Wertz Orthodontics Answers: What Causes TMJ Pain?

Jaw Pain Has a Way of Getting Your Attention

Your jaw aches before you have said a word in the morning. It clicks every time you bite into a sandwich. Your teenager says their jaw has felt tight ever since a hard hit at football practice.

Families bring these questions to our Lebanon, Robesonia, and Hershey offices every week. Dr. Robert Wertz Jr. holds a Master of Science in Oral Biology from Temple University, and that training shapes how we look at jaw pain: the joint, the muscles, the teeth, and how all three work together when you bite.

Here is what we want you to know up front. Jaw pain often has more than one cause; your bite may be one of them, and an out-of-balance bite can be corrected. An orthodontic evaluation is how you find out whether that is true for you.

What Is the Difference Between TMJ and TMD?

TMJ is the name of the joint, and TMD is the name of the problem. The temporomandibular joints (TMJs) connect your lower jaw to your skull, one on each side, just in front of your ears. Temporomandibular disorders (TMDs) are conditions that cause pain or dysfunction in those joints and in the muscles that move your jaw.

So when someone asks, "Do I have TMJ?" the answer is yes, everyone does. The better question is whether you have a TMD, and what is driving it.

The National Institute of Dental and Craniofacial Research(NIDCR) describes TMDs as a group of more than 30 conditions, which is one reason jaw pain can look so different from one person to the next.

What Causes TMJ Pain?

TMJ pain usually comes from a combination of factors rather than a single cause. Some affect the joint itself, some affect the chewing muscles, and some affect how your jaw is loaded every time your teeth come together.

Common Contributors to Jaw Pain

• Bite problems. When the upper and lower teeth or jaws do not meet the way they should, the jaw may close into a strained position. A 2025 review of 29 studies found that Class II and Class III bites, deep bites, and crossbites were associated with a high prevalence of TMD symptoms, including jaw deviation, joint pain, and muscle tenderness.
• Clenching and grinding. Clenching, grinding, gum chewing, and nail biting keep the chewing muscles working when they should be resting.
• Jaw injury. A fall, a car accident, or a blow to the face during sports can injure the joint.
• Arthritis and joint conditions. Degenerative and inflammatory joint disease can affect the jaw joint just as it affects knees and hips.
• Stress and pain sensitivity. The NIDCR notes that life stressors, genetics, and how a person perceives pain can all influence whether TMD develops and how long it lasts.

Most of these can be managed, and one of them, the bite, is exactly what orthodontists are trained to correct.

What Are the Symptoms of a TMJ Disorder?

Pain in the chewing muscles or the jaw joint is the most common symptom. Other signs that can point to a TMD include:

• Pain that spreads to the face, temples, or neck
• Jaw stiffness, especially in the morning
• Limited opening, or a jaw that catches or locks
• Painful clicking, popping, or grating when you open or close your mouth
• Ear pain, ringing in the ears, or headaches
• A change in the way your upper and lower teeth fit together

That last symptom deserves attention. If your bite feels different than it used to, an orthodontic evaluation can show whether the change is coming from your teeth, your jaws, or the joint.

Is Jaw Clicking a Sign of a TMJ Problem?

Clicking without pain is common and usually not a problem by itself. It is worth an evaluation if it comes with pain, if your jaw catches or locks, if opening gets harder, or if you also notice changes in your bite.

Can a Bad Bite Contribute to Jaw Pain?

Yes, for many people, a bad bite is part of the picture. When teeth and jaws do not line up, the chewing muscles and jaw joints work every day around that imbalance.

Researchers who followed adolescent girls in Sweden concluded that, on a group basis, bite type may contribute to the development of TMD. The bite patterns most often linked with jaw symptoms include:

• Class II bite (overbite or overjet), where the upper teeth sit well ahead of the lower teeth
• Class III bite (underbite), where the lower teeth sit ahead of the upper teeth
• Deep bite, where the upper front teeth cover too much of the lower front teeth
• Crossbite, where some upper teeth close inside the lower teeth, sometimes shifting the jaw to one side

A bite problem is rarely the only factor, and not everyone with a crooked bite has jaw pain. But when the bite is contributing, it is something that can be corrected.

Can Orthodontic Treatment Help With TMJ Pain?

Orthodontic treatment can help many patients with jaw pain, especially when a significant bite problem is contributing. Braces and Invisalign align the teeth and improve how the upper and lower teeth meet, which can take strain off the jaw.

Several studies support that benefit:

• Braces and Class II bites. In a prospective Swedish study of 65 girls with Class II bites treated with braces, TMD symptoms became less common over two years, while girls with similar bites who were not treated rated their symptoms as more severe.
• Orthodontics with jaw surgery. In 121 patients with significant jaw discrepancies treated with orthodontics and jaw surgery, muscle pain, joint pain, and disc displacement were all less common 18 months after treatment, and TMD rates fell to levels comparable with people without jaw discrepancies.
• Current reviews. A 2025 scoping review concluded that the available evidence suggests orthodontic and surgical treatment may ease TMD symptoms in selected patients.

Results are not the same for everyone, because jaw pain can have several sources. That is not a reason to avoid orthodontics. It is the reason a careful evaluation comes first.

Will Braces or Invisalign Make My Jaw Pain Worse?

Research does not show that orthodontic treatment causes TMJ disorders or worsens existing symptoms. The same Swedish research group found that treatment with braces, with or without extractions, did not increase TMD signs or make pre-treatment symptoms worse.

Some tooth tenderness is normal when brackets are adjusted or when you switch aligners, and our FAQ notes it typically lasts three to five days. If you feel pain in front of your ear, your jaw catches, or your jaw muscles stay sore, let us know so we can check it.

Why an Orthodontic Evaluation Is the Only Way to Know

You cannot tell from the mirror whether your bite is contributing to your jaw pain. There is no single test for TMD, so the answer comes from putting several pieces together, and an orthodontist is trained to read how the teeth, jaws, and joints fit into one system.

At an orthodontic evaluation, we typically look at:

• How your upper and lower teeth come together when you bite and chew
• How your upper and lower jaws line up with each other
• How far and how smoothly your jaw opens, and whether it shifts to one side
• Joint sounds and tenderness in the jaw joints and chewing muscles
• Your history: where the pain is, when it started, and what makes it better or worse
• X-rays and records that show tooth and jaw positions

From there, we can tell you whether correcting your bite is likely to help, whether another provider should be part of your care, or both.

What Can You Do for Jaw Pain Right Now?

While you are waiting for an evaluation, simple steps can make a sore jaw more comfortable.

When Should You Have Your Jaw Checked?

Schedule an evaluation when jaw pain keeps coming back or when you notice any of these signs.

From fall football to winter wrestling, student athletes across Lebanon, Berks, and Dauphin counties take their share of hits. A properly fitted mouthguard helps protect both teeth and jaw, and our guide to back-to-school sports with braces and aligners covers what to look for.

Why Families Across Central Pennsylvania Choose Wertz Orthodontics

• Bite and jaw evaluated together. At your consultation, we look at how your teeth, jaws, and jaw joints work as one system, not just how straight your smile looks.
• Oral biology training behind every exam. Dr. Wertz holds a Master of Science in Oral Biology from Temple University in addition to his DMD.
• A board-certified second set of eyes. Dr. An is board-certified through the ABO and served as chief resident during her orthodontic residency at the University of Connecticut.
• Options matched to your bite. Braces, Invisalign, and coordination with oral surgeons when a jaw discrepancy calls for surgical orthodontics.
• Three offices and virtual consultations. Lebanon, Robesonia, and Hershey, plus virtual consultations, keep answers close to home.
• Deep roots in Lebanon. Dr. Wertz was born and raised in Lebanon and took over the practice his father started more than 40 years ago.

Frequently Asked Questions

About the Author

Dr. Robert Wertz Jr. is an orthodontist at Wertz Orthodontics with a Master of Science in Oral Biology from Temple University. He evaluates how patients' teeth, jaws, and jaw joints work together to decide when correcting the bite belongs in a plan for jaw comfort. Learn more about Dr. Wertz.