I had TMJ from grinding so I got braces. I have bimax protrustion so my prev ortho ordered 4 premolar extracted. Now I switched to a functional ortho who says she wont close my gap because that would force the mandible backwards and that I needed implants. I dont understand how when it's just moving teeth, not the whole mandible. There seems to be two approaches to TMJ treatment: finding the correct jaw and muscle posture using TENS. My ortho plans on using the other technique, moving my jaw down and forward to relieve pressure, without using TENS. This doesn't take into account the muscles, will they adapt? Will I brux more?
Thank you Dr. Tooth975, your other answers have really helped me and what got me to switch to a functional orthodontist. I am still in the search for a good one. Where are you located?
tooth975 - First off, grinding does NOT cause TMJ, it only aggravates an existing TMJ condition. You need functional orthodontic treatment only if you have a TMJ disorder that is due to an internal derangement. Pulling lower front teeth back does not force the mandible back; it's when the UPPER front teeth are retracted that causes all the problems. When upper front teeth are pulled back to close up gaps, it causes the mandible to be forced posteriorly because the upper arch length becomes smaller. Think of the upper teeth as entrapping the mandible and forcing it back. There is also no known cause for bruxism and no known cure either so I cannot say whether bruxism will go away or not after TMJ treatment. That has never been a problem in my experience. Did you check www.iaortho.org to find a functional orthodontist near you?
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