TMJ Disorders – A Neck Problem in Disguise

TMJ disorders are common but often misunderstood. Many people focus on the jaw itself, but one of the most overlooked factors is the upper cervical spine. Addressing the upper neck can be the missing piece in effective TMJ treatment.

TMJ vs. TMD: Understanding the Difference

The temporomandibular joint (TMJ) refers to the physical jaw joint. Temporomandibular disorder (TMD) is a broad term covering various jaw-related issues, including tight muscles, sharp pain, clicking, popping, clenching, and different bite problems. While many factors contribute to TMD, one of the most underappreciated is the alignment and function of the upper cervical spine.

The TMJ contains a small cartilage disc similar to the one in your knee but much thinner. This disc moves as you open and close your mouth, gliding forward and backward. If the disc shifts out of place, typically backward, or if abnormal movement occurs, it can lead to TMD symptoms.

• Headaches in the temples
• Chronic jaw tension
• Sleep apnea
• Dizziness
• Anxiety
• Dysautonomia, including POTS

 

The TMJ disc contains numerous proprioceptors—specialized nerve endings that help regulate posture and balance. If the brain receives abnormal signals from these sensors, it can contribute to severe dizziness, anxiety, and even autonomic dysfunction.

 

The Role of the Upper Cervical Spine in TMJ Disorders

The upper cervical spine, particularly the atlas (C1) and axis (C2), plays a crucial role in TMJ function. These vertebrae control head and neck movement, directly impacting the TMJ. Injuries such as whiplash, concussions, or misalignments in this region can create tension and instability in the jaw.

Try this experiment: If you wanted to move only your lower teeth, you’d move your lower jaw. But to move only your upper teeth, you’d have to move your entire head. This demonstrates how the upper neck and TMJ work together.

When you open your mouth:

• C1 rolls backward beneath the skull.
• C2 rolls forward relative to C3.

When you close your mouth:

• C1 rolls forward.
• C2 rolls backward.

If C1 and C2 are misaligned, the TMJ can be forced into unnatural movement patterns. Instead of opening in a straight line, the jaw may zig-zag, indicating tension from the upper neck.

Common Causes of TMJ Disorders

1. Tongue tie – Even mild cases can prevent proper upper palate development, forcing the lower jaw backward.
2. Early orthodontic work – Straightening teeth too soon can lock cranial sutures prematurely, preventing natural movement and compressing the TMJ.
3. Overbite – This keeps the TMJ disc stuck backward, leading to chronic jaw tension. In severe cases, it can compress the vagus nerve, internal jugular vein, and carotid arteries (Eagle’s syndrome).
4. Whiplash and concussions – These injuries can disrupt the relationship between the skull, C1, and C2, leading to TMJ dysfunction. If C1 shifts forward or rotates, it affects jaw positioning. A forward misalignment of C2 can push the jaw backward, limiting the effectiveness of orthodontic treatment.

 

Assessing TMJ and Cervical Involvement

One way to determine whether TMJ issues stem from the jaw or upper cervical spine is by observing mouth movement:

• If the jaw moves straight to one side when opening, the problem is likely dental.
• If it moves to one side but then corrects itself, the issue is likely in the upper neck.
• If both patterns occur, both the TMJ and upper cervical spine need attention.

 

X-rays or CBCT scans should assess TMJ structure and function. Many scans are taken while biting a plate, which can mask disc displacement. Ideally, imaging should be done with the mouth fully closed, and optionally fully open.

Splints that create functional space for the TMJ can help, but teeth should move relative to cranial bones, not just to create straighter alignment.

Some people have cranial asymmetries affecting TMJ function. If glasses never sit evenly on both ears, this could indicate an uneven skull base or palate compression on one side. Misaligned cranial structures can alter TMJ pivot points, making conventional orthodontic treatments ineffective or even counterproductive.

The Role of Neuromuscular Dentistry and Upper Cervical Care

A neuromuscular dentist can assess the functional relationships of the jaw, skull, and cervical spine. Although this specialized approach can be costly, it has proven effective for many people with complex TMJ disorders.

Upper cervical chiropractic care is another key piece of the puzzle. Unlike general chiropractic, upper cervical care involves precise imaging (DAX or CBCT scans) and neurological testing to identify unique misalignments. Gentle, precise corrections help restore normal motion and stability to the upper neck, improving TMJ function in the process.

TMJ pain is often mistakenly attributed solely to the jaw. However, the upper cervical spine plays a critical role in jaw function and alignment. Addressing upper cervical misalignments can:

• Reduce TMJ-related pain and dysfunction
• Improve jaw movement patterns
• Enhance the effectiveness of orthodontic treatments
• Alleviate associated symptoms like dizziness and headaches

 

While it may not be the first thing people consider for TMJ disorders, upper cervical care is an essential component for long-term relief and improved quality of life.

If you are looking for help with an upper cervical chiropractor in Spokane, visit our home page more information. To schedule a new patient appointment with our Mead (north Spokane) or South Hill offices, complete a new patient request form here, or call us direct at 509-315-8166.