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Orthodontics/do braces fix jaw creaking?

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Question
When i was a kid i used to grind my teeth out of habit while i slept for a while. The dentist warned if i didn't stop, that he would give me a night guard, but shortly after i stopped and haven't until this day. Now, i'm 16 years old and my teeth are healthy, but uneven. My top two teeth don't touch my bottom teeth at all when i smile, i think it's called an open bite. I don't know if i've always had it, but i've noticed when i open my mouth really wide, i hear a little painless popping noise on the left side of my jaw. When i turn my neck to the left really far i hear a popping noise also. I just thought it was normal, until i looked it up. I think I may have TMJ. will getting braces get rid of this condition? What can i do to get rid of the little irritating popping noise. I have not had any wisdom teeth removed they haven't even grown in.
I haven't had any surgery or any root canals of any kind before and I haven't been in an accident that involved my jaw. I've briefly played the flute for a couple of months before.

Answer

Dear Layla,

What I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused on possible TMD or Temporo Mandibular Dysfunction and other issues.

First about the open bite. There are three kinds of open bite, namely skeletal based, dental based, or a combination of the two.

Sounds of popping and clicking from the joints is not considered normal, but may not necessarily be a problem.  There are patients hwo have clicking and popping sounds who have no other problems. Likewise, there are folks who have no clicks whatsoever, yet they have TMD related pain. There are also so called 'silent clicks" which while inaudible, still may represent a dysfunctional aspect to the joint.

TMD related pain can come in several flavors. Some is muscular related due to inordinate and or continuous muscle tension. Patients who clench their teeth at night may awaken with sore facial muscles  due to night long grinding of their teeth.

A second type of pain may be related to the actual disk which is located in the "jaw socket" so to speak. This in some ways can be compared to a ball and socket, but the movement is much more complex. Separating the lower jaw from the upper jaw "socket" or fossa, is a disk or meniscus similar to the disks between the vertebrae of the back. As the lower jaw opens, this disk functions to smoothen the opening and closing pathways. If the disk is perforated or damages, or perhaps slides out of place in a dysfunctional manner, then a jaw sound and or jaw pain may result.

getting to your situation Layla, it can not be said with certainty whether your jaw sounds are related to the open bite. If you have a strong and profound skeletal open bite the upper and lower jaws can not meet in a normal manner, and this may indeed affect the disk or meniscus.

Injuries to the disk can occur due to vehicular accidents, overzealous opening and stretching of the jaw due to wisdom tooth removal, extended dental procedures involving opening the mouth widely for long periods of time (root canals for example), and a myriad of other causes.

Treatment choices for these conditions can vary greatly. I think the best thing for you to do Layla is to have some radiographs taken, possibly 3D type cone beam analyses to better define what skeletal imbalances and asymmetries you have. Have your parents consult with an Orthodontist and perhaps an oral surgeon to help jointly interpret the results and to plan a treatment approach. Severe skeletal asymmetries may require surgical orthognathics to help resolve the dysfunctions. Again Layla, this is an extremely complex and fuzzy area regarding TMD. It is the dental equivalent of back pain or headaches in medicine, where causes sometimes are unclear, and the choice of treatment extremely varied.

Please feel free to write again once you have some radiographic diagnostic completed.

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Paul Supan, DDS, MA, MPH

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First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

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American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

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Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

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Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

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