Physical Therapy and TMJD

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Is Your Tooth Pain Actually From Your Jaw?

Understanding How TMJ Dysfunction Can Cause Tooth Pain

Many people experience tooth pain and head straight to the dentist, only to be told that nothing is wrong. No cavities. No infections. No gum disease. So what's going on?

In many cases, tooth pain can actually be caused by TMJ dysfunction, a problem with the temporomandibular joint, not the tooth itself.

Anatomy: How the Jaw and Teeth Are Connected

Your TMJ (temporomandibular joint) is the hinge that connects your jawbone to your skull. It sits just in front of your ear and is surrounded by muscles, ligaments, nerves, and fascia that all work together to help you talk, chew, and even breathe.

When something goes wrong with the TMJ because of clenching, grinding, poor posture, or joint instability, it can affect the muscles and nerves that share connections with the teeth.

Why TMJ Dysfunction Can Feel Like Tooth Pain

Here’s how jaw problems can cause what feels like tooth pain:

1. Referred Pain from Muscles

The muscles involved in jaw movement, like the masseter, temporalis, and pterygoids, can develop trigger points (tight, irritable spots). These trigger points can refer pain to nearby teeth, especially the molars or canines.

For example:

  • Masseter: Can refer pain to lower molars or premolars

  • Temporalis: Often causes pain near upper teeth and the temple

2. Trigeminal Nerve Involvement

The trigeminal nerve, also known as cranial nerve V, is the main sensory nerve for the face. It supplies both the TMJ and the teeth.

When TMJ dysfunction irritates or overstimulates this nerve, it can lead to:

  • Tooth sensitivity

  • Aching in one or more teeth

  • Pain that mimics a cavity but has no dental cause

This is a neurologic phenomenon, not a structural problem with the tooth itself.

3. Clenching and Grinding (Bruxism)

Clenching or grinding your teeth, often at night or under stress, creates excessive tension in the jaw muscles and pressure on the TMJ. This can lead to:

  • Muscle fatigue and pain

  • Sore teeth from overuse

  • A dull, widespread ache across the jaw and dental arch

In some cases, clenching is so forceful that people assume their tooth is cracked or infected.

4. Joint Instability and Bite Changes

When the TMJ is unstable or the disc inside the joint is displaced, it can alter how your teeth come together (occlusion). This may make one or two teeth feel:

  • “Off” when biting down

  • Overused or hypersensitive

  • Like they’re being hit harder than the others

It’s not always a dental alignment issue. Sometimes, the problem starts with jaw mechanics.

When to See a Physical Therapist

If you've been cleared by your dentist but you're still feeling:

  • Tooth pain without an obvious dental cause

  • Pain that moves around your jaw or face

  • Clicking, popping, or shifting in your jaw

  • Tension or fatigue when talking or chewing

It may be time to get your TMJ and jaw mechanics evaluated by a physical therapist.

Physical therapy for TMJ dysfunction can help by:

  • Reducing muscle tension and trigger points

  • Improving joint mechanics and jaw control

  • Calming irritated nerves

  • Addressing posture, neck tension, and stress patterns that contribute to jaw overload

The Bottom Line

Tooth pain isn't always about your teeth.

Because of the way the jaw, muscles, and nerves work together, TMJ dysfunction can create symptoms that feel exactly like a tooth problem, even when nothing shows up on X-rays or dental exams.

If your dentist can’t find the source of your pain, consider a different angle. Your jaw, your neck, and your nervous system may be the missing piece. A skilled physical therapist can help you figure out what’s really going on and get you on the path to relief.

Ready to Get to the Root of Your Jaw or Tooth Pain?

I treat patients in the Glen Allen and greater Richmond, VA area at H2 Health, with a strong focus on TMJ dysfunction, jaw pain, and related conditions. If you’re experiencing unexplained tooth pain, jaw tension, or facial discomfort, physical therapy may be the missing piece.

Schedule an appointment at H2 Health Glen Allen

Note: The views expressed in this blog are my own and do not necessarily reflect those of my employer.

Daniel Ballou