June 15th, 2022
Orthodontic treatment, also known as braces or aligners, is a common dental treatment used to correct misaligned teeth and improve the overall function and appearance of the smile. However, there is a common misconception that orthodontic treatment can cause temporomandibular joint (TMJ) issues or temporomandibular joint dysfunction (TMD).
It is important to understand that TMJ issues and TMD are multifactorial in origin, meaning they can be caused by a variety of factors, including genetics, trauma, occlusal disturbances (issues), stress, and most importantly – individual adaptability. There are many conditions that can cause pain in the area of the TMJ that are not related to the teeth at all. Some are serious like degenerative arthritis and certain cancers. Others are related to functional habits like clenching and grinding.
While cross bites and open bites may be linked to joint problems, not all imperfect bites result in TMD. Many orthodontic patients have imperfect bites, and yet very few report TMJ issues or TMD. And in other instances, many patients who report severe TMJ pain often have ideal bites. This simple observation supports the scientific studies that have separated the fields of TMJ and orthodontics. There is no scientific evidence to support the claim that orthodontic treatment causes TMJ issues or TMD.
Except for two exceptions, malocclusion (imperfect bite) in general cannot be linked to a higher prevalence of joint problems. The two exceptions are a posterior cross bite that causes the jaw to shift to one side upon closure, and an anterior open bite where all the biting force is on the back teeth only and the front teeth do not touch at all.
Some people may be more susceptible to developing TMJ issues or TMD due to certain risk factors, such as a history of jaw injury or a family history of the condition. However, these risk factors do not include orthodontic treatment.
In fact, orthodontic treatment can actually help alleviate TMJ issues and TMD by correcting misaligned teeth and improving the overall function of the jaw. Properly aligned teeth can help distribute the force of biting and chewing evenly across the jaw, reducing strain on the TMJ.
It is important to address any concerns about TMJ issues or TMD with a qualified healthcare professional, such as a dentist or an orthodontist. They can provide a proper diagnosis and recommend appropriate treatment options.
NOTE: The author, Dr. Graydon Carr, is a board-certified orthodontist who is in the private practice of orthodontics in Chico, California with his partner Dr. B. Scott Hood. Dr. Graydon Carr was trained at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California, and the University of Nevada at Las Vegas School of Orthodontics and Dentofacial Orthopedics. Dr. Graydon Carr & Dr. B. Scott Hood’s are experts in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems. This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. B. Scott Hood & Dr. Graydon Carr are licensed to diagnose and treat patients in the state of California. They cannot diagnose cases described in comments nor can they select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.