched many people go through them over the years on Facebook, disc surgeries are a waste of time especially when they are end stage or in very bad shape, so be very weary of any surgeons who suggest surgically touching them. 

[u/Full_Grapefruit_9972 → u/Chumbawumbah]

Thank you for your long and helpful response! I will definitely look into that Facebook group. Did you fix your disc issues? If so, how?

[u/Chumbawumbah → u/Full_Grapefruit_9972]

It’s a long story! Every case is so unique. I had a genetic open bite that never really bothered me until my 30s when I started having a disc issue on the right side. My condyle bones themselves were ok, discs displaced but morphology was ok. I consulted with 4 surgeons who do jaw and joint surgeries ultimately what to do. I ended up having standard jaw surgery which fixed my bite and so far 1 year later has helped stabilize my situation. Jaw surgeries can trigger tmj issues to worsen and it could still happen for me. If it does, or I relapse, I would go for a total joint replacement surgery in the future. In your case, you may be a candidate to go straight to total joint replacement (TJR in these groups) if your discs and condyles are both in bad shape.