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Guide

Bite problems and TMJ: what dental work can and can't do

A bite problem and a jaw-joint problem are not the same thing: worn, broken or missing teeth can change how your teeth meet, and a restorative dentist can rebuild that. Pain in the jaw joint and chewing muscles, called TMD (temporomandibular disorder), is different: health authorities recommend conservative, reversible care first, not dental work that changes the bite for good.

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In short

Will fixing my bite stop TMJ pain?

There is no good evidence that it does. The National Institute of Dental and Craniofacial Research says research does not support the belief that a bad bite causes TMD, and that there is insufficient evidence that crowns, grinding teeth down or orthodontics treat it. It recommends conservative treatment that avoids changes to the teeth or bite that cannot be undone. Many cases get better without treatment.

From the office of Dr. Angela Berkovich, DMD, Deerfield Beach · (954) 427-3000

Last updated

TMD
A group of more than 30 conditions of the jaw joints and muscles1
How common
About 5% of US adults1
First approach
Conservative, reversible treatment1
Bite-changing treatment for TMD
Insufficient evidence; sometimes makes it worse1
Bite change when rebuilding teeth
Tested first; with TMD symptoms, in a removable appliance2

Which problem do you have?

Patients often come in with these. Some are bite problems of the teeth; others point to the jaw joint and muscles.

  • Teeth worn flat or short, so the bite feels collapsed
  • A new crown or filling that feels high
  • Teeth that have drifted into the space of a missing tooth
  • Pain in the jaw joint or the muscles you chew with
  • A jaw that locks, or that is hard to open or close
  • Clicking that hurts (clicking without pain is normal)

Jaw pain that comes with other symptoms, or doesn't settle, is a reason to see your physician as well as your dentist.

How we approach the bite when rebuilding teeth

  1. Check the joints and muscles

    Before any rebuilding, your jaw joints, chewing muscles and how your mouth opens are checked.3

  2. Protect first

    If you grind, a night guard protects the teeth while the plan is made.4

  3. Test any bite change

    A change in bite height is kept small and tested before anything is made final.2

  4. Rebuild in stages

    Provisional restorations first; final restorations only once the bite is comfortable.2

Bite problem or TMD?

They can occur together, but they are treated differently.

Bite problem or TMD?
AspectBite problem of the teethTMD (jaw joint and muscles)
What it isTeeth that meet unevenly because they are worn, broken, high or missing1,3Pain or dysfunction of the jaw joints and chewing muscles
Typical careAdjusting a high filling or crown; rebuilding worn or missing teeth1Conservative, reversible care first; many cases get better on their own
Changing the biteSometimes part of rebuilding worn teeth; tested first1,2Not recommended as a TMD treatment
AppliancesA night guard protects teeth from grinding1,4A mouth appliance may be tried; it should not change the bite for good
Who treats itYour dentist1Your dentist and physician, sometimes a pain clinic

When dental work is not the answer

  • For jaw-joint pain on its own, irreversible dental treatment such as crowns, grinding teeth down or orthodontics is not recommended; there is insufficient evidence it helps.1
  • Many TMD cases get better without treatment, so waiting with self-care is often reasonable.1
  • Clicking without pain needs no treatment.1

Questions patients ask

Does a bad bite cause TMJ problems?

Research does not support that belief, according to the National Institute of Dental and Craniofacial Research. TMD has several possible causes, often acting together.1

Will a night guard help my jaw pain?

A guard protects teeth from grinding. For TMD pain the evidence is limited, and any appliance should not be designed to change your bite for good.1,4

My new crown feels high. Is that TMJ?

Usually not. A filling or crown that sits high can make biting sore, and your dentist can reshape it. Call promptly if your bite feels uneven after treatment.5,6

Can full-mouth reconstruction change my bite?

It can, when worn teeth are rebuilt. A minimal change is preferred, and the facts and steps above describe how any change is tested before it is made final.2

Who you'll see

Dr. Angela Berkovich, DMD

Dr. Angela Berkovich, DMD

Dentist, trained at Oregon Health & Science University School of Dentistry

Dr. Berkovich checks your jaw joints and bite before planning restorative work, and refers you to your physician when jaw pain needs medical care.

Medical content reviewed by Dr. Angela Berkovich, DMD on .

Office: 1348 E Hillsboro Blvd Suite A, Deerfield Beach, FL 33441. (954) 427-3000

About Dr. Berkovich

Sources

  1. National Institute of Dental and Craniofacial Research (NIH): TMD (temporomandibular disorders)
  2. PubMed: Abduo & Lyons 2012, clinical considerations for increasing occlusal vertical dimension
  3. American College of Prosthodontists (GoToAPro): Full-mouth reconstruction
  4. American Dental Association (MouthHealthy): Teeth Grinding and Jaw Pain
  5. Cleveland Clinic: Dental Fillings: Types, Materials & What They're For
  6. American Association of Endodontists: Root Canal Post Treatment Care

General information, not a diagnosis or a promise of results. Individual results vary, and whether a treatment suits you depends on your exam.

Talk it through at a consultation

Bring your questions and any X-rays you already have. We'll look at your teeth, explain which options are reasonable for you, and what each one involves.

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