TMJ disorders cause jaw pain, clicking, and headaches — and misaligned teeth can be a contributing factor. Learn how clear aligners may help, what they cannot fix, and when to seek specialist advice.
Jaw pain, clicking, headaches behind the eyes, difficulty opening your mouth fully — these are symptoms many people live with for years without understanding the cause. Temporomandibular joint (TMJ) disorders are surprisingly common, and while the causes are often multifactorial, misaligned teeth can be one of the contributing factors. This guide explains how TMJ problems and tooth alignment are connected, what clear aligners may be able to help with, what they cannot fix, and how to work out whether orthodontic treatment is worth exploring for your situation.
📌 TL;DR
Misaligned teeth can contribute to TMJ (jaw joint) problems by creating an uneven bite that strains the joint and surrounding muscles. Clear aligners may help by correcting the bite, which can reduce some TMJ symptoms — but they are not a cure-all. TMJ disorders have multiple causes, and orthodontic treatment alone may not resolve symptoms entirely. A proper clinical assessment is essential to determine whether aligner treatment is appropriate for your specific situation.
Who This Guide Is For
This article is for UK adults who experience jaw pain, facial tension, or related symptoms and are wondering whether straightening their teeth could help. It may be useful if you:
- Have been told you have a TMJ disorder and are exploring treatment options
- Experience jaw clicking, popping, or locking and suspect your bite may be a factor
- Suffer from tension headaches or facial pain that seems related to how your teeth meet
- Are considering invisible braces and want to understand whether they could also address jaw symptoms
- Have crooked teeth or a misaligned bite and notice jaw discomfort when chewing or at rest
⚠️ Who Should Seek a Clinician Assessment First
If you experience severe jaw pain, inability to open or close your mouth, jaw locking episodes, significant swelling around the jaw joint, or symptoms following trauma or injury, please see your GP or dentist before exploring orthodontic options. TMJ disorders can have causes that require medical investigation beyond what orthodontic treatment addresses. This article provides general information and does not replace clinical advice.
Key Definitions in Plain English
Temporomandibular Joint (TMJ)
The TMJ is the hinge joint on each side of your face, just in front of your ears, that connects your lower jaw (mandible) to your skull. It allows you to open and close your mouth, chew, speak, and yawn. It is one of the most complex joints in the body because it both rotates and slides, and it works under considerable force during chewing.
TMJ Disorder (TMD)
TMJ disorder — sometimes called TMD (temporomandibular disorder) — refers to a group of conditions that cause pain, dysfunction, or discomfort in the jaw joint and the muscles that control jaw movement. Symptoms can include jaw pain, clicking or popping sounds, difficulty opening the mouth, headaches, earache, and facial tension. The terms "TMJ" and "TMD" are often used interchangeably in everyday language, though technically TMJ refers to the joint itself and TMD to the disorder.
Malocclusion
Malocclusion simply means misalignment of the teeth or an incorrect relationship between the upper and lower dental arches. This includes conditions such as overbite, underbite, crossbite, crowding, and open bite. Malocclusion can affect how forces are distributed across your teeth and jaw joint when you bite and chew.
Other Terms You May Encounter
- Bruxism: Habitual teeth grinding or clenching, often during sleep. A common contributor to TMJ symptoms and tooth wear.
- Occlusion: The way your upper and lower teeth meet when you close your mouth — your bite.
- Attachments: Small tooth-coloured composite bumps bonded to teeth during aligner treatment. They help the trays grip teeth for more controlled movements.
- IPR (Interproximal Reduction): Carefully removing tiny amounts of enamel between teeth to create space for alignment. A routine part of many aligner treatments.
- Refinements: Additional sets of aligner trays produced after the initial series to fine-tune the result.
- Retainers: Custom-made devices worn after treatment to hold teeth in their new positions.
- 3D scan: A digital impression of your teeth using an intraoral scanner, used for treatment planning.
- Tracking: How closely your actual tooth movements follow the planned movements during aligner treatment.
- Wear time: The recommended number of hours per day your aligners should be worn — typically 22 hours.
What Causes TMJ Problems: Common Drivers
TMJ disorders rarely have a single cause. Understanding the range of contributing factors helps explain why orthodontic treatment may help in some cases but not others:
Bite-Related Factors
- Malocclusion: When teeth do not meet evenly, the jaw joint may be forced into a slightly unnatural position during biting and chewing. Over time, this can strain the joint, the surrounding ligaments, and the muscles of mastication (chewing muscles).
- Missing teeth: Gaps from missing teeth can cause the remaining teeth to shift, altering the bite and potentially affecting jaw joint mechanics.
- Uneven dental work: A crown or filling that is slightly too high can change how the upper and lower teeth meet, creating an uneven bite that stresses the joint.
- Deep bite or open bite: Significant vertical discrepancies between upper and lower teeth can affect how the jaw joint functions.
Muscle and Habit-Related Factors
- Bruxism (grinding/clenching): One of the most common contributors to TMJ symptoms. The sustained forces from clenching and the lateral forces from grinding put enormous stress on the joint and muscles.
- Stress and tension: Psychological stress commonly manifests as jaw clenching, facial tension, and muscle tightness — all of which can trigger or worsen TMJ symptoms.
- Poor posture: Forward head posture (common with desk work) can alter the resting position of the jaw and increase strain on the TMJ.
Structural and Medical Factors
- Joint disc displacement: The small cartilage disc inside the TMJ can shift out of position, causing clicking, locking, or pain.
- Arthritis: Osteoarthritis or inflammatory arthritis can affect the TMJ just as it can other joints.
- Trauma: A blow to the jaw, whiplash, or other injury can damage the TMJ structures.
- Genetic and developmental factors: Some people have jaw joint anatomy that makes them more susceptible to TMD.
💡 The Key Takeaway
Because TMJ disorders are multifactorial, fixing one contributing factor (such as tooth alignment) may improve symptoms but is unlikely to be a complete cure if other factors are also involved. This is why a thorough clinical assessment is important before starting any treatment — and why honest expectations matter.
TMJ Basics: What Aligners May Influence vs Separate Causes
Understanding what clear aligners can and cannot influence is crucial for setting realistic expectations:
What Clear Aligners Can Do (and What They Cannot)
What Aligners May Help With
- Correcting malocclusion: Aligners can address crowding, spacing, overbite, crossbite, and other alignment issues that may be contributing to an uneven bite and TMJ strain
- Improving bite distribution: When teeth are properly aligned, biting and chewing forces are distributed more evenly across all teeth, potentially reducing localised stress on the jaw joint
- Reducing compensatory muscle patterns: If your jaw has been shifting or muscles have been overworking to compensate for a bad bite, correcting the alignment may allow more natural, relaxed jaw function over time
- Providing a protective layer: During treatment, wearing aligners 22 hours a day means your teeth are covered by a thin plastic layer for most of the day and night, which can act as a buffer against grinding forces — similar to a splint
- Addressing specific bite issues linked to TMJ: Deep bites, crossbites, and asymmetric bites are commonly associated with TMJ symptoms, and aligners can often improve these
What Aligners Cannot Do
- Cure TMJ disorders: TMD is complex and multifactorial. Orthodontic treatment alone is unlikely to be a complete cure, especially if non-bite factors are involved
- Treat internal joint problems: Disc displacement, arthritis, or structural damage within the joint requires specialist assessment and management
- Stop bruxism: Teeth grinding and clenching are separate conditions that may need their own treatment (e.g., night guards, stress management, medication review)
- Replace physiotherapy or pain management: Muscle-based TMJ issues may require physiotherapy, massage, or other interventions alongside or instead of orthodontics
- Guarantee symptom relief: Even when malocclusion is a contributing factor, correcting it does not guarantee that TMJ symptoms will fully resolve — outcomes vary by individual
- Address severe skeletal discrepancies: If the jaw bones themselves are significantly misaligned (rather than just the teeth), surgery may be needed — aligners alone cannot reposition the jaw bones
How Treatment Typically Works: Step by Step
If you and your clinician decide that aligner treatment is appropriate for your situation — including any TMJ considerations — here is what the process generally looks like:
Step 1: Clinical Assessment
A thorough examination including a 3D scan of your teeth, clinical photographs, and a discussion of your symptoms and concerns. If TMJ symptoms are present, your clinician will assess the jaw joint function and may recommend additional investigations or a referral to a TMJ specialist before proceeding with orthodontics.
Step 2: Treatment Planning
Your 3D scan is used to design a digital treatment plan showing the proposed tooth movements. For TMJ-related cases, particular attention is paid to how the final bite will come together and whether the planned outcome is likely to improve the bite relationship in a way that may benefit jaw function.
Step 3: Fitting
Attachments (small tooth-coloured bumps) are bonded to specific teeth to help the aligners grip more effectively. IPR (interproximal reduction) may be performed to create small amounts of space where needed. Your first set of aligner trays are issued along with instructions on wear time, care, and what to expect.
Step 4: Active Treatment
Wear your aligners for approximately 22 hours per day, removing them only for eating, drinking (anything other than water), and oral hygiene. Change to a new set of trays every 1-2 weeks as directed. Maintain good tracking by seating your trays properly each time. Attend monitoring appointments every 6-8 weeks so your clinician can check progress and jaw function.
Step 5: TMJ Monitoring
If you started treatment partly to address TMJ symptoms, your clinician will monitor jaw function throughout treatment. Note any changes — improvements or new symptoms — and report them at each appointment. Treatment adjustments may be needed if symptoms change.
Step 6: Refinements
After completing the initial set of trays, additional refinement aligners may be needed to fine-tune the result. This is particularly common in cases involving bite correction, where getting the final bite relationship right is important for long-term comfort and jaw function.
Step 7: Retention
Once your teeth are in their final positions, retainers are fitted to maintain the result. This is essential — without retention, teeth naturally tend to shift back over time, which could undo any bite improvements that were helping your jaw.
Suitability Checklist
Not everyone with TMJ symptoms is a suitable candidate for aligner treatment. Here is a general guide — though only a clinical assessment can determine suitability for your specific case:
Your clinician will consider your overall dental health, jaw joint function, symptom history, and treatment goals before recommending whether aligner treatment is appropriate. In some cases, a phased approach may be recommended — stabilising TMJ symptoms first, then proceeding with orthodontics.
Risks, Side Effects, and Limitations
Any dental treatment carries some risks. Here is a balanced overview specific to aligner treatment in the context of TMJ concerns:
General Aligner Side Effects
- Initial discomfort: Mild soreness and pressure when starting a new tray set — this is normal and typically settles within 2-3 days
- Speech changes: A slight lisp may occur initially but usually resolves within a few days as your tongue adjusts
- Dry mouth or excess saliva: Temporary changes in saliva production are common when you first start wearing aligners
- Minor tooth sensitivity: Some patients experience mild sensitivity during treatment
TMJ-Specific Risks and Considerations
- Temporary symptom changes: Some patients notice temporary changes in their TMJ symptoms during treatment. Moving teeth alters the bite as treatment progresses, and this transitional phase can sometimes temporarily increase jaw discomfort before the final, improved bite is achieved.
- No guaranteed improvement: Even if malocclusion is contributing to your TMJ symptoms, correcting it does not guarantee symptom relief. TMJ disorders are complex, and other factors may continue to cause symptoms after orthodontic treatment.
- Potential for bite changes during treatment: As teeth move through intermediate positions, the bite may feel different or uncomfortable at times. This is usually temporary but should be monitored by your clinician.
- Bruxism interaction: If you grind or clench, the forces on your aligners may cause them to wear or crack. Your clinician may recommend additional measures to manage bruxism alongside aligner treatment.
- Need for multidisciplinary care: Some patients may need concurrent treatment from other specialists (physiotherapist, TMJ specialist, pain management) alongside orthodontics. Aligners alone may not be sufficient.
Limitations
- Clear aligners cannot reposition the jaw bones — they move teeth only
- Severe skeletal discrepancies may require surgery (orthognathic surgery) in combination with orthodontics
- Treatment cannot address internal joint pathology (disc issues, arthritis)
- Results depend on compliance — 22 hours of daily wear and good oral hygiene are essential
- Some complex bite corrections may be better suited to fixed braces — your clinician will advise
Red Flags: When to Seek Urgent Advice
The following symptoms warrant prompt attention from your dentist, GP, or A&E — whether or not you are currently undergoing orthodontic treatment. This is not a diagnostic list, but rather a guide to help you know when to seek professional assessment without delay:
- Jaw locked open or closed — unable to open or close your mouth normally
- Sudden severe jaw pain — especially if it came on rapidly after an injury or without clear cause
- Significant swelling around the jaw joint or face
- Numbness or tingling in the face, lips, or chin
- Difficulty swallowing or breathing associated with jaw symptoms
- Severe, worsening headaches that do not respond to over-the-counter pain relief
- Changes in how your teeth meet suddenly (bite feels very different overnight)
- Fever with jaw pain — may indicate infection
These symptoms may have many causes, most of which are manageable with appropriate care. The important thing is not to ignore them or assume they will resolve on their own.
How Long Treatment May Take
Treatment duration for aligner therapy depends on the complexity of your case, not specifically on whether TMJ symptoms are present. However, TMJ-related cases may involve additional considerations:
What Can Change the Timeline
- Compliance: Wearing your aligners for the recommended 22 hours per day is essential for keeping treatment on schedule
- Tracking: If teeth are not following the plan, mid-course corrections may add time
- TMJ flare-ups: If significant TMJ symptoms develop during treatment, your clinician may pause or slow treatment to allow the jaw to stabilise
- Refinements: Bite correction cases often require one or more rounds of refinement trays to get the final bite exactly right
- Concurrent TMJ treatment: If you are also receiving TMJ-specific treatment (physiotherapy, splint therapy), coordination between providers may affect the timeline
Costs in the UK
Treatment costs depend on case complexity, the number of aligners needed, and what is included in the treatment package. TMJ-related considerations do not typically change the price of aligner treatment itself, but additional assessments or concurrent TMJ treatments may involve separate costs.
What Drives the Price
- Case complexity — mild alignment vs comprehensive bite correction
- Number of aligner trays required throughout treatment
- Whether refinement rounds are included in the package price
- Retainer costs (included or charged separately)
- Provider location and clinical expertise
- Level of monitoring included (frequency of appointments, remote vs in-person)
- Any additional investigations or referrals needed for TMJ assessment
For a transparent breakdown of what is included at each level, you can review our pricing. We always recommend checking what is and is not included before committing to treatment with any provider — especially in complex cases involving jaw symptoms.
How to Keep Results: Retention and Aftercare
Maintaining the results of your treatment is essential — and particularly important if bite correction was partly aimed at improving TMJ symptoms:
Retention Essentials
- Fixed retainers: Thin wires bonded behind the front teeth, providing continuous retention without any action needed from you
- Removable retainers: Custom-made clear trays worn at night. These also provide some protection against grinding forces if bruxism is a factor
- Combination approach: Many clinicians recommend both fixed and removable retainers for the most reliable long-term stability
Aftercare for TMJ-Aware Patients
- Monitor your symptoms: Keep a note of any changes in jaw comfort, clicking, or pain after treatment is complete. Report changes to your clinician.
- Wear retainers consistently: Teeth shifting back can re-introduce the bite imbalances that may have been contributing to TMJ symptoms
- Manage bruxism separately: If grinding continues after treatment, discuss a dedicated night guard with your dentist. Removable retainers provide some protection but are not designed as heavy-duty bruxism splints.
- Maintain oral hygiene: Brush and floss daily, clean retainers regularly, and attend routine dental check-ups
- Stay aware of stress: If your TMJ symptoms are partly stress-related, continuing stress management strategies (exercise, mindfulness, physiotherapy) is important for long-term comfort
- Replace retainers when worn: A cracked or distorted retainer does not hold teeth effectively. Report any damage promptly.
Frequently Asked Questions
Can clear aligners cure TMJ?
No, clear aligners are not a cure for TMJ disorders. However, if your TMJ symptoms are partly caused by a misaligned bite, correcting the bite with aligners may reduce the strain on the jaw joint and improve some symptoms. TMJ disorders are complex and often have multiple contributing factors, so orthodontic treatment may be one part of a broader management approach rather than a standalone solution.
Will aligners make my jaw pain worse?
It is possible that some patients experience temporary changes in jaw comfort during treatment, particularly as the bite shifts through intermediate positions. This is usually temporary. However, if you notice significant worsening of symptoms, contact your clinician — treatment may need to be adjusted or paused. The overall goal of bite correction is to improve jaw function, but the journey is not always linear.
Should I treat my TMJ before starting aligners?
In many cases, clinicians recommend stabilising acute TMJ symptoms before beginning orthodontic treatment. This might involve a splint, physiotherapy, or other measures. Once the jaw is more comfortable and stable, aligner treatment can proceed with a clearer picture of your needs. Your clinician will advise on the best sequencing for your situation.
Are braces or aligners better for TMJ?
Both traditional braces and clear aligners can correct malocclusion and improve the bite. The choice between them depends on your specific clinical needs, not specifically on whether you have TMJ symptoms. Aligners offer the practical advantage of being removable, which may allow concurrent use of a TMJ splint when needed. Your clinician will recommend the option best suited to your case.
Can wearing aligners act as a night guard?
Aligners provide a thin plastic barrier between your upper and lower teeth, which can offer some protection against grinding forces — similar in concept to a night guard, though not identical. During treatment, this incidental benefit may be helpful. However, aligners are not designed or marketed as bruxism appliances, and after treatment you may still need a dedicated night guard if grinding persists.
How do I know if my TMJ is caused by my bite?
Only a clinical assessment can determine whether your bite is contributing to your TMJ symptoms. Signs that suggest a possible link include symptoms that worsen during or after eating, pain that corresponds to specific tooth contacts, or an obviously uneven bite that you can feel. However, many TMJ problems have multiple causes, and even with a clear bite issue, other factors may also be involved. A thorough examination is the only reliable way to understand your situation.
Is TMJ treatment available on the NHS?
The NHS may provide some TMJ treatments such as pain management advice, physiotherapy referrals, and in some cases, splint therapy. However, orthodontic treatment for adults is generally only available on the NHS in severe cases. Most adults seeking aligner treatment for bite correction — including TMJ-related cases — will need to arrange this privately. Your dentist can advise on what NHS support may be available for your specific symptoms.
What happens if my TMJ gets worse during treatment?
If TMJ symptoms significantly worsen during aligner treatment, your clinician may recommend pausing treatment, reverting to an earlier tray, or adjusting the treatment plan. In some cases, a TMJ splint or physiotherapy may be introduced alongside the aligner treatment. Open communication with your clinician about any symptom changes is important.
Can I wear a TMJ splint and aligners at the same time?
Not simultaneously — you would alternate between them. Some patients wear aligners during the day (approximately 22 hours target) and use a TMJ splint during particularly symptomatic periods. However, this needs to be managed carefully to maintain adequate aligner wear time and treatment progress. Discuss the logistics with your clinician, who can advise on the best approach for your case.
Do I need to see a TMJ specialist as well as an orthodontist?
It depends on the severity and complexity of your TMJ symptoms. For mild symptoms that appear related to your bite, your treating clinician may be able to manage your care. For moderate to severe symptoms, a history of jaw locking, or symptoms that do not clearly relate to your bite, a referral to a TMJ specialist (maxillofacial surgeon or specialist physiotherapist) may be recommended. Multidisciplinary care often produces the best outcomes for complex cases.
📚 References and Further Reading
- Manfredini D, et al. — Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology (2011)
- Michelotti A, Iodice G. — The role of orthodontics in temporomandibular disorders, Journal of Oral Rehabilitation (2010)
- Mohlin B, et al. — TMD in relation to malocclusion and orthodontic treatment: a systematic review, The Angle Orthodontist (2007)
- NHS — Temporomandibular Disorder (TMD)
- British Orthodontic Society — Patient Information
- GDC — Guidance on Advertising
Experiencing Jaw Pain? Let Us Help You Explore Your Options
If you are living with jaw discomfort and suspect your bite may be a factor, book an assessment. We will examine your teeth and jaw, discuss your symptoms, and explain whether aligner treatment could be part of the solution. No obligation to proceed.
Book Your AssessmentDisclaimer: This article is for general information only and does not constitute dental, medical, or TMJ-specific advice. TMJ disorders are complex and require proper clinical assessment for diagnosis and management. Treatment suitability, timelines, outcomes, and costs vary by individual. Only a GDC-registered dental professional can determine whether orthodontic treatment is appropriate for your situation following an in-person clinical examination.
Written by Pro Aligners Team
Medically reviewed by Pro Aligners Team • GDC: 195843