Expert: Steven C. Scherr, D.D.S. - 2/10/2007

Question
Hi. My lower jaw deviates about 4 or 5 mm to the left. I have some TMJ symptoms: my jaw pops on the right side sometimes when i yawn or eat and i get ringing in my ears from time to time. The resting point of my jaw is where my teeth meet, at the point where i chew, and i almost always have them somewhat clenched in place, but i do feel like i have to move my jaw to the left to make that happen. If i open my mouth and close it straight, one of my lower molars meets with my upper canine and doesn't allow me to fully bite down. If i try keeping it in this position, the left side of my jaw quickly starts to feel tired, so i always move my jaw to the left to the chewing position. This situation bothers me mainly because of the asymmetry of my face, and that it tires my left jaw muscles when i try to chew on my right side, so i end up chewing on my left side only. The popping is annoying and uncomfortable, but not painful.
Are jaws supposed to be aligned down the middle to correctly function? Can a malocclusion be to blame for the deviation? Can it be fixed with braces or a bite guard? I know you can't really tell me if it's my case without examining me, but can this happen? Also, can the jaw become accustomed to rest at an improper point because the teeth demand it that way?
thank you in advance!

Answer
Brenda,

You are correct.  TMJ damage is capable of causing the bite to shift in a way that can make the teeth close together out of alignment.

Think of the jaw as being like the front door of your house.  If the door stopped closing smoothly into its frame, there are several remedies that could be attempted.  One possibility is to shave the frame.  This wouldn't be very successful for long if the real problem was that the hinges had become loose.  Using braces, or modifying the shape or alignment of the teeth in any way, is like shaving the frame.  Unless the hinges (TMJs) are stabilized first, any other treatment may make the situation worse.

There are many different kinds of TMJ problems.  They are not all treated the same.  In some cases, an oral orthopedic splint (of which a bite guard is only one type) can be helpful.  In many cases, it will not be possible to realign the midlines, assuming that they were aligned in the first place.  The real goal is to stabilize the TMJs (jaw joints), so that the teeth can be helped to meet in a healthy and comfortable way.

Brenda, I wish you well.

Steve