Dr. Greg Jorgensen
(505) 891-9440
1401 Barbara Loop SE
Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Can Orthodontic Treatment Stop My Jaw from Popping and Clicking?

Posted by Dr. Jorgensen on June 10th, 2011

Every May our office sees an increase in the number of phone calls from patients worried because their jaws have begun to pop or click. They want to be seen by the orthodontist assuming this is related to their bite. What is the real relationship between the TMJ and orthodontics?

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.

There are many conditions that can cause pain in the area of the TMJ that are not related to the teeth at all. Some are serious like degenerative arthritis and cancer. Others are related to functional habits (like clenching and grinding). While cross bites and open bites may be linked to joint problems, not all bad bites result in TMJ pain. Most patients who come into an orthodontic office have “bad bites,” and yet very few report TMJ pain. On the other hand, many patients who report severe TMJ pain often have ideal bites. This simple observation supports the scientific studies that have separated the fields of TMJ and orthodontics. If all bad bites had TMJ symptoms and all great bites never had any pain, a direct relationship would be defendable.

Jaw joint issues can involve muscles, ligaments, tendons, and/or the cartilages associated with the joints. Many times these problems are due to the anatomy of the patient’s joints. Some folks’ joints just make noises or move roughly because of their shape and size. It is not uncommon for patients’ ankles to pop when they stand up, but rarely do they seek treatment for that noise. A pop in the jaw joint however is much more noticeable because it occurs close to the ear where the patient can hear it.

So what do we know about TMJ noises and what causes them? First of all, the jaw joints are like many other joints in the body. There are two bones that come together with a piece of padding (a disc made of cartilage) between them. The disc is held between the bones by a ligament from behind and a muscle from the front. As the joint functions, the muscle pulls on the disc to keep it centered between the two bones. When it works perfectly, it functions almost silently.

If the ligament is loose so that it doesn’t hold the disc in the right place however, the disc travels a little too far upon opening and then suddenly pop back into place when the ligament finally applies enough tension. If the muscle pulls too hard on the front of the disc, it can also hold it too far forward until the ligament ultimately pulls it back into place. Ligaments can be naturally loose, get loose during childbirth (when all the ligaments in the body relax), or become damaged by trauma. The muscles pull too much if they have been busy chewing (gum, bagels, etc.), clenching, or grinding. Clenching or grinding can actually cause spasms in the chewing muscles which can be painful as well as pull the disc forward.

Nearly half of American women report they have had a pop or a click in their jaws while about one-fourth of the men report the same. While some popping may not be related to an identifiable event, many patients know exactly what sets it off. Studies have indicated that more than 50% of TMJ symptoms are attributable to stress alone. That helps explain the rise in calls we get during the last two weeks of the school year. Almost without fail our patients identify that their symptoms arrived about the same time as their finals and associated end-of-year projects. While there definitely are TMJ conditions that warrant treatment, most popping and clicking is not serious. Sometimes just recognizing the relationship between these noises and their stress level is all that is needed to get a patient on the road to recovery.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

6 comments so far in response to “Can Orthodontic Treatment Stop My Jaw from Popping and Clicking?”

  1. cassandra says:

    I found your article very informative. I am experiencing this exact situation. Not much pain but constant clicking and popping when I open my mouth too wide or chew any food. I used to have braces so I feel my teeth are pretty straight but my bite feels off. There’s definitely a disc or cartilage issue going on. My question is, I’ve heard Invisalign can help this issue, my main concern is the noise since the pain isn’t excruciating. Would you recommend Invisalign or is there another treatment you’d recommend? Thank you for your time.

    • Invisalign is the trade name for clear aligners that can be used to straighten the teeth. Neither they or braces can eliminate the click in your jaws if it is an anatomical problem. Don’t spend your money on either if your teeth are not crooked.

  2. Ariana Dee says:

    Hello, I’ve had braces for almost 3 years now, and about a year ago I started to wear rubberbands. Nothing happened, my jaw was fine until recently. My orthodontist changed the thickness and the position of my rubber bands about a month ago and recently my jaw started to pop on my right side when I chew. The popping doesn’t hurt but it’s so annoying. My jaw has been tight and hard to open fully ever since I got the rubber bands. I just wanted to know why my jaw is popping, is it because of my jaw moving because of the rubber bands? Or do I have TMJ? I also haven’t chewed anything because I’m afraid it will worsen it. So I’m eating all soft foods currently. Let me know please, thank you.

    • Temporary popping and/or clicking is a common report with patients who are wearing elastics. Remember that rubber bands only move teeth, not jaws. They do however pull on your jaws and can temporarily make your joints pop. After you stop using the rubber bands you should find that your popping and clicking will return to pre-treatment levels.

  3. Hanh Nguyen says:

    Dear Dr Jorgensen
    Reading your article is very interesting. I am having popping sound when I chewing or open the mouth too. I could not eat any hard food anymore. Now my problem is getting worse. My jaw is pain when I chewing. I wonder how can it can be fixed. I live in California. I am wearing brace formy grinding teeth. But if don’t wear it at night time, it is hard for me to open my mouth in the next morning. Could you give me an advice. I appreciate your help. Good bless you.

    • As I mentioned in the article, braces cannot fix popping or clicking joints. Neither can braces solve clenching or grinding. If you are having problems with your joints or jaws, you should find and oral surgeon who treats joint issues as you won’t get much relief from braces alone.

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