People ask about braces and the jaw joint from two opposite directions. Some worry that straightening their teeth might start jaw pain or clicking. Others already have jaw pain and hope that straightening their teeth will end it. Research gives a similar answer to both: orthodontic treatment has not been shown to cause temporomandibular disorders (TMD), and it has not been shown to cure them either.
An old belief that did not survive testing
For decades, many clinicians believed that changing the bite, or removing teeth as part of orthodontic treatment, could damage the jaw joint. That idea, and the legal claims that followed it, prompted a great deal of research (Michelotti and Iodice, Journal of Oral Rehabilitation, 2010). A study that followed more than a thousand children in Wales from age 11 or 12 into their early thirties found no link between orthodontic treatment and new or persistent jaw problems (Macfarlane and colleagues, American Journal of Orthodontics and Dentofacial Orthopedics, 2009). A 2026 meta-analysis of five studies also found no significant association, though it rated the certainty of the evidence as very low (Lang and colleagues, Medicine).
A Cochrane review by Luther, Layton and McDonald in 2010 looked for trials of orthodontics to treat or prevent TMD and found none that met its standards, so it could not show that orthodontics does either. That review has since been withdrawn as out of date, and good quality trials in this area are still lacking.
For anyone without jaw symptoms, that is reassuring. Concern about the jaw joint is not, on its own, a reason to avoid treatment that would otherwise help.
Why the bite plays only a small part
Jaw pain usually involves the chewing muscles, the joint itself or both, and it is influenced by many things: clenching and grinding, stress, sleep, general pain sensitivity, posture, injury and the shape of the joint. How the teeth meet is one factor among these, and in most people a small one. A 2017 systematic review by Manfredini and colleagues in the Journal of Oral Rehabilitation found the evidence fairly consistent that ordinary features of the bite have no clinically relevant link with TMD.
Where the bite is markedly uneven, for example when the jaw has to slide sideways to bring the teeth together, there may be good reasons to correct it, but evidence that doing so relieves jaw pain is weak. It is not a reason to promise that moving teeth will end jaw pain.
What a good assessment checks before teeth are moved
Before braces or aligners, the jaw should be examined along with the teeth. That usually means asking about past clicking, locking or pain, feeling the chewing muscles, listening and feeling for joint sounds, and measuring how wide the mouth opens. It gives a baseline, so any change during treatment can be compared. It also identifies people whose jaw problem needs attention first, or who would suit a gentler plan.
Clicking without pain and with normal opening is common in the general population and is not usually a reason to delay treatment. Our article on jaw clicking when you open your mouth explains when a click matters.
If you already have jaw pain
Most jaw pain improves with simple, reversible care: understanding the condition, a softer diet for a while, gentle jaw exercises, attention to daytime clenching and stress, and short courses of pain relief. A physiotherapist with an interest in the jaw can help. An occlusal splint worn at night may help some people, particularly those who grind or clench, though results vary. Our overview of TMJ disorder causes and treatment covers these steps, and bruxism and teeth grinding in adults looks at the grinding side.
Orthodontic treatment can still be reasonable in someone who has had jaw pain, for the usual reasons of crowding, spacing or bite. It is usually best started once pain has settled, and planned with the jaw in mind rather than as a treatment for it. Irreversible changes to the bite purely to treat jaw pain are not supported by current evidence.
Braces or aligners: is one easier on the jaw?
There is no strong evidence that either carries a different risk for jaw symptoms. Some people notice their jaw muscles feel tired when they first start wearing aligners, as they tend to bite into the trays, and this often settles. If you clench heavily, mention it, because it can affect tray wear and comfort. Other differences between the two are covered in braces versus aligners for adults.
Things to tell your dentist or orthodontist
Mention any history of clicking, locking, jaw pain, headaches on waking or difficulty opening wide, even if it seems minor. If new jaw pain, a new click or reduced opening starts during treatment, raise it at your next visit rather than waiting for it to pass. If someone else is already treating your jaw, such as a physiotherapist or a registered oral medicine specialist, let each of them know about the other's plan.
Common questions
Can braces cause TMJ problems?
Research has not shown that braces or aligners cause jaw joint disorders. Jaw symptoms can appear during treatment, as they can at any time of life, and should be checked if they do.
Will straightening my teeth cure my jaw pain?
It is unlikely to on its own. Jaw pain usually responds better to reversible care aimed at the muscles and joint, with orthodontics considered for its usual reasons.
I have a painless click. Can I still have aligners?
Usually, yes. Painless clicking with normal opening is common. It is noted at the start so any change can be tracked.
Planning treatment with your jaw in mind
If you are thinking about braces or aligners and have had jaw symptoms, or you want to know if your bite plays any part in jaw discomfort, a dentist at Lumi Dental can examine your teeth and jaw together and explain the options, including referral where needed. See our current deals or read about general dentistry at Lumi Dental.
Sources
- Macfarlane TV and colleagues. Twenty-year cohort study of health gain from orthodontic treatment: temporomandibular disorders. Am J Orthod Dentofacial Orthop, 2009
- Lang X and colleagues. Correlation between temporomandibular disorders and the history of orthodontic treatment: a systematic review and meta-analysis. Medicine, 2026
- Manfredini D and colleagues. Temporomandibular disorders and dental occlusion: a systematic review of association studies. J Oral Rehabil, 2017
- Luther F, Layton S, McDonald F. Orthodontics for treating temporomandibular joint (TMJ) disorders. Cochrane Database Syst Rev, 2010 (withdrawn 2016)
- Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil, 2010
- Singh BP and colleagues. Occlusal interventions for managing temporomandibular disorders. Cochrane Database Syst Rev, 2024
This article is general information only and is not a substitute for an individual orthodontic or TMJ assessment.
