Orthodontics and Temporomandibular Joint (TMJ) Disorder

Dysfunction of the temporomandibular joint is a complex problem. Problems in this unique joint can cause facial pain, TMJ clicking and issues with the proper function of the mouth. There are a number of possible treatments for TMJ pain. Unfortunately not every TMJ disorder treatment works for every patient with temporomandibular dysfunction (TMD). However many effective treatments are available by working with your orthodontist.

TMJ disorder treatment, in general

The goal of TMJ disorder treatment is to do the least invasive treatment first before more aggressive TMJ pain treatment is tried. In general it is best to begin with rest, ice and exercises to treat TMJ pain. These exercises can be directed and explained by a physical therapist. When this form of TMJ disorder treatment fails (and it often does) the next step is usually to see an orthodontist or dentist for more focused treatment of TMJ pain.

Orthodontic treatment of TMJ pain – Splints

The nonsurgical mainstay of orthodontic treatment of temporomandibular dysfunction is a TMJ splint. A TMJ splint is similar to a mouth guard in that it protects the teeth from excessive clenching (bruxism). The TMJ splint fits over both the upper and lower jaws and is most often worn at night. By having this mouth guard in between the two rows of teeth, the temporomandibular joint is held in a different, less extreme position. While bruxism will be a hazard for teeth and the temporomandibular joint in general, the TMJ splint relieves some of the excessive and damaging bruxism forces.

Orthodontic treatment of TMJ pain – Braces

In select cases, orthodontic treatment for temporomandibular dysfunction may include braces. It should be noted, however, that problems with the temporomandibular joint are rarely the only indication for braces. In other words, patients and orthodontists should carefully consider using braces as a sole treatment for temporomandibular dysfunction. Usually an orthodontist will suggest braces for TMJ disorder treatment if the patient is not getting relief from other TMD treatments, the patient has significant malocclusion, and orthodontic treatment is likely to correct the TMJ pain.

Orthodontic treatment of TMJ pain – Surgery

By most accounts surgery for temporomandibular dysfunction is considered a last resort after other treatments have been tried and exhausted. Surgery for problems with the temporomandibular joint usually includes one of two possible procedures. The first is similar to orthopedic surgery for arthritic joints. The temporomandibular joint is resurfaced to make it smoother and thus move in with more fluidity. The other surgical option for severe and treatment-resistant TMJ pain is temporomandibular joint replacement surgery. This type of surgery is a big step and should not be entered into lightly. Extensive discussions with your orthodontist, oral surgeon, physician, and possibly orthopedic surgeon should be considered before temporomandibular joint replacement is performed.


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