So in today’s blog, dear readers, I will present to you a fairly simple rule of physics: No two objects can occupy the same place at the same time. It’s pretty simple, admittedly. But now let’s get into the example that I have in mind for you. As you all know, I do complicated orthodontics in my practice every day. What that entails is ‘growing’ or ‘lifting’ or ‘erupting’ the teeth taller so that the jaw joint is properly supported and does not collapse further. As you can see in the picture below, there is a little white thing called a turbo buildup that creates a fulcrum or lifting point to get the teeth to raise up taller. All very important things to do.
What is unfortunate, and I saw this in last week’s orthodontic class, is that without that little turbo to stimulate the teeth to grow taller, you basically end up forcing the jaw bone (the condyle) to jam into the socket and impinge on the disc space. So when you use orthodontic elastics to pull the teeth together, without a turbo there, you just jam that condyle into the socket and displace the discs because two objects cannot occupy the same space at the same time. Since the jaw bone is much harder than the soft disc, that little disc just slips out of the socket and becomes displaced and now will pinch blood vessels and nerves in that area. And now you have TMD (Temporo Mandibular Disorder). When I think back over the years about all the orthodontic training that I have done, I realize that this concept was never taught to us. We were always taught, actually, that the teeth have little or nothing to do with TMD. In truth, however, the teeth have EVERYTHING to do with TMD issues.
When you do braces and drag the teeth through the bone to line them up nicer, you are actually putting forces on the cranial bones and these bones can readily distort. I see this every day of the week. Then, on top of all that, if there is no fulcrum to lift the teeth against, and all you do is elastics to pull the teeth together, you can indeed jam the condyle into the socket and displace the discs. A very simple law of physics is then violated: two objects – the condyles and the discs- are now occupying the same space at the same time. End of discussion.