Short answer: Clear aligners or braces can often be used in people with a jaw joint problem, but the joint and muscles need to be evaluated first. According to the current scientific view, orthodontic treatment alone has not been shown to cause jaw joint disorders; even so, if symptoms are active, the dentist may prefer to calm them down first and then do the planning.
Many people who have a jaw joint problem and want to straighten their teeth ask the same question: my joint clicks or hurts, so would it get worse if I wear clear aligners or braces? The short answer is this: orthodontic treatment is often possible in these people, but the joint and the chewing muscles first need to be carefully evaluated and treatment planned accordingly. This article is for general information; diagnosis and treatment decisions require an exam.
What is a jaw joint problem and what symptoms does it show?
The jaw joint is the joint that connects the lower jaw to the skull, located just in front of the ear. Complaints involving this joint and the surrounding chewing muscles are generally described under the heading of temporomandibular disorders (TMD or TMJ disorders). For detailed information, you can take a look at our article on jaw joint disorders.
Common symptoms are as follows:
- Clicking, popping or grating sounds in front of the ear when opening and closing the mouth
- Pain or a feeling of fatigue in the jaw area, temple or cheek
- Limited mouth opening or the jaw getting stuck
- Stiffness in the jaw muscles and headaches in the morning
- Discomfort when chewing or a feeling of fullness in the ear
Because these symptoms can be confused with other health problems, do not try to diagnose yourself. Clicking on its own does not always mean a disease; evaluation becomes important if pain and loss of function accompany it.
Does orthodontic treatment cause a jaw joint problem?
The general view in the scientific literature is that orthodontic treatment alone has not been shown to cause jaw joint disorders. Likewise, it cannot be said that orthodontic treatment definitively prevents or treats these disorders. Jaw joint complaints are already common in the population and can also appear in young adulthood, which is when many people have orthodontic treatment. For this reason, a complaint that happens to coincide in time should not automatically be counted as a result of the treatment.
In addition, jaw joint complaints do not have a single cause. Many factors can play a role, such as stress, clenching and grinding, trauma, differences in joint structure, sleep pattern and muscle tension. These factors can continue during orthodontic treatment as well, so it is important for the patient and the dentist to record the starting condition together.
Why is an evaluation needed before treatment?
An evaluation is needed before treatment because, when there is active pain or limitation, it becomes difficult to take orthodontic records, measure the bite relationship and set treatment goals. The dentist first examines joint movements, the tenderness of the muscles, mouth opening and, if there is clicking, its nature. If necessary, additional tests may be requested to image the joint.
Three kinds of approach can emerge from the evaluation:
- No symptoms, or mild and stable: Orthodontic treatment can usually begin as planned, and the joint is monitored throughout treatment.
- Active symptoms: The dentist may first wait for the complaints to settle; options such as muscle-relaxing approaches, adjusting habits or a protective splint may come up.
- Marked joint pathology: The decision may need to be made together with the relevant specialties (jaw surgery or orofacial pain).
As a patient, describing the symptoms you experience, when they started and what increases or reduces them makes this evaluation easier.
Is there a difference between clear aligners and braces with regard to the joint?
There is no general rule about which method is more suitable for people with joint complaints; the choice is made according to the problem with the teeth, the bite and the patient's overall condition. One aspect of clear aligners is that, because they are removable, they can offer the flexibility of pausing treatment when joint complaints flare up; a thin aligner may also have some protective effect in the mouth. However, for someone who constantly clenches with the aligners in, this on its own is not considered a solution.
Fixed braces, on the other hand, may be preferred in complex situations where they can guide the teeth in a more controlled way. Which is more suitable becomes clear after an exam with the dentist. For a general comparison of the two methods, you can look at our page on clear aligners or braces. Our clear aligner problems page also helps with situations that may come up during treatment.
What is the relationship between a night guard and clear aligners?
A night guard (occlusal splint) and a clear aligner serve different purposes. A night guard is a protective appliance, usually used during sleep, intended to reduce the load that clenching and grinding put on the teeth and muscles. A clear orthodontic aligner, on the other hand, is designed to move teeth. These two products do not replace one another.
In a person with bruxism, the dentist may recommend a night guard during orthodontic treatment, or may choose the retention method after treatment to suit the bruxism. For example, guards of different hardness and thickness vary according to their intended use. You can read our article on night guards and our article on bruxism; our article on joint splints is also useful for splints used for the joint.
How is the link between the bite and the jaw joint thought of?
The relationship between the bite and the jaw joint has been debated for many years. It used to be thought that a particular bite problem was the main cause of jaw joint complaints. The current view sees jaw joint disorders as multifactorial problems; the bite may be one factor, but it is not accepted as the sole explanation. For this reason, recommending orthodontic treatment for a jaw joint complaint just to change the bite is not a common approach.
On the other hand, chewing difficulties caused by crowding, crossbite or open bite can affect the patient's quality of life. In such cases, orthodontic correction is done for dental reasons, and treatment proceeds with the joint being monitored. The dentist's job is to explain clearly the goal for which the treatment is planned, that is, not to promise a solution to the joint complaint and to keep expectations within the right frame. From our pages on bite problems, you can look at the topics of crossbite and open bite.
If joint complaints have been going on for a long time and factors such as clenching, sleep problems or stress are dominant, it may be more beneficial for the patient to address these factors before orthodontic treatment. That way both the symptoms and the comfort of the treatment process are better managed.
What should be kept in mind during treatment?
While someone with jaw joint sensitivity is having orthodontic treatment, paying attention to a few daily habits can bring relief:
- Limiting very hard and very sticky foods, and cutting large bites into smaller pieces
- Chewing less gum and avoiding habits such as biting nails and pens
- Avoiding opening the mouth very wide (long yawns, big bites)
- Trying to manage stress levels; paying attention to sleep routine
- Letting your dentist know without waiting for your appointment if there is new pain, locking or an increase in clicking
These are general recommendations and do not replace individual treatment. Be sure to consult your dentist about medication use or special exercises.
When should you seek an evaluation in Ankara?
If you have jaw pain, clicking or difficulty opening your mouth and are also thinking about straightening your teeth, at our clinic in Çankaya, Ankara, the joint and the bite are first evaluated together; if clear aligners are considered suitable, they are planned with the Invisalign system. To make an appointment, you can use our contact page.
Frequently asked questions
If my jaw joint clicks, can I use clear aligners?
If there is no pain or limitation, clicking on its own may not be an obstacle to treatment. Even so, the dentist examines the joint and monitors it throughout treatment. The final decision is made after the exam.
Will clear aligners relieve jaw pain?
Clear orthodontic aligners are designed to align the teeth, not to treat jaw pain. If there is pain, an evaluation directed at its cause is needed.
Can a night guard and clear aligners be used at the same time?
In some cases the dentist may recommend a night guard during or after treatment. How they are used together is determined according to the person and the stage of treatment.
What should I do if my jaw pain increases during treatment?
If the pain increases, the jaw locks or opening the mouth becomes difficult, let the clinic know without waiting for your appointment. The dentist can review the treatment plan or refer you for the necessary support.