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Can Orthodontic Treatment Cause TMJ?

TMJ may be related to a poor fit between our teeth, what is known as malocclusion. When people have undergone orthodontic treatment to fix their teeth, they may then blame their orthodontist for the problem, but is this fair?

Understanding TMJ

Temporomandibular joint disorder, sometimes called TMJ or TMD, is a hard disorder to diagnose and treat. This disorder affects the joints on either side of the skull, where the jaw hinges on the base of the skull.

Because of its location near numerous important nerves and muscles, disorders in the temporomandibular joint can cause a number of symptoms, ranging from jaw pain to headaches to neck aches and back aches to tingling in the hands and feet. Two of the most common symptoms are chronic jaw pain and chronic headaches, which can be mistaken for migraines. People may see many medical professionals trying to get relief from their symptoms before finding a dentist who identifies their problem as being related to their jaw and teeth.

Can Orthodontic Treatment Cause TMJ?

Dental BracesMany studies have been done to look into the possible connection between orthodontic treatment and developing TMJ. So far, they uniformly conclude that orthodontic treatment doesn’t cause TMJ.

A 1995 review of the relationship between orthodontics and TMJ concluded “There is no elevated risk of TMD associated with any particular type of orthodontic mechanics or with extraction protocols.” It notes that this is true even if a person has a failed orthodontic treatment. A more detailed 1997 review by the same authors comes to essentially the same conclusion, but adds that there isn’t a preventive effect from orthodontics.

A 2003 study looked at this question by looking at TMJ in three groups: girls who had orthodontic treatment, girls with malocclusion but who had not received treatment, and girls with normal occlusion. There were about 180 subjects divided roughly evenly among the three groups. All groups showed some amount of TMJ.

A 2007 study focused on the question of whether orthodontic treatment with extraction may be more likely to result in TMJ, and looked at 50 individuals, all of whom had some form of orthodontic treatment, and half had had surgical intervention (such as tooth extraction). It showed that there was no association with the type of orthodontic treatment (though it did note that there was some association with the outcome of treatment–non-working side occlusion tended to be associated with TMJ.

What Causes TMJ?

According to Dr. Adam Hahn, a neuromuscular dentist at Smile Columbia Dentistry in Columbia, SC, “The causes of TMJ remain as mysterious as some of their symptoms. In individuals with TMJ, we can typically point to a cause, but we can’t yet predict who will get TMJ on the basis of possible causes.”

Some possible causes of TMJ include:

  • Erosion of the cushioning disk by arthritis
  • Trauma to the joint
  • Bruxism (teeth clenching)
  • Poor posture
  • Sleep problems

Although the causes of TMJ are still poorly understood, treatment of TMJ can be very successful. About 75-85% of people get relief from TMJ with treatment.

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Thanks to Dr. Adam Hahn of Smile Columbia Dentistry in Columbia, SC for his contribution to this article.

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