Relapse after orthodontic treatment is a major concern both for patients and for dentists. Patients feel that they didn’t get their money’s worth out of what can be an expensive cosmetic dentistry procedure, while dentists often blame relapse on a patient’s failure to wear their orthodontic retainer.
But there’s another important factor for teeth that relapse after treatment with braces: the temporomandibular joint. The temporomandibular joint plays a major role in the way teeth come together and the forces they experience, and an irregular function of the temporomandibular joint can lead to irregular forces that tend to cause relapse.
As a result, people who experience a relapse after orthodontic treatment should be evaluated for temporomandibular joint disorder (TMJ).
How TMJ Causes Relapse
After orthodontic treatment, your teeth may still be subject to the same forces that helped cause them to be crooked or crowded in the first place. Many of these forces are related to your TMJ.
People with TMJ often have a retruded mandible–a lower jaw that is further back than it should be. When your jaw is retruded, not all your teeth will come together. The teeth that come together are subjected to more forces than those that aren’t coming together as often.
Another problem is that TMJ may be associated with an irregular force delivered to your teeth. For example, if you have a displaced disk, that disk will slip into place when your mouth is open, then slip back out of place as you closing your mouth. Depending on when your disk slips back in place, it could cause a change in the way your joint is moving, resulting in sideways forces being applied to your teeth.
When some teeth are being subjected to more force than others, these teeth will drift from the high-force zones to the low-force zones. And when your teeth are experiencing a lateral force, they can be driven in that direction, and in both cases you might experience relapse after braces.
An Early Symptom of TMJ
Researchers note that people who experience orthodontic relapse might not have other symptoms of TMJ yet, such as jaw pain or headaches. They should consider orthodontic relapse as a potential warning sign and consider treatment before they suffer additional symptoms.