Does Invisalign Help With Tmj

Written By: admin - Feb• 08•12

Invisalign retainers accomplish the same feats that conventional braces do, only they are transparent and don't have the negative side effects that braces come with. They can't fix everything that braces are able to do, but they are still the best option in most oral correction attempts.

The perfect smile can be tainted with even a small gap- especially if it's between the two front teeth. A gap can give the impression that a patient has poor hygiene or negatively impact their beauty in the eyes of others. Gaps are easy to fix in adults when Invisalign retainers are used. Even wide gaps can be fixed, although it may take longer to do so.

Opposite of the widely spaced teeth, the overly crowded teeth can cause an extreme deformation of the rest of one's teeth. Because of this, dentists must correct crowded teeth before the rest of the teeth are moved beyond repair. Invisalign retainers will space out the teeth just enough, so that they still look uniform and won't be subject to dental decay.

More serious problems might present in the form of an overbite. An overbite looks poor, since the upper teeth will extend beyond the bottom teeth by a large amount. An overbite is a serious condition that is fixed by both braces and Invisalign, despite some concerns that Invisalign is only for small alignments. Invisalign has cured remarkable cases of overbite- but know that a more serious problem will take a longer period of time to fix on average.

When the jaw is misaligned to the point where the bottom jaw extends passed the top, this is called an underbite. The underbite is much like the overbite- unsightly and slightly harder to fix. Invisalign retainers will still fix the problem through several treatments. This condition is sometimes confused when you are missing teeth. In that case, you may also consider a replacement.

Sometimes the teeth can be so mangled that they form something known as the crossbite. A crossbite can take a long time to fix if it is severe, since both the upper and lower jaw will need to be transformed. A crossbite doesn't necessarily look bad in a cosmetic stance, but it does have odds in causing dental problems. As a result, even if you can get by with a crossbite, it is better to have a dentist fix it. It's better to get it fixed with Invisalign than to be sorry several years down the road when you have an oral disease or complication.

Final Thoughts

Dentists all over are starting to recommend Invisalign over regular braces. Your options shouldn't be limited thanks to the widespread support for Invisalign. Start talking to a few local dentists to see if they are certified to work with Invisalign. If so, schedule a meeting to find out more.

Frequently Asked Questions

  1. QUESTION:
    Could stopping wearing my invisalign give me TMJ? please help me I am scared?
    I quit wearing my invisalign In August when I had my wisdom teeth taken out. In about october, my TMJ area began hurting more, my inner ears hurt, and I got head aches a lot. Parts of my face started hurting too. None of these things had hurt to this degree in the past. My previous tinnitus became louder too. I do not know if this has something to do with the postural orthostatic tachycardia syndrome (a bizarre neurological syndrome) that I have or the fact that I have not been wearing my invisalign for months. The dentist acted like it was no big deal back in August that I would not be wearing my invisalign. I guess I need to back in and see him and maybe get him to make me another fitting for my teeth. idk I am scared

    • ANSWER:
      Using Invisalign at this point, when you have TMJ problems will further aggravate the problem.

      Therefore, see a TMJ specialist first...before it gets out of control.

  2. QUESTION:
    Braces as an adult to fix TMJ problems?
    I'm a 22 college student and have been having jaw issues for about a year. My dentist referred me to an orthodontist who told me to fix my problem I would have to wear wire braces on top and bottom for 16 to 22 months (Invisalign is not an option)! I was honestly really surprised because my teeth are generally very straight except for my front two teeth on bottom which shifted from clenching.

    I don't experience that much pain from the TMJ and actually just wanted to fix the front two teeth on bottom. I've done some research and read that braces can actually make TMJ worse. I don't want to go through all the embarrassment and pain of having braces as an adult if it's not going to help! Anyone have any suggestions or personal experience that can help me figure out what steps to take? I heard a chiropractor can help with readjusting the jaw, does this actually help?
    This would be my first time having braces!

    • ANSWER:
      My dentist specializes in TMJ and he has said that some of the problems arise when your jaw does not meet or if you are moving it a certain way (for me, I crush my food rather than chew up and down, this puts pressure on my jaw, plus I have an overbite). Your ortho is right, even though many people say that Invisalign will fix the jaw (as does their website), it will not significantly. I have Invisalign right now with my overbite and after I still will have the overbite. I'm 20 and so that also helped me make the decision about Invisalign because for me, I found braces would be embarassing, esepcially because I'm getting my commerce degree and talking to professional people all the time. My Invisalign has yet to make my TMJ worse so I'm pretty happy about that, but then again, I'm not taking the agressive steps to move my jaw (they would have had to glue on brackets onto 4 of my teeth and then I would have had to do the whole elastic thing). If you want to fix those teeth and don't care about your jaw, then sure go for Invisalign. Just keep in mind that they will be gluing some tooth colored attachments to your teeth (I have 7 in total) no matter how messed up they are (my bottom teeth only had 1 tooth misaligned and I have 4, where as my top has 4 teeth misaligned and I only have 3).

      Have you ever tried getting a nightguard to help you? My dentist told me that after my Invisalign treatment that he is going to make me a special one to help reduce the pressure that my clenching causes. I have never heard about the chiropractor helping but it could. I personally wouldn't do it because the whole throught of what they do scares me. I also heard that some physical theorpy can help as well.

  3. QUESTION:
    found out i have tmj i think i have hd it for 6 years from clenching got my mouth guard i plastic hard one?
    made used it last night it helped the pain for the last week was bad i mean im still feeling soreness and stuff i also have a n appt aug 27 with the oral sx so they can do xrays and see how bad my tmj is will the mouthg uard help the alingmnet or not the mouthguard looks like invisalign kind of and it helps i guess i just wore it last night its my ear that are throbbing bad ly now and im leaving sat for vacation on a plane im eating soft foods when i can and trying to rest my mouth

    • ANSWER:

  4. QUESTION:
    Why would an orthodontist take longer with invisalign treatment than a dentist if the results are the same?
    When I went to my family dentist in Omaha, NE, they said my treatment would take about 9 months (after they did the impressions and all of that). I then moved to Lincoln, Ne and visited an Orthodonist who told me that my jaw is slightly misaligned and that I should see a TMJ doctor ("to make her job easier"). She then said that she would take 18 months for the treatment. I don't know if she meant she would take that long no matter what, or just if i do not see a TMJ doctor. I'm just sooooo confused about what I should do. I want to do the treatment that takes half the time and gives the same results.. Invisalign is supposed to correct a misaligned jaw so I really don't get why it was such a huge problem. I don't want to make the wrong choice. Please help!!

    Thanks!

    • ANSWER:
      Invisalign can only apply so much pressure to the teeth. Regular braces have much better precision and control on the tooth and has an easier time making the corrections. Invisalign is not appropriate if your jaw is misaligned. It can make the teeth look straighter, but really mess up your jaw. The TMJ person might be someone to see. Find out if they take a submental vertex xray and corrected tomograms to see the condition of the jaw joint. Generally, just straightening teeth isn't enough. You need to take into account the TMJ. Most orthodontists don't and then I get to see the people with damaged jaws and chronic pain.

  5. QUESTION:
    TOOTH975 could you please answer this question about getting braces?
    Hi Tooth975!

    I'm 20 years old and had two premolars extracted in the upper jaw yesterday and am getting braces in a month. My orthodontist wants to extract two premolars in the lower jaw as well but I've heard some bad things about extraction/retraction orthodontics lately and I was wondering if it's possible not to have them extracted after all. What do you suggest I do at this point?

    I've heard about TMJ disorder and facial changes and how does one avoid them? Does this primarily happen when you extract premolars in your lower jaw? In that case, since I don't think my teeth on the lower jaw necessarily needs to straighten out since they're barely crooked at all I'm thinking of only aligning the teeth in my upper jaw which is the one I'm mostly concerned with.

    Can I get a good result bearing in mind that I now have more teeth on my lower jaw?

    What kind of braces should I be getting? Do you think invisalign is good or is it all right to use traditional braces in the upper jaw? I don't want my teeth to move backwards, only be "turned right". And my wisdom teeth are also coming up, will that affect my teeth and press them forward?

    I mentioned my worries about the negative results (TMJ disorder and facial changes) I've heard traditional braces can cause but my orthodentist said she hadn't heard of any cases like that. Should I change dentist?

    Please help me I have no idea of what to do.

    • ANSWER:
      I am sorry to tell you that it is the extraction of the upper premolars and their retraction that causes the most harm and lead to TMJ disorders. When upper premolars are extracted, it creates way more space than is necessary to straighten teeth and in order to eliminate the excess space, the front teeth are retracted or pulled back. Since upper front teeth play an important role in providing adequate lip support, commonsense should tell you that retraction of these teeth will reduce lip support and cause the facial profile to suffer by becoming sunken in around the mouth area. In some cases this is a desired effect but in a majority of patients this is undesirable and disfiguring. Retraction of the upper front teeth also forces the mandible to bite further posteriorly and this will cause the condyles to be posterior-superiorly displaced leading to anterior displacement of the articular disk. Traditional orthodontist are not aware of this and do not know anything about TMJ, its cause, and its treatment so informing your orthodontist about these facts will be futile.

      The way to avoid TMJ disorders and worsening of the facial profile is to NOT have any premolars extracted. Since the upper premolars are already gone, do not make your situation worse by allowing the lowers to be extracted. Since I cannot review your cephalometric records or see you in person, I would strongly advise you to find an orthodontist who knows functional orthodontic technique to salvage your situation. Your present orthodontist will not know what to do except to proceed as she has been trained - extract bicuspids and retract teeth. If you were my patient and walked into my office with recently extracted upper premolars, I would maintain the extraction spaces, use expansion to gain the necessary room to straighten your teeth, and then suggest implants to restore the gaps where the extracted premolars used to be when your braces are removed. When expansion is used in adults, wearing a retainer for life at bed time will be necessary but I see this as a small price to pay to avoid TMJ problems and facial disfigurement. May I suggest you check this link out to find someone who may help - www.iaortho.org. The best thing to do would be to find a traditional orthodontist who have "seen the light" and uses functional orthodontics in his practice. An increasing number are so call the office and simply ask the receptionist if the doctor knows how to do functional orthodontics. If you are asked, "what's that?" then go to the next office on the list.

  6. QUESTION:
    Tooth975, reversing bicuspid extractions? Please have a look at my case...?
    First, I wanted to get braces at age 15, because I thought my teeth were “too forward”. I consulted with 2 orthodontists who both said I needed to have my 4 bicuspids extracted. I went to a third orthodontist who gave me 2 options after he saw the required X-Ray: either to extract or not to extract. If I extract he said, I will have room for my wisdom teeth when they erupt. If not, I have to remove them surgically before I get the braces. Unfortunately I chose bicuspid extractions, even though all my teeth fitted in my mouth, and I just had a bite problem.
    I got braces for 4 years; first my lower jaw was brought back and then my upper jaw, both by wearing headgear (J-Hook), then the orthodontist used elastics. I need to mention that he pushed my front teeth back a little, and advanced my molars forward a little in order to close the gaps but I don’t know if this is a good thing or if it diminishes the damages done. I hope you can clarify this point :)

    Now I’m 25, and I have one wisdom tooth erupted (it’s perfectly healthy and fits well in my mouth), one erupting and the other 2 are starting to show. Also I think I have no TMJ, no headaches, no sleep disorders, so in general no health problems. However, my tongue does not fit well in my mouth and it bugs me sometimes, even though I quite got used to it… also, I do not like how my profile looks as I think it moved from a class I to a class II profile (I compared before and after pictures after doing an online research). When I bite my upper jaw does not meet well with my lower jaw, meaning that I have to push harder for my lower jaw to come forward (overbite?...) and I find that my smile is narrow. I used to have a wider smile. My nose which already has a bump is more prominent and the bump looks bigger. My lips are less full than before the extractions. See, my problems are mostly from a cosmetic viewpoint…

    I have a few questions:
    -If I want to reverse all these unwanted effects, is it necessary to replace the 4 bicuspids in my case, or can my jaws simply be moved forward to return to a class I profile without recreating spaces and getting implants? I mean can all teeth be moved forward without creating TMJ problems?

    -Will my face and profile look like before? Will I look good from a cosmetic point of view?

    -What kind of appliances apply to my case?

    -Is it necessary to use expansion in my case?

    -Do I need to be in full brackets the whole time of treatment?

    -I understand from one of your replies that sometimes when the upper jaw is moved forward the lower jaw tends to move forward naturally. Can this be applied to my case even though headgear was used on my lower teeth?

    -Is it an option to use invisalign?

    -How long will the whole process take?

    Sorry for the load of questions… :)
    I thank you a lot in advance for your time and your help.
    Suzie B.

    • ANSWER:
      You had typical bicuspid extraction treatment where bicuspids were pulled and the front teeth were retracted. This results in loss of lip support and a dished-in profile. When the spaces created by this treatment are closed, almost all is the result of the front teeth moving posteriorly and very little from molars moving forward. And YES, molars moving forward would definitely be a plus but unfortunately such movement is almost always insignificant because multirooted molars are VERY difficult to move and takes much more time to do.

      Pulling the upper jaw and the lower jaw back usually causes posterior-superior displacement of the condyles which in turn will cause anterior displacement of the articular disk whenever your teeth come together. This causes the jaws to click and pop. You are 25 now but you are not out of the woods yet. TMJ has been known to develop in patients as old as in their mid 30's. You can self diagnose TMJ by inserting your pinkies into your ear canals with the soft portion forward and opening and closing. If you feel no clicking then you do not have TMJ; if you do feel clicking then you have a TMJ disorder. Pain and the other symptoms often associated with the disorder may come later; it will all depend on how well your body handles stress and trauma. You may just be lucky enough to be one of the few females who will not develop a TMJ disorder.

      A cephalometric analysis and full orthodontic workup including a model analysis will need to be done before any of the questions you asked can be answered. Not being able to actually see you in person and assess your profile also makes it impossible to answer your questions. I can only tell you that the normal way to reverse the effects of bicuspid extractions is to reopen all the spaces and use implants to restore the gaps. When an entrapped mandible is released, the mandible often comes forward on its own and how much is uncertain but in adults it is usually minor. Usually a functional appliance (like Twin Blocks) will be needed to move it to a Class I after the maxilla is properly situated again. What appliances will be used will depend on the orthodontist's experience and expertise as each patient is an individual case.

      Invisalign cannot do any of this.

      Expect a treatment time of no less than 2 years. A cephalometric analysis will show the severity of your problems and what will need to be done. I apologize for not being more specific but only very generalized treatment plans and procedures can be given online since the patient is not physically present and the necessary records are not available.

      Although I have not done so, I have attended TMJ seminars where the orthodontist have maintained the 4 bicuspid extraction situation and moved the upper and lower jaws anteriorly to correct a TMJ disorder. From this one can assume that partial facial profile improvements also resulted. You cannot just move teeth alone, entire jaws must be moved.

  7. QUESTION:
    OUCH! Jaw keeps popping!!! :( Help?
    I've been having difficulties with this FOREVER because I have a really bad overbite. My dentist said it was causing the allignment of the plates in my jaw to go a little askew and thus resulting in the popping. I did some of my own research and it sounds like it's probably TMJ. The weird thing is that it doesn't even hurt half the time and I don't even notice it popping, but the other half, whenever I eat something chewy, it starts causing a lot of aching and soreness.

    This is pissing me off now and I'm tired of it! I feel like I'm making it worse by not doing anything!!!! I told my mom about it and that she should probably call the orthodontist to make an appointment to see if I need jaw splints. I CANT GET BRACES THOUGH!! I'll be a senior in 2 years (SENIOR PICS!!), my sister is going to get married soon (WEDDING PHOTOS), graduation, prom, MORE PICTURES TO BE TAKEN THAT WILL LAST FOREVER!!!!! I could handle splints b/c they hide in the back of your mouth.

    Anyways, my mom said I really don't need to do this, BUT I DO. How do I make her understand that this is a serious problem?

    Also, some more questions:
    1.)What are splints like?
    2.)How expensive?
    3.)Do they slur your speech or affect it in any way? (I do a lot of singing and talent shows each year, so I can't have any of that!)
    4.)Is there another solution to braces? Like invisalign?
    5.)How expensive are those?
    6.)How much pain is involved in either splints OR invisalign??

    Thanks for taking the time to read this. Please, provide good advise!!

    • ANSWER:
      You definitely have a TMJ disorder (aka TMD) and the absence of pain is immaterial. Pain will come later when you are older and when your body starts to break down and can no longer cope with the stress and trauma caused by the constant dislocation and going back into place of the articular disk (the source of the jaw noises) within your jaw joint. Some people have TMJ all their lives and never experience any pain at all because their body is able to handle the stress caused by TMJ; however, many more people are incapacitated to varying degrees depending on their genetic makeup. You need to find a dentist who knows how to treat TMD (not all do) but avoid oral surgeons and traditional orthodontists, trust me. TMD treatment is usually done in 2 phases. Phase 1 consists of reversible procedures that will stop the dislocation of the disk and stabilize the TM joint and will involve wearing a splint 24/7. You can stay in this stage indefinitely and when you are ready, you may proceed to Phase 2, which involves permanent changes to your teeth, bite, and lower jaw position to maintain the stability established in Phase 1. Phase 2 usually involves functional orthodontics and braces.

      To answer your specific questions:
      1) there are many designs but all are made of dental acrylic (a kind of plastic); some are made to be worn on the upper teeth and some on the bottom. Regardless of which one is made, all have the purpose of keeping your teeth from coming together so that they are separated a certain distance. Some are also designed so that when your teeth come together, it forces your lower jaw to bite forward to relieve pressure on the jaw joint.
      2) cost will depend on where you live as with anything else in dentistry.
      3) Speech will be affected for probably a month or so. Anything that is worn in the mouth will affect the way you talk until the tongue gets used to having the new neighbor around.
      4) Phase 2 will involve braces as well as functional appliances and there is not way around it. Invisalign cannot solve the type of problems that will need to be addressed when there is a TMJ problem.
      5) same as #2
      6) there should be no pain involved.


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