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Facial/Jaw Growth Problems Can Cause TMD (Temporomandibular Joint Disease)

By Anthony P. Urbanek, DDS, MD –

mandibularTemporomandibular Joint Disease is a very common problem, especially among women. Patients with TMD suffer from a range of symptoms including headaches, earaches, neck and jaw pain, ringing and fullness in the ear. These symptoms, caused by inflammation of the Temporomandibular Joint, appear due to one of three causes: bruxism, trauma or facial/jaw growth problems. Of the three causes for TMD, facial growth problems are the least understood by patients and are therefore poorly addressed and corrected.

Eight Varieties of Facial (Jaw) Growth Problems
Facial growth problems can be categorized into eight varieties which break down to four varieties in the upper jaw (maxilla) and four in the lower jaw (mandible). Each variety has a pronounced appearance that most people can recognize as unattractive and out of proportion. A proportional face is considered to be an attractive face and is celebrated most frequently as that “Hollywood appearance.” Each jaw can have too little or too much growth horizontally or vertically.

The Varieties of Facial Growth Problems for Each Jaw are:
1. Prognathism – too much horizontal growth
2. Retrognathism – too little horizontal growth
3. Vertical Hyperplasia – too much vertical growth (“long faces”)
4. Vertical Hypoplasia – too little vertical growth (“short or squished faces”)

All the different varieties of jaw growth problems can be observed in both children that are growing and adults after they have reached growth maturity. Correcting the growth problem with orthodontics (braces) in the growing child will sometimes alleviate the problem, but once facial growth has been completed a combination of orthodontics and surgery of the facial bones is necessary to properly align the jaws.

The Functional & Painful Component to Facial Growth Problems
Besides the unattractive nature of a disproportional face, there is a functional and painful component to facial growth problems. Facial growth problems create excessive stresses over time to the Temporomandibular Joint causing the common denominator of all joint problems – inflammation. As discussed in earlier articles, inflammation is the origin of the headaches, earaches, neck and jaw pain, ringing (tinnitus) and feeling of a stopped up ear (fullness) associated with all types of TMD.

Each of the eight varieties of facial growth problems can, in time, cause inflammation of the Temporomandibular Joint and the subsequent painful symptoms, but a retruded lower jaw or “mandibular retrusion” in particular is notorious for causing TMD. This variety is seen more frequently in women and presents as a lack of growth of the lower jaw and a dental occlusion in which the lower front teeth align significantly behind the upper front teeth. This “plunger effect” of the lower teeth into the palate of the upper jaw significantly overloads the TMJ. This will ultimately create inflammation of the joint leading to headaches, earaches, neck and jaw pain, ringing and a feeling of fullness in the ear.

Finding a Solution
Misaligned jaws can cause Temporomandibular Joint Disease and should be considered a contributing factor for anyone who complains of TMJ/TMD symptoms. Patients with facial growth problems and simultaneous TMD symptoms should seek a consultation with a Board Certified Oral and Maxillofacial Surgeon and an Orthodontist to determine the best treatment plan applicable to their particular problem.

To learn more about TMD or to schedule an appointment to discuss your symptoms, please call Dr. Anthony P. Urbanek at 615-771-1983 or visit us online at

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