Q: Dr. Eppley, I have this grinding type noise when I open my jaw on my right side. I have had orthodontic treatment years ago and have a underdeveloped lower jaw. I consulted my orthodontist about the grinding noise possibly being linked to my underdeveloped lower mandible. He told me that my jaws are lined up correctly and I should do nothing about this grinding noise. At the beginning if my orthodontic treatment a lower mandibular advancement was recommended, however I decided at that time that I would just have orthodontic treatment without surgery. After orthodontic treatment I have a clearly recessive jaw with extra skin around my lower jaw area. As a craniofacial and maxillofacial surgeon I would highly consider your opinion in what my next step should be.
A: Many people have asymptomatic grinding noises which emanate from their temporomandibular joints. This is usually caused by the disc in the joint which may catch on opening as the mandibular condyle comes forward. Underdeveloped lower jaws with Class II malocclusions (orthodontically corrected or not) have a greater propensity for these disc noises. But as long as one is having no pain in the TMJs or any difficulty with opening, there is no treatment indicated. For the recessive jaw and loose skin around it, this can be aesthetically addressed by either a sliding genioplasty or a chin implant. Either approach has certain advantages and disadvantages that must be assessed based on each person’s anatomy and aesthetic desires. The first place to make this determination would require an assessment of pictures from the side and front views.
Dr. Barry Eppley