I Hear Clicking from My Jaw, Are Braces or Clear Aligners Suitable for Me?

A Guide from Dr. Begüm Ulaşan, Orthodontic Specialist at Milim Dental Bursa

"I hear a 'click' from my jaw when I open and close my mouth."

"Sometimes my jaw feels like it locks up, and my jaw joint hurts in the mornings."

"My teeth are also crooked, but is it right to get braces when I have a problematic jaw joint?"

If you frequently ask yourself these questions, you are not alone. Temporomandibular Joint (TMJ) problems have become a much more frequent topic in recent years, both in Bursa and worldwide.

In this article, based on the clinical experience of Dr. Begüm Ulaşan, an orthodontist at Milim Dental in Bursa, we will discuss in detail the following topics:

1. What is the Temporomandibular Joint (TMJ), and what structures comprise it?
2. What are the symptoms of TMJ problems?
3. Does orthodontic treatment (braces or clear aligners) harm the TMJ, or can it be beneficial?
4. Which TMJ patients require joint treatment first, and which require orthodontics first?
5. How does Dr. Begüm Ulaşan in Bursa establish this balance?

1. What is the Temporomandibular Joint (TMJ)?

The jaw joint, known medically as the Temporomandibular Joint (TMJ), is the joint where the:

1. Lower jaw (mandible)
2. Connects with the skull (temporal bone).

This joint plays an active role in all movements such as:

1. Eating
2. Speaking
3. Yawning
4. Smiling

Within the joint, there are complex structures such as:

1. A disc structure that cushions the joint
2. Muscles, ligaments, and synovial fluid

It is not surprising that a joint used so intensively can occasionally become tired, strained, exposed to trauma, and develop functional disorders.

2. What Are the Symptoms of TMJ Problems?

TMJ problems do not manifest the same way in every patient. Common symptoms include:

1. Clicking, popping, or grating sounds during jaw movement.
2. Pain or tenderness in the jaw joint area.
3. Jaw fatigue in the mornings.
4. Inability to fully open or close the mouth, or a sensation of locking.
5. Pain around the face, head, and ear.
6. Tension in the neck muscles.

Sometimes, complaints such as:

1. Fullness in the ear.
2. Tinnitus (ringing in the ears).
3. Dizziness

may also accompany the condition.

Specifically, teeth grinding (bruxism), stress, one-sided chewing habits, and malocclusions (bad bites) are closely linked to the jaw joint.

3. Can Orthodontics (Braces/Aligners) Be Applied to Someone with a Jaw Joint Problem?

There is no single standard answer to this question because:

1. The condition of every TMJ patient is different.
2. The causes of TMJ problems are not tied to a single factor.

However, the general principle is: In the correctly selected patient, a properly planned orthodontic treatment can be beneficial in the long run by making the jaw joint load more balanced.

How?

When the malocclusion is corrected:

1. The contact between the teeth becomes more physiological.
2. The muscles work more symmetrically.
3. Unbalanced forces on the TMJ can be reduced.

However:

Attempting to solve the problem solely with orthodontics may not be correct for a patient who has:

1. Very severe pain.
2. Frequent jaw locking.
3. Advanced disc displacement.

In Dr. Begüm Ulaşan’s approach at Milim Dental Bursa, such cases are managed in a multidisciplinary manner, often involving:

1. Jaw surgery, if necessary.
2. Physical therapy.
3. A night guard (splint).

4. Which Patient Receives Joint Treatment First, and Which Receives Orthodontics First?

For patients with severe joint symptoms:

1. Intense pain.
2. Jaw locking.
3. Marked restriction in mouth opening.
4. Advanced joint damage seen on X-ray/tomography.

The standard approach is generally to:

1. First, control joint pain and dysfunction (splint, physical therapy, medical approaches, surgery if necessary).
2. Then, decide whether orthodontics would be appropriate.

In patients with milder joint findings and significant malocclusion:

1. Orthodontics can be planned to make the joint load more balanced.
2. Concurrent use of a night guard can also be supportive during this period.

This decision is made on a patient-by-patient basis after examination and imaging.

Therefore, generalizations like "I have a joint problem, I can never have braces" or "Orthodontics is good for everyone with a TMJ problem" are incorrect.

Dr. Begüm Ulaşan at Milim Dental in Bursa develops a personalized roadmap for every patient through:

1. Detailed joint assessment.
2. Bite analysis.
3. Inquiry into teeth grinding habits.

5. Braces or Clear Aligners: Which is Better for TMJ?

There is no single "best" system in terms of TMJ; but there are some differences:

Braces (Brackets):

1. Very powerful in performing all types of 3D tooth movements.
2. Offers extensive technical possibilities for detailed adjustment of the jaw relationship.

Clear Aligners:

1. Can provide a degree of "splint" effect due to their surface covering the teeth.
2. When worn at night, they can reduce tooth-to-tooth contact, thereby reducing the number of sudden impacts on the muscles and joint.

The choice of system is determined by factors such as:

1. The patient's joint findings.
2. The type and severity of their dental malocclusion.
3. Aesthetic expectations.
4. Compliance with the treatment duration.

Dr. Begüm Ulaşan uses combined approaches for many TMJ patients in Bursa, which often include:

1. Short-term use of a night guard or splint first.
2. Followed by orthodontics with braces or clear aligners, if appropriate.
3. Regular monitoring of the joint throughout the treatment.

6. I Have a Jaw Joint Problem and Want Orthodontics: What Should I Do?

The most correct step is to:

1. Schedule an appointment for a detailed assessment of both the joint and the bite.
2. If necessary, establish a ** joint plan** with an oral and maxillofacial surgeon or physical therapist.

Dr. Begüm Ulaşan, an orthodontist at Milim Dental Bursa, adopts the approach of:

1. "Let's consider the joint-muscle-teeth-bite balance together," rather than simply "Let's straighten the teeth."

Remember: A TMJ problem is not an automatic barrier to getting orthodontics. With the right diagnosis and a well-planned treatment, it is possible to improve both your smile and your jaw health simultaneously.