Looking for 2nd opinion on Invisalign? (Photo)

Question

42 and looking to get Invisalign. I do have TMJ and they recommended having to pull 4 teeth. I already had wisdom teeth pulled when I was young! Please give any opinions based on pics! Thanks!! I’ve had people say they think I need jaw surgery /braces :/

Jefferson T. Twomley, DDS, MSD · Answer

From what I can see, your teeth seem flared. Straightening your teeth without any extractions would flare your teeth out even more than they already are. This might provide you with an unsatisfying look. More importantly, it could cause potential damage to your gum tissue, possibly exposing the roots of your teeth. The extent of correction to your crowding that could be obtained without extractions would be based on a closer look at your gums and x-rays. However, based on the pictures, for ideal correction, I would also advise extractions. I see no need for any surgery here besides the extractions.All that said, you are a good candidate for Invisalign. For what it's worth, it's hard to guess how TMD will be affected by orthodontic treatment. Sometimes it helps, sometimes it irritates symptoms. It depends on the root cause. If it's a "bad bite," Ortho can help. If it's a functional problem with the jaw, other avenues will need to be taken for relief.

Kent Lauson, DDS, MS · Answer

Find a dentist/orthodontist who has many years (over 10) in treating TMJ Dysfunction (TMD) 
1.  Fix the TMD first,
2. Then orthodontics, but this should include Functional Facial Orthopedics (Jaw widening) and eliminate the need for extracting any teeth.

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