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.

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

  1. Natalie says:

    Thank you for the article. I am experiencing the popping or clicking of my jaw too. My husband says that I have started grinding my teeth at night. This has been happening for a few months. For the first month or two my jaw hurt. Now I just can’t open my mouth wide without it “popping” into place. My dentist told me that my bite is off and to see an orthodontist to get it fixed. Would you recommend the same based on this information?

    • Orthodontic treatment will not fix your clenching/grinding at night. That is a habit that is going to take place whether or not your bite is correct. If your bite is off or your teeth are crooked, then consider braces. If you grind your teeth at night, ask about a nightguard or splint.

  2. Angela says:

    Before braces as an adult had healthy teeth + gums & now jaw issues.
    One week into braces I started having jaw popping & for the whole first month I was in a lot of pain. I could barely open my mouth or chew- I had to just swallow oatmeal (chewing that even hurt) & drink protein shakes.

    I’m wondering if this is normal?

    During braces I went to my 6 month cleanings & got good report back. When braces were removed I found out I got bad TMD, bone loss & a lot of gum recession. The dentist said it wasn’t periodontal disease. From getting the TMD I noticed I clench at night. But my final pano x-ray on removal showed bone loss. Is that normal for adults to have bone & gum loss after braces?
    If teeth are moving fast during treatment can that cause bone & gums loss?

    • Hi Angela. Of course none of these things are “normal,” otherwise we would not even attempt braces on adults. I have a feeling that wearing the braces was stressful for you and that may account for your jaw problems. I can’t imagine how else everything could change so quickly (I mean there is very little change during that first week due to the tooth movement itself). As for “fast moving teeth” causing bone loss, the teeth move at a uniform speed that is limited by your biology. I think you need to try to work with your orthodontist and dentists rather than try to figure out who is as fault.

      • Angela says:

        Hi Dr. Jorgensen, I’m not trying to find fault in the orthodontist. I’m just trying to figure out what happened to me.
        I’m just confused in how this happened. I forgot to add that I had bite turbos that were placed on the lower 1st molars b/c I had an overbite. Five days after the braces & bite turbos were place is when I started having cheek spasms & pressure. Then 2 days later I noticed the jaw popping & had pain for that first month were I couldn’t chew foods b/c it hurt. I’m just trying to figure out if I had an unknown jaw issue if that’s why the popping happened so quickly or if that is a normal reaction to having Damon braces & bite turbos placed for adults?

        • Joint popping and clicking can occur as a result of muscle spasms created by clenching or grinding. If the bite turbos caused you to clench or grind, there could be a cause-effect relationship there. The Damon brackets have nothing to do with it. They are just braces.

  3. Paula says:

    Hello Dr. Jorgensen,
    I have jaw popping on both side on opening, have an overbite and so moderate crowding. After my cleaning, my dentist said I have healthy teeth and gums. I’ve wanted to do Damon braces to straighten my teeth, but wondering if braces would make the jaw popping worse? Is the jaw popping on opening, with no pain TMJ disorder?
    If I got the braces would rubberbands help correct the jaw or are they just for moving teeth?

    • Please re-read this article. Joint noises are common and are not indicative of TMJ problems. Rubber bands and braces will NOT correct your jaw at all. Oh, and Damon braces are just braces. There is nothing they can do that cannot be done by any decent orthodontic bracket.

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