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Oral Surgery/Mandibular tori / bruxism / tongue thruster / overbite / TMJ


I'm in my mid 30s. I've had braces as a teen to correct overbite and TMJ. Wisdom teeth were also removed. I'm not sure if the TMJ was ever fully corrected, but the jaw no longer locks up. In x-ray, one jaw is not fully in the socket, but you can't tell from the outside. It still makes clicking and grinding noise.

My concern is that through bruxism (I've been wearing an upper acryllic guard for 4-5 yrs now), and because I have mandibular tori (about the size of a piece of chewing gum each side), AND I am a tongue thruster, I seem to be pushing my front teeth during sleep. My tongue seems to be crowded by the guard and the tori. In the last year, it has started to affect my speech with the overbite. The tori is annoying (speech), but not painful (eating).

The overbite was examined by an orthodontist, and it was suggested braces could help (again). The young dentist I recently visited suggested having the tori removed would be "life changing."

Based on my description, do you have suggestions for treatment? And would you suggest one treatment over another, or one having higher priority? This has been giving me much grief and anxiety because I used to have an okay bite and straight teeth. I want to stop/correct/slow the overbite issue. Thank you in advance for your knowledge and recommendation.

Marie -  The most important thing to make you comfortable is to have a solid bite, where adjustments have been made so the stimulus for grinding of the teeth is reversed.  The problem is that many dentists and orthodontists don't want to attack this situation.  There is  not a simple, quick procedure to fix.  The dentist needs to take time and makes the bite correct.  

Once the bite is corrected, the overbite can be properly evaluated.  An overbite can produce TMJ.  The important thing to determine the cause of the overbite.  An overbite can produce TMJ problems, but the cause can be just the position of the teeth or it could occur from a larger upper jaw, compared to the lower jaw, or it could be a small lower jaw and a normal size upper jaw.  The importance in determining and finding the cause makes the TMJ cure much easier and will create a stable bite and allows the TMJ to be better.

My suggestion, is to seek an evaluation of the overbite by both an orthodontist and an oral and maxillofacial surgeon to determine if the overbite is due to the teeth or the jaw bones.  

If you have any additional questions, feel free to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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