Keeping Your Braces Safe If You Have TMJ

Temporomandibular joint disorders (TMJ) are fairly common, especially among children and adolescents. It is unfortunate that this is also the age bracket that most people receive orthodontic treatment, which increases the risk of patients wearing braces experiencing TMJ before, during, or after their orthodontic treatment. So, how can one keep their braces safe when TMJ occurs during the course of their orthodontic treatment?

Relation between TMJ and Orthodontic Treatment

Temporomandibular dysfunction comprises multiple subjective symptoms and clinical signs that affect the temporomandibular joint and neighbouring structures. TMJ is considered a major cause of non-dental pain in the orofacial region. The main signs and symptoms include: locking or luxation of joints, joint sounds, pain from the jaw muscles or mouth joints, pain with mouth movement, and restricted movement of the mouth.

TMJ can be caused by, among other things, untreated malocclusions, unstable occlusion, trauma, psychological factors such as stress, genetic predisposition, and a range of structural conditions.

Although studies suggest that orthodontic treatment does not cause TMJ, also known as temporomandibular disorder (TMD), there are instances when TMD symptoms occur during active orthodontic treatment. Depending on the severity of TMD symptoms, your braces treatment may need to be slowed or momentarily discontinued as TMD therapy is administered through medications, occlusal appliance therapy, or adjunctive therapies, etc.

Otherwise, there are a number of ways to ensure the safety of your braces, including:

1. Addressing the need to fiddle with the braces by using distractions, leaving notes to serve as reminders, or asking your family/friends to stop you when they notice you fiddling.

2. Relieving any discomfort safely by applying an icepack to the affected gums or other area externally; eating chilled food such as ice cream or smoothies; using floss thread, an interdental toothbrush, or antibacterial mouthwash to remove food particles and germs from your braces; using dental wax and an appropriate fluoride toothpaste; or using other ways to manage pain and discomfort as instructed by your orthodontist.

Final note

Considering the risk for TMJ signs and symptoms during braces treatment, it is recommended that a TMD screening examination be conducted before starting the orthodontic treatment. Any signs, such as pain, TMJ sound, or deviation during mandibular movement, should be noted and addressed using home exercises, behavioural therapy, occlusal appliances, medication, or counselling.

Addressing TMJ prior to treatment is important, because you will have to stop active orthodontic mechanics immediately if TMD is detected whilst under braces treatment as a practical and medico-legal matter while basic pain management and support is administered.