# Which of the following is the most consistent finding regarding the impact of orthodontic treatment on TMD signs and symptoms based on high-quality systematic reviews?
A. Correction of a deep overbite is the only proven method to prevent TMD in high-risk patients.
B. Orthodontic treatment significantly decreases the risk and severity of TMD for all patients.
C. Orthodontic treatment significantly increases the risk and severity of TMD due to prolonged appliance wear.
D. Orthodontic treatment neither prevents nor causes TMD
The correct answer is D. Orthodontic treatment neither prevents nor causes TMD
High-quality systematic reviews and meta-analyses, including those by Kim et al. (2002), Manfredini et al. (2016), and Jeong et al. (2024), consistently find no causal relationship between orthodontic treatment and TMD development or resolution, with pooled odds ratios near 1 (e.g., OR 0.75, 95% CI: 0.37–1.51; p=0.42) and qualitative syntheses showing only transient, mild signs (e.g., clicking) without prevalence increases. Methodological heterogeneity in TMD diagnostics (e.g., RDC/TMD vs. questionnaires) limits definitive claims, but no evidence supports causation, prevention, or exacerbation across diverse populations and techniques. Claims of increased risk (e.g., OR 1.84 in a 2023 review) stem from flawed designs (e.g., excluding RCTs, selection bias) critiqued in Evidence-Based Dentistry. Deep bite correction (A) shows inconsistent TMD benefits; universal risk reduction (B) or increase (C) lacks substantiation in longitudinal cohorts.
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