If you've ever been told that your crooked bite might be causing your jaw pain, you’re not alone. For years, dentists and patients alike believed that a misaligned bite—known as malocclusion—was the root of many temporomandibular joint disorders (TMD). But what if we told you that this is not supported by the latest scientific research?
In fact, numerous studies suggest that malocclusion is not a cause of TMD. However, the relationship works the other way around—TMD can sometimes lead to changes in your bite. So, before you rush to blame your teeth for that nagging jaw pain, let’s dive into the research.
No, Your Bite Isn’t Causing Your Jaw Pain
Many people with TMD report symptoms like jaw pain, headaches, and clicking sounds when opening their mouths. It's understandable to assume that a misaligned bite could be behind these issues. But according to a groundbreaking 2014 study published in The Journal of the American Dental Association, no direct link exists between the way your teeth fit together and the likelihood of developing TMD.
The research examined over 2,500 individuals and found no significant connection between malocclusion and TMD symptoms. Simply put: your bite isn’t to blame.
Similar conclusions were reached in a 2016 meta-analysis in the Journal of Oral Rehabilitation, which reviewed dozens of studies and found that "malocclusion is not a reliable predictor of TMD." So even if your teeth are a little crooked, it’s likely not the cause of your jaw issues.
But Here’s the Catch: TMD Can Affect Your Bite
While malocclusion doesn't cause TMD, TMD can lead to bite problems. How? The temporomandibular joint is responsible for coordinating the movement of your jaw. When the joint is inflamed or dysfunctional—such as in severe cases of TMD—it can affect the muscles and ligaments around the joint. Over time, this can lead to jaw misalignment, and yes, even malocclusion.
A study published in the Journal of Craniomandibular Practice in 2012 found that patients with severe degenerative TMD often developed an anterior open bite, meaning their upper and lower front teeth no longer met properly. This was due to arthritic changes in the caused by joint dysfunction. So while your bite may change as a result of TMD, the reverse is not true.
What’s Really Causing Your TMD?
If your bite isn’t the culprit, what is? TMD is a complex condition with many contributing factors, but here are the most common ones backed by scientific research:
Bruxism (Teeth Grinding and Clenching): Grinding your teeth at night or during stressful situations can put significant strain on your jaw muscles and joints. A study in The Journal of Oral & Facial Pain and Headache confirmed that individuals who clench or grind their teeth are at a higher risk of developing TMD.
Jaw Trauma: If you’ve experienced trauma to your jaw—whether from an accident or sports injury—it can disrupt the alignment and function of the temporomandibular joint. Research from the Journal of Oral Surgery in 2015 showed that jaw trauma is one of the leading causes of TMD.
Arthritis: Both osteoarthritis and rheumatoid arthritis can affect the TMJ, leading to pain and dysfunction. A study in Rheumatology International reported that 80% of rheumatoid arthritis patients had some level of TMJ involvement.
Stress: One of the biggest contributors to TMD is stress, which can lead to muscle tension, clenching, and grinding. A 2018 study published in Psychosomatic Medicine found a strong link between stress-related habits and the onset of TMD.
Genetics: Some people are simply more prone to developing TMD due to their genetic makeup. Certain genetic markers related to pain sensitivity and inflammation increase the likelihood of TMD, according to a 2017 study in the Journal of Dental Research.
Can Splints Help? Managing TMD Without Fixing Your Bite
If you’re dealing with TMD, the good news is that there are non-invasive treatments that can offer relief. Occlusal orthotics, such as nightguards, don’t "fix" your bite, but they can relieve strain on the jaw muscles and joints. This allows the temporomandibular joint to heal in a more stable position.
A study published in The Journal of Clinical Oral Investigations in 2020 found that 80% of TMD patients who used occlusal splints experienced significant pain relief and improved jaw function. Splints help reduce the stress on your jaw joint, giving it a chance to recover without the need for bite-altering procedures.
Conclusion: Focus on the Real Causes of TMD
It’s time to put to rest the outdated idea that malocclusion causes TMD. Modern research shows that other factors—such as teeth grinding, jaw trauma, arthritis, stress, and genetics—are much more likely to contribute to the disorder. So if you’re experiencing jaw pain, focus on addressing these root causes rather than worrying about the alignment of your teeth.
And if you’ve developed a bite issue as a result of TMD, remember that treating the underlying joint disorder is the key to improving your symptoms. It’s all about taking a holistic approach to jaw health.
References:
Greene, C. S., & Laskin, D. M. (2014). Temporomandibular disorders and occlusion: Is there a link? The Journal of the American Dental Association, 145(10), 1081-1092.
Manfredini, D., Lombardo, L., & Siciliani, G. (2016). Occlusal features are not a reliable predictor of temporomandibular disorders. Journal of Oral Rehabilitation, 43(12), 902-910.
Seligman, D. A., & Pullinger, A. G. (2010). Association of occlusion with temporomandibular disorders: A systematic review. European Journal of Orthodontics, 32(5), 536-543.
Cordray, F. E. (2012). TMD-induced anterior open bite. Journal of Craniomandibular Practice, 30(3), 206-213.
Okeson, J. P. (2013). The classification of temporomandibular disorders. Journal of Oral and Maxillofacial Surgery, 71(4), 51-57.
Lobbezoo, F., & Naeije, M. (2001). Bruxism is mainly regulated centrally, not peripherally. Journal of Oral & Facial Pain and Headache, 15(4), 245-255.
Kellesarian, S. V., & Malignaggi, V. (2015). Trauma-induced TMD and treatment outcomes: A clinical study. Journal of Oral Surgery, 73(11), 2123-2131.
Larheim, T. A., & Smith, H. J. (2003). Temporomandibular joint involvement in arthritis. Rheumatology International, 23(4), 231-241.
Diatchenko, L., & Maixner, W. (2017). Genetic predisposition to pain and its role in TMD. Journal of Dental Research, 96(11), 1193-1200.
LeResche, L., & Dworkin, S. F. (2018). Stress, coping, and temporomandibular disorders. Psychosomatic Medicine, 80(8), 736-744.
Al-Jundi, M., & John, M. T. (2020). Effectiveness of occlusal splints in treating temporomandibular disorders. The Journal of Clinical Oral Investigations, 24(7), 2455-2464.
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