Orthodontics and the jaw joint: do braces cause pain?
What jaw joint problems are, whether orthodontic treatment causes or cures them, what a meta-analysis says and when another specialist is needed.
AuthorDr. Fidan AliyevaOrthodontist, Pitts Masters graduate
Short answer: according to a meta-analysis, orthodontic treatment does not increase the risk of jaw joint problems and does not cause them. At the same time there is no strong evidence that orthodontic treatment cures these problems either. Jaw joint pain, clicking and limited mouth opening are often linked to muscle tension, stress and clenching. If you have such complaints, it is important to assess them before orthodontic treatment.
Some patients worry after hearing that "braces damage the jaw joint". Others, on the contrary, come hoping that "if we fix the bite, the jaw pain will go away". Both ideas are oversimplified. In this article I explain what science says about this and how I act in practice.
What jaw joint problems are
The jaw joint sits in front of the ear and allows the lower jaw to open and close. Problems of the joint and the chewing muscles together are called temporomandibular disorders. This is not a single disease but a group of conditions.
- Pain around the jaw or ear, especially when chewing
- A click or grating sound when opening the mouth
- Not being able to open the mouth fully or the jaw "locking"
- Tired jaw muscles in the morning
- Headache, especially in the temples
Causes
| Factor | Explanation |
|---|---|
| Clenching and grinding | Overloading the muscles at night or during the day |
| Stress and anxiety | Increase muscle tension |
| Trauma | A blow to the jaw |
| Internal changes in the joint | Displacement of the joint disc, arthritis |
| General health | Some systemic diseases, joint hypermobility |
The role of the bite has long been debated. According to the current view, the bite alone is not the main cause of jaw joint problems; many factors play a role together.
Do braces damage the jaw joint
A meta-analysis compared people who had and had not had orthodontic treatment. Orthodontic treatment was not shown to increase the risk of jaw joint problems. No difference was found in this respect between treatment with and without extractions either. So there is no reason to fear orthodontic treatment.
Do braces cure jaw pain
This is not always true either. The aim of orthodontic treatment is to correct the teeth and the bite. Jaw joint pain is mainly related to the muscles and the joint and is usually treated in other ways: muscle exercises, a night guard, stress management, physiotherapy. That is why I do not promise a patient with jaw pain that "it will go away once we fit braces".
How I act in practice
- Before treatment I check the jaw joint in every patient: pain, sounds, how wide the mouth opens
- If there is a complaint, I record it before orthodontic treatment and refer to the relevant specialist
- If there is active pain, we wait for it to settle first
- I monitor the jaw joint during treatment
- If a new complaint appears during treatment, we assess the mechanics and change them if needed
What helps at home
- Check that you are not clenching during the day: at rest the teeth should not touch
- Cut down on very hard foods that need long chewing, do not chew gum
- Avoid opening the mouth very wide
- A warm compress on the sore area
- Habits that reduce stress, a regular sleep routine
Myths and facts
| Belief | Fact |
|---|---|
| Braces damage the jaw joint | According to a meta-analysis, orthodontic treatment does not increase the risk |
| Once the bite is fixed, jaw pain will definitely go away | This has not been proven; the cause of pain is often in the muscles |
| A click always needs treatment | A painless click is very common and monitoring is often enough |
| Extractions harm the jaw joint | No difference was found in this respect between treatment with and without extractions |
These facts do not mean jaw joint complaints are not serious. They simply mean that their cause and treatment often lie outside orthodontics and should be assessed by the relevant specialist.
What the science says
- Meta-analysis (2002): orthodontic treatment does not increase the risk of temporomandibular disorders. At the same time there is no evidence that orthodontic treatment prevents or cures these disorders.
The jaw joint needs attention of its own. It should not be confused with the teeth.
About the specifics of orthodontic treatment in adults: orthodontics for adults. If you have questions, book a consultation.
Frequently asked questions
My jaw clicks. Can I have braces?
A painless click is very common and usually not an obstacle to treatment. We record it at the examination and monitor it during treatment.
Do elastics harm the jaw joint?
There is no evidence that correctly used elastics harm the jaw joint. If you feel discomfort, tell me and we will assess the mechanics.
Is a night guard the same as a retainer?
No. A retainer keeps the teeth in place, while a guard for clenching protects the teeth and muscles. Sometimes we plan with both functions in mind.
Who should I see?
A dentist with a special interest in jaw joint problems or an oral and maxillofacial surgeon. I refer you when needed.
What should I do if my jaw starts to hurt during treatment?
Message me. We assess the elastics or the mechanics and change them if needed; if the cause is muscle tension, I give appropriate advice.
Can braces stop clenching?
Clenching is mainly related to the muscles and stress, and braces do not stop it. A night guard can help protect the teeth and muscles.
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Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Kim, M. R., Graber, T. M., & Viana, M. A. (2002). Orthodontics and temporomandibular disorder: a meta-analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 121(5), 438-446. [PMID: 12045761] | [DOI: 10.1067/mod.2002.121665]
