Can braces cause TMJ?

You got braces or started aligners, and now your jaw seems to ache more than it used to. Maybe it is your teeth after every adjustment, or maybe it is a pull in front of your ear when you chew. Many people in treatment worry that the brace is damaging their jaw joint, so you are in good company.

A quick note on terms: the TMJ is the temporomandibular joint itself, and TMD is the name for disorders of that joint and the chewing muscles around it (NIDCR, 2026). Most people say "TMJ" for both.

Key takeaways

Braces do not appear to cause TMJ disorders. The US National Institute of Dental and Craniofacial Research says research does not support the belief that orthodontic treatment such as braces causes TMD (NIDCR, 2026). Sore teeth after a fitting or adjustment are expected and usually settle within a few days (NHS Orthodontics, 2026).

• A Welsh study that began with 1,018 children aged 11 to 12 and followed 337 of them to age 30 found no link between orthodontic treatment and new or persistent TMD (Macfarlane et al., 2009).
• Sore teeth after an adjustment are normal, while regular pain in the jaw joint or chewing muscles, or a jaw that sticks, is worth reporting to your orthodontist.
• Braces have not been shown to treat TMD either (NIDCR, 2026).

What does the research say about braces and TMJ?

The longest study followed Welsh children from 1981 to age 30 to 31. Orthodontic treatment was not associated with new TMD or with TMD that persisted. The only predictors of TMD in young adults were being female and having had TMD as a teenager, and the authors concluded that orthodontic treatment neither causes nor prevents TMD (Macfarlane et al., 2009).

A 2010 Cochrane review set out to test whether orthodontics reduces TMD symptoms and whether it leads to TMD. Not one study met its quality bar, so the authors concluded there was insufficient research to guide practice (Luther et al., 2010). Cochrane withdrew that review in 2016 as out of date (Luther et al., 2016). Its 2024 replacement looked at bite treatments for TMD more broadly. All 57 trials it included tested splints, and the authors found insufficient evidence to reach conclusions about occlusal treatments, with very low certainty for every outcome (Singh et al., 2024).

Recent meta-analyses disagree. A 2022 analysis of six observational studies found that people who had orthodontic treatment had higher odds of TMD (Coronel-Zubiate et al., 2022). A 2026 analysis of five studies and 6,971 people found no significant link and rated the certainty of evidence as very low (Lang et al., 2026). Studies like these show association, and they cannot prove the brace was the cause.

In 2025 the orthodontist Ambra Michelotti summarised the field for the European Orthodontic Society. She concluded that no orthodontic approach has been shown to cause TMD pain, and none has been shown to resolve or prevent it either (Michelotti, 2025).

What does the American Association of Orthodontists say?

I could not find a formal AAO position statement on braces causing TMD. The AAO's patient page on treatment says that deep overbite, underbite and crossbite can strain the jaw and lead to TMJ disorders, and that orthodontic treatment can correct these misalignments (AAO, 2026). That sits awkwardly with the research. The NIDCR says current evidence does not support a strong link between a bad bite and TMD (NIDCR, 2026), and Michelotti calls the link between bite and TMD weak and inconsistent (Michelotti, 2025).

As a physiotherapist I would put it this way: straightening teeth can be worthwhile for its own sake, but braces are not an evidence-based way to get rid of jaw pain.

Why does jaw pain so often show up during treatment?

Timing explains a lot. Jaw joint sounds and other TMD signs are common in children and teenagers and become more common between ages 15 and 45. Treatment lasts around two years, so some people notice jaw symptoms during or after it and blame the brace (Michelotti and Iodice, 2010). In the Welsh study, TMD affected 3.2% of children at age 11 to 12, 17.6% at age 19 to 20 and 9.9% at age 30 to 31 across the whole group (Macfarlane et al., 2009).

Jaw problems are also common before anyone gets braces. Michelotti cites a review in which up to 40% of people with a bad bite already had TMD signs (Michelotti, 2025). If clicking is your main symptom, our guide to jaw clicking explains when it matters.

Can bite changes make an already sore jaw worse?

People react differently to changes in their bite. In Michelotti's experiments, small artificial bumps were bonded onto teeth. People without jaw pain clenched less afterwards, while people with TMD pain kept clenching, and heavy clenchers reported more headache and muscle pain (Michelotti, 2025). She also notes that pain reduces the brain's capacity to adapt to change (Michelotti, 2025).

That is why she recommends screening for TMD before braces go on. If painful TMD is found, it is treated conservatively first, and tooth movement starts or continues once the pain is under control (Michelotti, 2025).

Finishing treatment does not seem to set off TMD either. In the Welsh cohort, having had braces was not linked to TMD in adulthood (Macfarlane et al., 2009). You will usually wear a retainer for a period your orthodontist sets (NHS Orthodontics, 2026), so mention any jaw pain at your retainer checks.

Is it normal for your jaw to hurt with braces?

Sore teeth are part of the deal. A review of orthodontic pain describes it as an inflammatory response to the force on the teeth (Long et al., 2016). The NHS says your teeth may be sore for a few days after braces are fitted, and suggests soft food and painkillers to get through it (NHS Orthodontics, 2026).

TMD feels different. The NHS lists pain around the jaw, ear and temple, clicking or popping noises, difficulty opening your mouth fully and a jaw that locks as TMD symptoms (NHS TMD, 2023).

Is it normal for your jaw to hurt with Invisalign?

Aligners cause similar soreness. A meta-analysis of 12 studies found that people with clear aligners had less pain than people with fixed braces only on days three and four of treatment, with no difference at other time points (Li et al., 2023).

In a review of six studies on chewing muscles, muscle activity and discomfort changed in the first days of aligner wear and faded at later follow-ups (Almalki et al., 2024). Michelotti also cites work showing that people who clench or grind a lot felt more discomfort in passive aligners (Michelotti, 2025). A 2026 review of jaw joint imaging found small changes after aligner treatment but could not say whether they matter clinically (Sicilia et al., 2026).

Try it: a quick jaw check before your next appointment

This check is quick enough to run at home. The three questions come from a validated screening tool that Michelotti recommends orthodontists use before and during treatment (Michelotti, 2025). Sore teeth after an adjustment do not count here.

1. Do you have pain in your temple, face, jaw or jaw joint once a week or more?
2. Do you have pain once a week or more when opening your mouth or chewing?
3. Does your jaw lock or get stuck once a week or more?

Write your answers down and bring them to your next appointment. A yes to any question means it deserves a proper examination (Michelotti, 2025).

What should you do if your jaw starts hurting during treatment?

Tell your orthodontist. Michelotti's decision flowchart is simple: if TMD is diagnosed, conservative treatment comes first, orthodontic care resumes if you respond, and referral to a TMD specialist follows if you do not (Michelotti, 2025).

In the moment

The NHS advises soft food, gentle massage of the sore jaw muscles, and an ice pack or heat pack wrapped in a tea towel, whichever feels better (NHS TMD, 2023). Check with your orthodontist before taking anti-inflammatory painkillers regularly, because they relieve orthodontic pain but their effect on tooth movement is still debated (Long et al., 2016).

Long term

A 2024 consensus Michelotti cites starts TMD care with self-management, including education, jaw exercises, self-massage, heat, diet changes and dropping habits like clenching (Michelotti, 2025). Keeping your teeth apart at rest greatly reduces how hard your chewing muscles work. People without jaw pain have their teeth touching outside of chewing for about 9% of their waking time, while people with muscle-based jaw pain can reach 35% (Michelotti, 2025). Our pages on teeth grinding and TMJ exercises have routines you can run past your orthodontist.

How JawBuddy helps

JawBuddy is a digital companion for guided jaw exercises and self-management, with short routines you can fit in while your brace or aligners do their work.

JawBuddy does not replace emergency care or an individual diagnosis from a qualified healthcare professional. Questions about your brace and treatment plan always belong with your orthodontist.

When should you see a doctor?

Emergency: call 999 (or 911 in the US) if you have chest pain that spreads to your arms, neck or jaw, because the NHS lists this as a possible sign of a heart attack (NHS Heart attack, 2026).

Urgent: ask for an urgent GP appointment, see your doctor or contact NHS 111 if (NHS TMD, 2023):

• you are unable to eat or drink
• you have difficulty opening your mouth fully or your jaw is locking
• you have frequent, severe headaches
• you have pain or tenderness at the side of your head or on the scalp
• you have vision problems, such as double vision or loss of vision in one or both eyes

Contact your orthodontist soon if any answer in the jaw check is yes, if your teeth hurt for more than a few days after a fitting or adjustment, or if your gums are very red, swollen or painful (NHS Orthodontics, 2026).

You are allowed to speak up

Based on today's research, your braces are very unlikely to be the cause of a TMJ disorder, and jaw pain during treatment can be sorted out and managed. Run the jaw check this week and take your notes to your next appointment.

If you want to understand TMD from the ground up, our TMJ disorder guide is the best place to start.