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Question
I have a 16 year old son who has braces. I have been told he needs to have forsus springs put on to correct his overbite. I understand why they want to do it, but I am very concerned about the effects of this in the years to come. I had braces also with rubberbands, but now suffer horribly from tmj. I wear a tmj splint at night because I have had my jaw lock on me in the past. I have had an MRI done and it shows I have very little joint left on the right side. I was a 5 out of 6 for needing TMJ surgery, which I won't do. When I ask my son's  orthodontist about long term effects, he just tells me everything will be fine and that there aren't any problems with them "yet". I would just like to correct the straightness  of his teeth and not mess with his bite, but I get the feeling from his orthodontist that is not something he wants to do. I would take him to see my TMJ dr, but she is no longer with the practice. What suggestions do you have for me?

Answer
Thanks for your question.
  There are many different appliances that are designed to accomplish a variety of tasks within the orthodontic treatment plan.  The forsus spring is a relatively recent development in the vast array of orthodontic techniques. I have not had any experience with this technique so I can't comment specifically on the use of this device.
  I can,however, make some general comments regarding your concerns.  There are many different factors that can contribute to tmj symptoms. There have not been any reliable studies that specifically link orthodontic treatment with tmj disorders and certainly there is nothing to suggest that any particular orthodontic technique will contribute to tmj disorders.
  I can also understand your orthodontist's reluctance to only partially treat certain aspects of your son's bite problem since he understands that proper treatment requires correction of all aspects of the bite problem.
  I suggest that you and your son continue to be alert to any signs or symptoms of tmj problems and if something should occur you make your orthodontist aware of that right away.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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