Table of contents

Introduction

Why TMD during Orthodontic Treatment is Generally Seen as Coincidental

Prevalence of TMD in the General Population

Orthodontic Treatment is Not a Direct Cause

Individual Variation

Elements Possibly Contributing to TMD Symptoms during Orthodontic Treatment

Occlusion changes

What Should Patients Do If They Think a Connection Exists?

Patients should discuss their symptoms with their orthodontist

Final Thoughts

Introduction

The great debate among dentists for years has been whether or not braces and other orthodontics could cause TMD or even make it worse. TMD refers to any condition that presents in the temporomandibular joint (TMJ), as well as muscles that attach and control the movements of the jaw. Such problems can lead to pain, a clicking sound when the mouth opens, and difficulty in moving the jaw. Some of those who have undergone orthodontic treatment report the start of their TMD symptoms after their treatment, which raises the question of whether there is a correlation.

Why TMD during Orthodontic Treatment is Generally Seen as Coincidental

The idea that TMD during orthodontic therapy is mostly regarded as a coincidental result of several influences:

1. Prevalence of TMD in the General Population:

 TMD is a rather frequent illness that affects a considerable share of the general population at some point in their lives. The high prevalence of sickness, rather than a direct consequence of the treatment, may explain the coincidence of TMD symptoms during orthodontic therapy.

2. Orthodontic Treatment Is Not a Direct Cause:

 Most studies indicate that TMD does not directly result from orthodontic treatment itself. By enhancing the distribution of stresses across the TMJ, orthodontic therapy aims to improve the alignment of teeth and occlusion (bite), therefore lowering the TMD disease.

3. Individual Variation:

 People’s reactions to orthodontic treatment can differ greatly. While some may not, others could suffer TMD symptoms during or following therapy. Individual variations in anatomy, the existence of pre-existing TMD, and the particular methods applied during orthodontic treatment all contribute to this variability.

Elements Possibly Contributing to TMD Symptoms during Orthodontic Treatment

The early stage of TMD during orthodontic therapy is generally thought to be accidental; some variables could help to explain the beginning or aggravation of TMD symptoms:

1. Occlusion changes:

 In some people, major alterations in the occlusion may affect the temporomandibular joint (TMJ) and its adjacent muscles during orthodontic treatment, thus aggravating TMD symptoms.

The orthodontic forces would, in theory, influence the TMJ, especially with the greater degree of tooth movement or the bite change in question.

In those patients with pre-existing TMDs or disorders affecting the TMJ, the chances of symptoms arising during orthodontic treatment may be greater.

What Should Patients Do If They Think a Connection Exists?

Patients who suspect their orthodontic treatment may be related to the onset or aggravation of TMD symptoms can take the following steps:

1. Patients should discuss their symptoms with their orthodontist.

The orthodontist carefully assesses whether the treatment may be causing the TMD symptoms and adjusts the treatment plan if needed.

In some cases, a recommendation to a specialist managing TMD (such as an orofacial pain expert or a prosthodontist with experience in TMD) may be worthwhile for a thorough assessment and treatment of TMD symptoms.

2. Patients can be counseled on different ways to control TMD, including occlusal splints, physical treatment, pain management medications, and relaxation techniques to lower stress and muscle tension.

Final Thoughts

TMD symptoms may develop in patients during or after orthodontic treatment. The link between orthodontic therapy and TMD is complex and, often, just a coincidence. By understanding the causes of TMD and how to control its symptoms, patients can address any issues put forth during orthodontic treatment. Regular communication with the orthodontist and timely seeking of expert attention will ensure that the best outcome is achieved for both the TMD and the orthodontic treatment.