Can a Palatal Expander or Braces Cause TMJ?

Question

There is a review titled "I now have TMJ for life" and several people have commented that they have TMJ problems, and also had palatal expanders and braces when they were younger. Is there a link between palatal expanders, braces, and TMJ?

Greg Jorgensen, DMD, MS · Answer

Following a landmark lawsuit in 1987 where a Michigan patient received a legal judgment against her orthodontist for giving her "TMJ," hundreds of studies and millions of dollars have been spent by the scientific community to find if there really is a relationship between orthodontic treatment and the health of the temporomandibular joint (TMJ). Obviously this would be an important finding for doctors and patients alike. These studies have examined the different types of bad bite as well as the various approaches to treatment to show any cause and effect relationships.

	Time and time again scientific studies have supported the conclusion that orthodontics neither causes nor cures TMJ disorders. Except for two exceptions, malocclusion in general cannot be linked to a higher prevalence of joint problems. The two exceptions are a posterior cross bite that causes the jaw to shift to one side upon closure, and an anterior open bite where all the biting force is on the back teeth only and the front teeth do not touch at all. Scientific studies have been unable to uncover any links between the use of headgear, extractions, rubber bands, oral surgery, or any other treatments and TMJ problems

	Having said that, although it is possible that an expander or braces could have been a factor in a patients joint problems, it is highly unlikely. Especially if the patient started with a crossbite that was actually corrected by the expander. There is scientific proof to show that leaving the crossbite is directly related to TMJ problems later on.

Hasan Othman, DDS, MS, PhD · Answer

There is no scientific evidence that braces or expanders would cause TMJ problems,  Many patients that have TMJ problems have normal bite and never had braces before.  The answer can get more complicated than this, but I'm trying to stay with the scientific evidence.

Kent Lauson, DDS, MS · Answer

Is there a link between palatal expanders, braces, and TMJ? The answer is that there can be.  In other words, braces can cause TMJ Dysfunction if the practitioner  is not knowlegable about the relationship of teeth to the TMJ.  Although there are multiple reasons for TMJ Dysfunction to occur, orthodontic tooth movement can be one of them.   Any treatment that causes the lower jaw to retrude can precipitate TMJ Dysfunction.  Therefore treatment should protect against this movement and encourage the jaw to be held in a forward position.  Repositioning splints, orthotics (mouth ones), bite plates, bite ramps can help this forward position and can all be used with braces, however the most important thing for you is to work with a competent dentist/orthodontist., i.e. one who has a great deal of experience with braces and  treating TMJ Dysfunctions.  Then he/she would create an appropriate plan, and explain it to you so it makes sense. TMJ Dysfunction is a solvable problem in the hands of an experienced TMJ dentist/orthodontist.  Good luck to you.

Can a Palatal Expander or Braces Cause TMJ?

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Can a Palatal Expander or Braces Cause TMJ?

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