COVID TMJ: Causes, Symptoms, and Jaw Pain Factors

Jaw pain has become a notable complaint among individuals recovering from COVID-19. Often linked to temporomandibular joint (TMJ) dysfunction, this discomfort can cause stiffness, inflammation, and difficulty moving the jaw. While TMJ issues are not exclusive to COVID-19, emerging reports suggest a connection between infection, immune response, muscle tension, and joint stress.

Jaw Inflammation And Discomfort

Inflammation of the temporomandibular joint (TMJ) and surrounding tissues has been increasingly reported in individuals recovering from COVID-19. The TMJ, which connects the jawbone to the skull, is sensitive to mechanical stress and inflammation. When irritated, it can cause swelling, tenderness, and restricted movement, making activities like chewing and speaking uncomfortable. Post-viral inflammation, mechanical strain, and altered jaw function contribute to this discomfort.

Many individuals recovering from COVID-19 report prolonged mouth breathing due to nasal congestion, which alters jaw positioning and fatigues muscles. This forces the jaw to remain slightly open for extended periods, placing continuous stress on the TMJ and surrounding musculature, exacerbating joint irritation.

Clenching and grinding of the teeth, known as bruxism, have also been observed post-COVID. While commonly linked to stress, bruxism can also stem from neuromuscular disruptions. Increased jaw muscle activity, particularly during sleep, can cause microtrauma within the TMJ, leading to inflammation and discomfort. This repetitive strain wears on the joint surfaces, resulting in stiffness and pain that may persist for weeks or months.

Prolonged TMJ inflammation can lead to synovial fluid imbalances and cartilage degradation. Synovial fluid lubricates and absorbs shock within the joint, and disruptions in its composition increase friction and discomfort. Research published in the Journal of Oral Rehabilitation highlights changes in synovial biomarkers among individuals with TMJ inflammation, suggesting biochemical alterations may contribute to persistent jaw discomfort following COVID-19.

Immune And Musculoskeletal Factors

The immune system’s response to COVID-19 may contribute to TMJ discomfort. Systemic inflammation triggered by infection can affect connective tissues, including those in the jaw. Elevated levels of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) have been documented in individuals with prolonged post-viral symptoms, potentially heightening joint sensitivity and disrupting tissue homeostasis.

Muscle involvement further complicates recovery, as prolonged illness and systemic inflammation can cause stiffness and fatigue. Studies in The Journal of Clinical Medicine report that individuals recovering from COVID-19 often experience musculoskeletal symptoms, including weakness that may extend to the jaw muscles. The masseter, temporalis, and pterygoid muscles play key roles in jaw movement and stabilization, and when affected by inflammation or fatigue, they place additional strain on the TMJ. This imbalance can lead to compensatory movements that worsen joint stress.

Changes in neuromuscular coordination may also contribute to post-COVID TMJ issues. Viral infections have been linked to disruptions in autonomic nervous system function, which can affect muscle tone and coordination. A study in Frontiers in Neurology noted that individuals with post-viral fatigue syndromes often exhibit altered neuromuscular control, leading to unintended muscle contractions and spasms. In TMJ dysfunction, these irregularities can cause uneven jaw movements, increased joint loading, and heightened pain sensitivity.

Symptoms That Indicate Joint Involvement

Individuals experiencing jaw discomfort after COVID-19 may notice pain near the jaw hinge, particularly in front of the ears. This discomfort often intensifies with movement, such as opening the mouth wide or chewing, and may radiate to the temples, neck, or shoulders. Unlike general muscle soreness, which improves with rest, pain from joint dysfunction often persists or worsens with continued use.

Clicking, popping, or grinding sensations when moving the jaw may indicate joint irregularities. These noises, known as crepitus, suggest cartilage issues or disc displacement within the TMJ. Occasional joint sounds without pain are not necessarily concerning, but persistent or painful clicking may signal dysfunction. Some individuals report a sensation of the jaw locking or feeling unstable, which can interfere with normal oral function.

A restricted range of motion is another indicator of TMJ involvement. Those affected may struggle to fully open their mouth, with stiffness more pronounced in the morning or after extended periods of inactivity. This limitation can make eating, speaking, or yawning uncomfortable. Over time, compensatory movements can strain surrounding muscles, reinforcing a cycle of dysfunction.

Stress-Related Muscle Tension

Psychological stress significantly contributes to muscle tension, particularly in the jaw. Stress triggers involuntary muscle tightening, affecting the masseter and temporalis muscles, which play a primary role in chewing and jaw stabilization. This sustained tension increases pressure on the TMJ, leading to persistent tightness and discomfort.

Sleep disturbances linked to stress further exacerbate the issue. Bruxism, or unconscious grinding and clenching of teeth, frequently occurs during sleep and is worsened by anxiety. Research in The Journal of Oral & Facial Pain and Headache highlights a strong correlation between psychological distress and increased nocturnal jaw muscle activity, particularly in individuals with pre-existing TMJ sensitivity. The repetitive force exerted on the joint during grinding can cause microtraumas, leading to inflammation and discomfort that persist even after waking. Over time, these movements wear down the joint’s protective cartilage, increasing susceptibility to dysfunction.

Observations In Dental Examinations

Dental evaluations have provided insights into the prevalence and characteristics of post-COVID TMJ discomfort. Many patients exhibit visible signs of strain, including excessive tooth wear from grinding, tenderness along the jaw muscles, and asymmetrical jaw movement. Dentists and oral health specialists note that these symptoms often correlate with muscle hyperactivity and joint stress, exacerbated by prolonged or altered oral habits during illness. Clinical examinations typically include palpation of the jaw muscles, assessment of movement patterns, and evaluation of occlusal wear to determine dysfunction severity.

Imaging techniques such as panoramic radiographs, magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) help assess structural changes within the TMJ. MRI scans can reveal inflammation within the joint capsule or displacement of the articular disc, contributing to pain and restricted movement. Recent case reports have documented post-COVID patients with subtle but measurable alterations in TMJ morphology, suggesting inflammatory processes or prolonged mechanical strain may have lasting effects on joint integrity. These findings emphasize the importance of early intervention to prevent further deterioration and improve long-term jaw function.