Temporomandibular Joint Disorder (TMD) is a painful condition that affects the joints of our jaws and also the surrounding muscles, causing intense discomfort, limitations in mobility, and pain.
Now there are several conditions that can contribute to the development of TMJ TMD, including stress, dental problems, arthritis, injuries, and more.
Nevertheless, one question that often arises is whether undergoing orthodontic treatments, especially wearing braces can be the cause of TMJ TMD.

Understanding TMJ TMD

TMJ TMD is a complex condition that can manifest along with various causes and symptoms of the disease. The typical symptoms of the ailment are jaw pain, popping and clicking sound when closing or opening the mouth, earaches, headaches, and in most cases difficulty in chewing or opening the mouth wide.

Additionally, the causes of TMJ TMD can be multifactorial, including trauma to the jaws, genetic predispositions, misalignment of the jaw or teeth, and excessive stress on the muscles around the jaws.

Orthodontic Treatment and TMJ TMD

The use of braces, aligners, or other dental appliances is often used in orthodontic treatments to reform misaligned teeth and also improve the bite.
However, while orthodontic treatments can help to overcome some of the causes of TMJ TMD (like misaligned teeth and improper bites) dental appliances used in the treatment can also potentially contribute to the development of TMJ TMD in certain cases leading to discomfort and pain.

Potential Causes of TMJ TMD Related to Orthodontic Treatment

  • Occlusal Changes

When the teeth are repositioned during orthodontic treatment, in certain instances the way the upper and lower teeth fit together (occlusion) changes, shifting the jaw into an unfavorable position, leading to jaw muscle tension and TMJ TMD symptoms like earaches and muscular pain.

  • Excessive Bite Force

During orthodontic treatments, the teeth may even get moved into a position that can temporarily increase the bite force which can strain the muscles around the jaws leading to TMJ TMD symptoms in patients suffering from this malady.

  • Appliance Discomfort

The use of orthodontic appliances, like aligners and braces can cause irritation and discomfort inside the mouth, leading to grinding or clenching of teeth, which can also exacerbate TMJ TMD symptoms in the long run.

Statistical Data on TMJ TMD and Orthodontic Treatment

In a study published by the Journal of Oral Rehabilitation, it has been noted that 25-30% of patients with TMJ TMD had a history of orthodontic treatments, while in another study published in the American Journal of Orthodontics and Dentofacial Orthopedics, approximately 8-10% of orthodontic patients experience TMJ TMD symptoms during or after treatment.

However, the study also found that these symptoms were generally mild and temporary, resolving within a few months after the completion of treatment.
Moreover, the relationship between orthodontic treatment and TMJ TMD is complex and can be influenced by various factors, such as the severity of malocclusion and the patient's age at the time of orthodontic treatment.

Minimizing the Risk of TMJ TMD During Orthodontic Treatment

Even though orthodontic treatment can potentially contribute to TMJ TMD in certain cases, nevertheless there are steps that can help to minimize the risk:

  • Plan For Proper Diagnosis and Treatment

Most experienced orthodontists will carefully evaluate the jaw alignment, the patient’s bite, and the overall dental health of the patient before recommending orthodontic treatments since appropriate treatment planning can reduce the risk of TMJ TMD.

  • Monitoring and Adjustments

Regular adjustment and check-ups of the aligners and braces can help identify and address potential issues that may contribute to the symptoms of this ailment.

  • Managing Stress

Stress is accounted as a major risk factor for TMJ TMD. Hence orthodontists may recommend counseling and techniques for stress-reduction, like relaxation techniques, and jaw exercises to help manage stress during the treatment.

  • Appliance Adjustment

The orthodontist may adjust or modify the orthodontic appliances if they are causing irritation or discomfort to alleviate the issues and reduce the risk of TMJ TMD.

Hence to conclude this can be summarized that even though orthodontic treatment has been associated as one of the causes of TMJ TMD, their relationship is complex and can influenced by various factors for the pain.
It's important to note here that the International College of Craniomandibular Orthopedics (ICCMO) is an organization dedicated to advancing the understanding and treatment of craniomandibular disorders, including TMJ TMD. 

ICCMO provides education and resources for dental professionals, promoting evidence-based practices and interdisciplinary collaboration in the management of these conditions.

So if you are experiencing any symptoms of TMJ TMD during or after orthodontic treatment, it's crucial to consult with your orthodontist or a qualified healthcare professional trained by ICCMO for proper evaluation and management.