COVID-19 and temporomandibular joint (TMJ) pain are connected through several distinct pathways, from pandemic-driven stress and teeth grinding to direct viral effects on the nerves that supply the jaw. A survey of orofacial pain specialists found that about a third reported the onset of their patients’ pain was often or extremely often related to COVID-19, with masticatory muscle soreness, bruxism, and anxiety topping the list of worsened symptoms.1PubMed Central. The impact of the COVID-19 pandemic on orofacial pain practice: Perceptions from a convenience sample of orofacial pain practitioners The relationship is not a single cause-and-effect story but a tangle of psychological, neurological, mechanical, and medical-treatment factors that converged during and after the pandemic.
Pandemic Stress as the Biggest Driver of Jaw Pain
The most widely documented link between COVID-19 and TMJ disorders is indirect: psychological stress. Lockdowns, job losses, health anxiety, and social isolation sent stress levels soaring, and the jaw is one of the body’s favorite places to store tension. One study examining COVID-19 patients found a correlation between the disease and temporomandibular joint disorders, but that correlation dissolved once researchers adjusted for stress, suggesting that anxiety and psychological distress were doing much of the heavy lifting.2American Journal of Dentistry. Increased occurrence of temporomandibular joint disorders in COVID-19 confirmed patients In other words, it wasn’t the virus itself causing the jaw trouble for many people. It was the fear and upheaval surrounding it.
Stress shows up in the jaw most obviously as bruxism, the habit of clenching or grinding your teeth, often without realizing it. Research tracking TMJ disorders across pre-pandemic, pandemic, and post-pandemic periods found that the problem persisted even after lockdowns eased. One interesting wrinkle: some researchers have proposed that awake clenching during a stressful period may actually serve as a coping mechanism, an unconscious way of releasing cortisol and managing negative mood.3PubMed Central. The continuous adverse impact of COVID-19 on temporomandibular disorders and bruxism: comparison of pre- during- and post-pandemic time periods That doesn’t mean clenching is harmless; over weeks and months, it overloads the muscles and joint. But it helps explain why the behavior ramped up so dramatically: the body was trying, in its clumsy way, to manage a psychological crisis.
Orofacial pain clinicians noticed the trend in real time. Beyond bruxism and muscle soreness, the five symptoms practitioners saw worsening most in their patients were masticatory muscle myalgia, anxiety, tension-type headache, bruxism, and fragmented sleep.1PubMed Central. The impact of the COVID-19 pandemic on orofacial pain practice: Perceptions from a convenience sample of orofacial pain practitioners The cluster is telling: poor sleep feeds anxiety, anxiety feeds clenching, clenching feeds jaw pain, and jaw pain disrupts sleep. Breaking any link in that cycle is a reasonable treatment target, which is worth remembering if you developed TMJ symptoms during the pandemic and still have them.
How the Virus Itself Can Affect Jaw Nerves
Stress explains a lot, but not everything. SARS-CoV-2 has a documented ability to invade nervous tissue, and the trigeminal nerve, which is the main sensory nerve supplying the face and jaw, appears to be one of its targets. Autopsy studies found high levels of viral RNA in the trigeminal ganglion of people who died from COVID-19, providing direct evidence that the virus reaches the nerve bundle responsible for jaw and facial sensation.4PubMed Central. Trigeminal neuropathy presenting secondary to SARS-CoV-2 infection Researchers believe the virus can travel along nerve fibers in a process called retrograde transport, moving from peripheral tissue back toward the brain along the very same nerve pathways that carry pain signals from the jaw.
This isn’t just a lab curiosity. Clinical case reports describe patients developing trigeminal neuritis, an inflammation of the trigeminal nerve, after a COVID-19 infection. In one reported case, a patient presented with numbness on one side of the jaw following COVID-19, and MRI imaging revealed abnormal signal along the trigeminal nerve as it exits the brainstem, consistent with inflammation rather than a tumor.5PubMed Central. Post COVID-19 trigeminal neuritis: Case report Trigeminal neuritis can produce a range of symptoms from numbness to burning pain to stabbing “electric shock” sensations across the jaw, cheek, or forehead, depending on which branch of the nerve is affected.
This pathway is distinct from the stress-clenching pathway and may help explain cases where jaw pain seems disproportionate to any muscle tension. If you had COVID-19 and then developed sharp, shooting, or burning facial pain rather than the dull ache typical of muscle overuse, nerve involvement is worth considering with your healthcare provider. The treatments are different: nerve-related pain often responds better to medications used for neuropathic conditions than to the splints and physical therapy that help muscle-based TMJ problems.
Jaw and Oral Symptoms in COVID-19 Survivors
A growing body of evidence shows that jaw trouble is surprisingly common among people recovering from COVID-19, even after they’ve cleared the acute infection. A study following 122 hospitalized COVID-19 survivors in Milan found oral manifestations in roughly 84% of the group at a median of about three and a half months after hospital discharge. TMJ abnormalities, facial pain, and weakness in the chewing muscles were all commonly detected, alongside salivary gland changes.6Journal of Dental Research. Frequent and Persistent Salivary Gland Ectasia and Oral Disease After COVID-19 These are patients who may have gone to the hospital for breathing problems and came home with jaw pain they never expected.
A systematic review of jaw-related complications in COVID-19 patients cataloged the main issues as dry socket, osteonecrosis (bone death in the jaw), and orofacial pain related to TMJ disorders.7PubMed. Jaw-related complications in COVID-19 patients; a systematic review The spectrum is broader than many people assume. Someone recovering from COVID-19 might attribute jaw stiffness to sleeping in odd positions while sick or to general deconditioning, and never connect it to the infection. The Milan data suggest clinicians should be actively screening for these problems in survivors, particularly those who were hospitalized.
Jaw Trouble After ICU Stays and Prolonged Intubation
For patients whose COVID-19 was severe enough to require intensive care, there is an additional mechanical factor: intubation. Having a breathing tube placed through the mouth forces the jaw open for extended periods, sometimes days or weeks. This can strain the TMJ and the surrounding muscles in ways that leave lasting problems. A study of 176 severe COVID-19 survivors who required prolonged intubation found that about 12% developed craniomandibular disorders. The strongest predictors were bilateral loss of back teeth, a particular facial skeletal pattern (a receding lower jaw), and high levels of C-reactive protein (a marker of inflammation) during the ICU stay, specifically a peak level above 40 mg/L.8Journal of Stomatology, Oral and Maxillofacial Surgery. What factors predict craniomandibular disorders in severe COVID-19 survivors after prolonged intubation?
That last finding is worth pausing on. The C-reactive protein result suggests that systemic inflammation during the acute illness itself may predispose the jaw joint to problems afterward, independent of the physical trauma of intubation. When the body is in a state of widespread inflammatory overdrive, joint tissues throughout the body take hits, and the TMJ’s delicate cartilage disk is no exception. So for the sickest patients, the jaw problems may be part of a broader inflammatory aftermath rather than a purely mechanical consequence of the tube in their mouth.
If you were intubated during a COVID-19 hospitalization and have noticed clicking, locking, or soreness in your jaw afterward, this is a recognized complication. A dental or orofacial pain specialist familiar with post-ICU jaw issues can evaluate whether the joint itself was damaged or whether the muscles around it are simply in spasm from the prolonged stretch.
The Surprising Role of Face Masks
Here’s a connection most people never considered: wearing a face mask for hours every day may have contributed to TMJ problems during the pandemic. The mechanism is mechanical and somewhat counterintuitive. While wearing a mask, people tend to push their jaw forward and downward repeatedly to keep the mask in place, and these repetitive jaw motions can activate pain receptors in the joint area.9PubMed Central. The Impact of Wearing a Face Mask during the COVID-19 Pandemic on Temporomandibular Joint: A Radiological and Questionnaire Assessment Think about it: you adjust a mask dozens or hundreds of times a day using your jaw, and each adjustment involves small protrusive movements that the joint was never designed to repeat that often.
N95 respirators, which fit more tightly than cloth or surgical masks, appear to pose the bigger issue. A study of people wearing N95 masks for at least five hours daily found a significant increase in masseter muscle activity both at rest and during speech. The N95 mask was associated with restricted TMJ movement and greater discomfort, and the longer the daily wear time, the worse the symptoms became.10PubMed Central. Does the use of protective face masks affect temporomandibular joint function? Healthcare workers who wore tight-fitting masks for entire shifts were especially affected.
A narrative review of the topic also noted that mask pressure on the muscles responsible for chewing could itself contribute to TMJ disorders, and that pain in the area just in front of the ear, a hallmark of TMJ problems, was reported more frequently among mask wearers.11PubMed Central. Potential Impacts of Prolonged Face Mask Use on Temporomandibular Joint Health as Neglected Lifestyle Repercussions of COVID-19 Pandemic—A Narrative Review For most people, this was a temporary problem that faded as mask mandates lifted. But for someone who already had a borderline TMJ issue, the months of mask wearing may have been enough to push them into a chronic pain pattern. If your jaw trouble started during the mask-wearing period and you can’t identify another trigger, this is a plausible contributor.
Treatment Approaches That Work for Pandemic-Related TMJ Pain
Regardless of which pandemic pathway led to your jaw pain, the good news is that most TMJ disorders respond to conservative treatment without surgery. A systematic review of therapeutic approaches found that occlusal splints (the clear plastic nightguards your dentist can make) produced a significant decrease in short-term TMJ pain, whether used alone or combined with other therapies. Laser therapy and photobiomodulation also showed significant pain reduction compared to doing nothing.12PubMed. Effectiveness of conservative therapeutic modalities for temporomandibular disorders-related pain: a systematic review
For pandemic-era TMJ pain specifically, addressing the stress component tends to be at least as important as any mouth appliance. Cognitive behavioral therapy, relaxation techniques, and deliberate habit awareness (catching yourself clenching during the day and consciously relaxing your jaw) all have roles. Many dentists and orofacial pain specialists now screen for anxiety and sleep problems as part of TMJ treatment because those issues feed the muscle tension that keeps the cycle going.
If you suspect nerve involvement, the treatment toolkit is different. Neuropathic pain medications, such as certain anticonvulsants and antidepressants used for nerve pain, can help calm an inflamed trigeminal nerve. The distinction matters: a splint won’t do much for a nerve that’s been irritated by a virus, and a nerve-pain medication won’t help muscle tension from clenching. Getting the right diagnosis is half the battle.
Physical therapy targeting the jaw can be helpful across both categories. Exercises that gently stretch and strengthen the muscles of mastication, combined with manual techniques that mobilize the joint, have a solid track record for TMJ disorders of various origins. Heat, ice, and soft-diet periods during flare-ups provide temporary relief while longer-term strategies take hold.
Trigeminal Nerve Issues After COVID-19 Vaccination
A separate but related question is whether COVID-19 vaccines themselves can trigger jaw and facial nerve problems. Multiple case reports have documented trigeminal neuralgia developing after vaccination. One report described a patient who developed acute trigeminal neuritis following a Pfizer-BioNTech COVID-19 vaccine.13PubMed Central. A case of trigeminal neuralgia developing after a COVID-19 vaccination Another described a 36-year-old woman who developed chronic pain attacks on the left side of her face the day after receiving a third dose of the same vaccine, and was ultimately diagnosed with trigeminal neuralgia. The authors concluded that, based on the timing, the absence of other causes, and similar reports in the literature, the neuralgia was likely a complication of the vaccination.14PubMed Central. Trigeminal neuralgia occurring after the third dose of Pfizer BioNTech COVID-19 vaccine. Complication or coincidence? An illustrative case report and literature review
These are individual case reports, not large studies, and they need to be understood in context. Trigeminal neuralgia exists in the general population independent of any vaccine, with a background rate that means some cases will inevitably occur around the time of vaccination by pure chance. The reports are concerning enough to warrant attention and tracking, but they do not establish a strong population-level risk. Billions of COVID-19 vaccine doses have been administered, and the reported cases of trigeminal neuralgia remain rare relative to that number.
That said, if you developed sudden-onset sharp facial or jaw pain shortly after a COVID-19 vaccination and it persists, it is worth mentioning the timing to your doctor. Trigeminal neuralgia is treatable, and catching it early can prevent the condition from becoming entrenched. The mechanism is thought to involve a brief immune-mediated inflammatory response affecting the nerve, similar to how other vaccines occasionally trigger nerve inflammation in rare cases.
Why the Referral Surge Matters for Getting Help
One underappreciated aspect of the COVID-19 and TMJ story is how the pandemic reshaped the clinical landscape for people seeking care. Nearly half of orofacial pain providers reported an increase in referrals from other healthcare providers during and after the pandemic, and about a third noticed more patients referring themselves.1PubMed Central. The impact of the COVID-19 pandemic on orofacial pain practice: Perceptions from a convenience sample of orofacial pain practitioners That volume increase meant longer wait times for specialist appointments in many areas, and many patients ended up cycling through general dentists, primary care physicians, and ENT doctors before landing with someone who recognized the problem as a TMJ disorder.
The gap matters because TMJ disorders are frequently misdiagnosed or underdiagnosed in general practice. Jaw pain can mimic ear infections, sinus problems, or even toothaches, and a provider who isn’t specifically looking for TMJ issues may chase the wrong diagnosis for months. If you developed persistent jaw pain, clicking, or limited mouth opening during or after the pandemic and haven’t seen improvement with initial treatments, asking specifically for a referral to an orofacial pain specialist or a TMJ-focused dentist can short-circuit an otherwise frustrating diagnostic journey. The pandemic generated a generation of new TMJ patients, and many of them are still looking for answers.