TMJ conditions are multifaceted with various ailments potentially mimicking TMJ pain. While braces are sometimes considered an effective treatment for some TMJ related disorders, it’s essential to recognize that the relationship between orthodontics and TMJ dysfunction is complex. Both braces and treatments like Invisalign® can influence the harmony between the jaw, teeth, temporomandibular joints (TMJs), and chewing muscles. While orthodontic treatments can sometimes alleviate some TMJ symptoms, they can also contribute to TMJ problems. It’s crucial to consult with a certified TMJ specialist to determine the best approach for TMJ-related concerns. If TMJ orthodontics are determined to be the best solution, orthodontists possess specialized training that are distinct from general dentists which make them much more qualified to address certain TMJ related dental issues.
What are TMJ Disorders?
The temporomandibular joint (TMJ) is a pivotal joint situated just in front of the ears that links the jawbone to the temporal bones of the skull. These joints play a fundamental role in our daily activities and facilitate actions such as speaking, chewing, and yawning through their unique sliding and rotational movements. While many people colloquially refer to related disorders as “TMJ,” the accurate terminology for any dysfunction of this joint is temporomandibular disorders (TMD or TMJD).
TMD can arise from a variety of causes and factors and the manifestations of TMD can vary widely among individuals. Some people experience mild temporary discomfort while others endure chronic and severe pain. The disorders can also be acute and present themselves suddenly. It’s noteworthy that TMD is particularly prevalent among adults between the ages of 20 to 40.
Symptoms of TMJ Disorder
Symptoms of temporomandibular joint disorders (TMD) can vary among individuals but commonly include:
- Jaw pain or discomfort
- Tenderness in the jaw or face
- Stiffness in the jaw muscles
- Earaches or ringing in the ears (tinnitus)
- Headaches
- Neck or shoulder pain
- Difficulty in opening the mouth fully
- Jaws that lock in an open or closed position
- Painful or difficulty chewing
- A change in how upper and lower teeth fit together
- Swelling on the sides of the face
- Popping, grating, or clicking noises when opening or closing the mouth
- Pain radiating in the jaw, neck, or face
- Teeth pain or sensitivity
Causes of TMJ Disorders
Temporomandibular joint disorders (TMD) can arise from a variety of causes, and pinpointing the exact origin can sometimes be challenging. TMJ specialists, dentists, orthodontists, or ENT doctors can conduct thorough examinations that include X-rays, CT-scans, or MRIs to assess the jaw’s structural integrity. Commonly identified causes or contributing factors to TMD include:
- Trauma or injury to the jaw or joint
- Arthritis in the temporomandibular joints
- Teeth grinding or jaw clenching (bruxism)
- Dislocation of the disc within the joint
- Erosion of the joint over time
- Missing teeth, which can alter the jaw’s natural alignment
- Pre-existing bite problems or misalignment of the teeth or jaws
- Structural abnormalities of the jaw present from birth
- Stress, which can lead to behaviors that strain the jaw
Can Braces Cause TMJ Disorders?
The answer to this is complex because while braces may not be responsible for TMD directly, the impact they have on moving teeth and adjusting bite can cause TMJ related pain. This relationship has been a topic of debate and research for decades. Several studies have been done on the relationship between orthodontic treatments and temporomandibular joint disorders (TMD) which question whether braces can cause TMJ dysfunction. Subsequent research that encompasses thousands of studies have indicated that orthodontic treatments like braces and Invisalign do not inherently cause TMD or increase the risk of its development. However, it’s essential to note that TMD symptoms can manifest in individuals regardless of orthodontic intervention with symptoms tending to increase with age. This correlation is mistaken for causation due to symptoms presenting from adolescence to early adulthood which is a period when many undergo orthodontic treatments. While orthodontics might not directly cause TMD, they can impact changes in bite, tongue position, and airway spaces due to teeth movement which can sometimes result in symptoms like TMJ pain, teeth clenching, and mouth breathing. The following examples are all instances when orthodontic improvements can sometimes be confused with TMJD symptoms.
Closing Spaces Between Teeth with Braces Can Cause TMJ Pain
Closing spaces between teeth using orthodontic treatments like Invisalign or braces can involve drawing the teeth backward into the mouth which may reduce the size of the dental arch and mouth. This reduction can lead to a crowded tongue space which pushes the tongue closer to the throat. Such changes can potentially result in teeth clenching and TMJ pain.
Braces for Crooked Lower Teeth Can Cause TMD Like Symptoms
Crooked teeth often result from a lack of adequate space for all teeth to align correctly. Using braces to address this issue can involve moving the teeth backward into the mouth which might lead to crowding of the tongue space and a misaligned bite. This rearrangement can subsequently cause sore muscles, jaw joint discomfort, and TMJ pain.
Removing Teeth for Braces Can Cause TMJ Related Problems
Extracting teeth to make room for straightening the remaining teeth has been associated with certain complications. Dental extractions followed by retraction can lead to TMJ issues and compromised sleep quality in many cases. While these symptoms might not manifest immediately post-treatment, they can develop over time. Additionally, such extractions can alter the facial profile and lead to a reduced appearance, forward head posture, and an unfavorable bite due to decreased bite height. A significant concern is the repositioning of the tongue closer to the throat after retraction which can result in airway resistance. This change can promote mouth breathing and contribute to sleep apnea.
TMJ Disorder Treatment Options
Temporomandibular joint disorders (TMD) treatment plans are tailored to individual patient needs and factor in their health, medical history, and the severity of the disorder. A holistic approach often combines lifestyle changes, therapeutic interventions, and in some cases, surgical procedures. Common treatment options include:
- Homecare: Prioritizing jaw rest, opting for soft foods, avoiding large bites, and refraining from gum chewing can help alleviate TMJ pain. Cold compresses can be applied for sharp pain, while warm compresses can address dull, persistent aches. Gentle TMJ exercises and stretches can be introduced once pain subsides to strengthen chewing muscles and enhance joint mobility.
- Stress Reduction: Since stress can exacerbate TMD, incorporating relaxation techniques like deep breathing, yoga, meditation, or even therapy can be beneficial.
- Physiotherapy: This involves treatments like moist heat or cold therapy, ultrasound, and exercises to fortify and stretch the muscles and joints.
- Custom TMJ Appliances: A dentist or orthodontist can recommend a TMJ appliance. Night guards can protect against grinding forces, especially when TMD results from bruxism. TMJ splints can help by positioning the jaw joints to alleviate pressure and promote healing.
- Prescription Medications: For severe TMD, doctors might prescribe anti-inflammatories, specific antidepressants, or muscle relaxants.
- Injections: Corticosteroid injections can address joint pain and inflammation. BOTOX® injections into the jaw muscles can also be beneficial by preventing muscle contraction which can potentially alleviate TMJ pain.
- Orthodontic Treatment: While orthodontic treatments like Invisalign and braces typically neither cause nor cure TMD, addressing dental issues like crossbites or open bites can alleviate stress on the TMJs which can prove beneficial.
- Surgery: In rare cases where non-invasive treatments don’t provide relief and symptoms are severe, surgical intervention might be considered. It’s crucial to weigh the risks and benefits of surgery as its effects are permanent.
It’s essential to consult with TMJ specialists to determine the most suitable treatment approach for TMD.
When Are Braces a Solution for TMJ Disorders
Orthodontic braces have been recognized as a viable solution for TMJ disorders when the root cause is bite misalignment or malocclusion. By realigning the bite, braces can correct the positioning of the teeth and jaw which can potentially alleviate or eradicate TMJ symptoms. However, it’s crucial to ensure that braces are genuinely needed, as unnecessary orthodontic interventions might exacerbate TMJ issues. Some bite problems, like open bites and crossbites, have been linked to TMJ dysfunction so addressing these with orthodontic treatments might offer relief. Additionally, bruxism which often results from a misaligned bite can lead to TMJ disorders. When this is the case, orthodontic treatments that address such misalignments might indirectly alleviate TMJ symptoms.
Can Invisalign Help with TMJ Disorders?
Invisalign is a popular alternative to traditional braces which has been considered a potential treatment for TMJ disorders that stem from dental misalignments. Invisalign and other orthodontic solutions can be an appropriate treatment for common malocclusions like teeth crowding or gaps. However, it might not be best for more complex orthodontic needs. When it is an appropriate treatment, Invisalign offers the added benefits of being discreet and user-friendly which make it a preferred choice for individuals who would like to avoid the invasiveness of braces and other orthopedic tools. It’s important to consult with an orthodontic specialist with expertise to determine the most appropriate and safe treatment plan.
TMJ Disorder Diagnosis
Diagnosing TMJ disorders (TMJD requires a comprehensive understanding of the musculoskeletal structures that make up the TMJ. A formal diagnosis is important before considering orthodontics to provide TMD relief. The diagnostic process typically involves a TMJ specialist who conducts a thorough physical examination of the jaw joint that includes X-rays or CT scans that can unveil any internal structural anomalies. Any abnormalities like bone deterioration, diseases, or fractures can contribute to TMD symptoms. Identifying these structural problems is important to treatment as they might not be apparent during a normal examination.
Contact Dr Omrani if You Are Dealing with TMJ Pain
Navigating the complexities of TMJ pain or TMJD can be daunting, but you don’t have to face it alone. Dr. Omrani possesses the expertise and experience to provide accurate diagnoses and effective treatment plans tailored to your unique needs. Remember, enduring pain or discomfort isn’t a norm; it’s a signal from your body urging you to seek help. By consulting with a specialist, you’re taking a proactive step towards reclaiming your health and well-being. Don’t let TMJ pain dictate your life. Reach out to a trusted TMJ specialist like Dr. Omrani and embark on your journey towards a pain-free future.
Braces for TMJ FAQs
Can TMJ be treated with braces?
Yes, braces can be used to treat TMJ in cases where the disorder is caused by bite misalignment or malocclusion. By correcting the position of the teeth and jaw, braces can potentially alleviate TMJ symptoms.
What is better for TMJ, braces or Invisalign?
Both braces and Invisalign can address TMJ issues related to bite misalignment. The best choice often depends on the specific needs of the patient and the severity of the malocclusion, though Invisalign offers a more discreet treatment option.
Do braces fix jaw clicking?
Braces can potentially address jaw clicking if it's caused by misaligned teeth or bite issues. By realigning the teeth and improving the bite, braces might reduce or eliminate the clicking sound in some patients.
Is TMJ an orthodontic condition?
TMJ refers to the temporomandibular joint itself, and everyone has it. However, TMJD (temporomandibular joint disorder) is a condition involving pain and dysfunction of this joint. While TMJD can be influenced by orthodontic issues like bite misalignment, it's a multifactorial condition that can also be influenced by other non-orthodontic factors.
