Can Lyme Disease Cause Jaw Pain? TMJ Arthritis and Misdiagnosis
Can Lyme disease cause jaw pain? Yes. In some cases, Lyme disease can affect the temporomandibular joint (TMJ), causing inflammation that mimics a common temporomandibular disorder (TMD).
When TMJ treatments don’t work, the underlying cause may not be mechanical—it may be infection.
For a full overview of Lyme arthritis, including symptoms and treatment, see our main guide.
Case Report: TMJ Arthritis Due to Lyme Disease
A 25-year-old patient developed acute pain in the temporomandibular joint along with difficulty opening her mouth.
Over several months, her symptoms progressed to include:
- Severe TMJ pain
- Restricted mouth opening (20 mm)
- Jaw deviation
She was initially diagnosed with internal derangement of the joint and treated with:
- Anti-inflammatory medications
- Bite splints
- Corticosteroid injection
None of these treatments were effective.
Despite no known tick bite or rash, Lyme disease testing was positive.
She was diagnosed with Lyme arthritis affecting the TMJ.
After a 3-week course of antibiotics, her symptoms began to improve within one week.
This case highlights how Lyme disease can mimic common TMJ disorders—and be missed.
Why Lyme Disease TMJ Pain Is Often Misdiagnosed
TMJ pain is commonly attributed to:
- Temporomandibular disorder (TMD)
- Dental misalignment
- Stress-related jaw tension
- Non-infectious arthritis
But Lyme-related joint inflammation behaves differently.
It may persist despite standard treatment and lack a clear mechanical cause.
This reflects a broader pattern seen in Lyme disease misdiagnosis.
When to Suspect Lyme Disease in Jaw Pain
Lyme disease should be considered when TMJ symptoms:
- Do not improve with standard treatment
- Occur without clear structural abnormalities
- Are accompanied by fatigue, joint pain, or neurologic symptoms
- Occur in patients from tick-endemic regions
Recognizing this pattern can help avoid unnecessary procedures and prolonged symptoms.
Clinical Takeaway
Lyme disease can present as TMJ arthritis, causing jaw pain that mimics common temporomandibular disorders.
- Symptoms may not respond to standard TMJ treatment
- Infection should be considered when patterns don’t fit
- Early recognition can improve outcomes
Not all jaw pain is mechanical—some cases require a broader diagnostic approach.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
For years I had right face TMJ pain. I went through all the dental treatments available including equilibration and Tens. It helped for a while but the horrible nerve pain would return. As I was further into my miserly I was sitting by a vase of Lilies. Soon my ear pain started and I had to leave. As I got farther from the house the pain eased off. This was the same thing I felt in Church from flowers and smells like perfume. I had just started allergy treatments and was really into things I came in contact with and my bodies response. Seems, I figured this out, my Eustachian tube filled up due to reaction and was pressing on a nerve, maybe the 5th. I finally found an Ear Dr that bought my theory and inserted 3 tubes, the last being bigger to help drain the fluid and a graft to the drum to accommodate. After a few months it stopped hurting. I have twinges now and then when the Barometric Pressure is high or I smell something I’m really allergic to. I’ve had Lyme for almost twenty years and I know it affects my body’s nervous system and has days where it reeks havoc on my whole body.
I typically look a second time for persistent infection in patients who have unusual presentations.
Dear Dr. Daniel Cameron,
Thank you for your recent article on TMJ/TMD.
Around age 25, I began to get TMJ /TMD, as well as other symptoms consistent with Lyme disease and tick-borne illness.
My CDC Lyme disease test was negative and I was advised to take prescribed) ibuprofen for 3 weeks.
5 years later, I still suffer from TMJ/TMD and a host of the same multi-system illness symptoms.
Can you help me? What can I do?
Thank you,
Brittney
I have Lyme disease patients whose TMJ pain has resolved if I treat their underlying Lyme disease. Some have not.
pain yes,but tinnitus and hyperacusis omvolved jass ligament ,what treatment can help?
The authors added Lyme disease to long list of considerations. I advise my patients with TMJ with clinical manifestations of Lyme disease to consider treatment.
I have seen TMJ clear in some of my Lyme disease patients. I have included ENT and dentists in my evaluation.
what is the most reliable Lyme’s test? My daughter was diagnosed with toxic mold exposure and has had fatigue anxiety and depression for years among other issues. Her functional medicine Dr wants to test for lymes with the Galaxy test. How reliable are these tests? I am concerned she is talking herself into diagnosis and figures it is a quick fix with a pill.
Galaxy is a research lab best known for Bartonella testing. I do not know how reliable the testing is.
I am searching for the underlying cause of acute thoracic parastesia, L’Hermittes Sign and TMJ among other symptoms. I did find a physical therapist who does dry needling. It was near instant relief for my TMJ. I have not had pain in my jaw for 8 weeks now!
My daughter has recently been diagnosed with bilateral Trigeminal Neuralgia with left cerebral artery impinging on superior surface and venous structure on right side impinging on trigeminal nerve. We don’t know the cause of the constant and sharp pains. Might a lyme evaluation be indicated? Can lyme affect the trigeminal nerve in this way? Your feedback is most appreciated. Thank you.
You never know. Dr. Halperin, a neurologist, stated “”Other cranial nerves can be involved – the trigeminal nerve causing numbness and pain, the nerves to the extraocular muscles causing paralysis of innervated eye muscles and diplopia, or the acousticovestibular nerve affecting hearing and balance.” in the literature. Here is the link. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440423/ I have had a few patients where it has been difficult to be sure of the diagnosis. My Lyme disease patients often have other issues that help with diagnosis.
Disseminated Lyme can also mimic toothache.
Mello I, Peters J, Lee C. Neuropathy mimicking dental pain in a patient diagnosed with Lyme disease. Journal of Endodontics. 2020 Sep 1;46(9):1337-9.
DOI: 10.1016/j.joen.2020.06.011
https://pubmed.ncbi.nlm.nih.gov/32562700/
This post made me consider testing for lyme in a patient who’s had chronic athralgias, severe TMJ, brief paralysis of the lower extremities years ago, and closed eye visual hallucinations at night (he sees racing images of random people and places – very atypical of any primary psych disorder).
I have seen patient with similar symptoms including distorted vision despite a normal ophthalmologist and Brain MRI that resolves with Lyme treatment.
Lyme disease can mimic dental and endodontic pain.
Reference: Mello, I., Peters, J., & Lee, C. (2020). Neuropathy Mimicking Dental Pain in a Patient Diagnosed with Lyme Disease. Journal of Endodontics, 46(9), 1337-1339: doi: 10.1016/j.joen.2020.06.011. Epub 2020 Jun 17. PMID: 32562700.