The bones in the human body form the skeleton that supports posture. Whether standing or sitting, how the body is positioned is crucial for long-term bone health and correct alignment, reducing stress on the spine and maintaining an equal weight distribution. Poor posture continues to grow as a public health problem, with 73% of university students and 64.7% of people who work from home reporting neck or back pain.[i]
The global posture correction market was valued at nearly £1 billion in 2024, with an 8.4% growth per year expected from 2025-2030.[ii] Whilst this illustrates a growing awareness of poor posture and the steps needed to correct it, research is still developing, especially regarding its association with temporomandibular disorder (TMD). Dental practitioners with a firmer understanding of the relationship between poor posture and TMD will be better equipped to help at-risk patients lead a better quality of life.
Making a connection
The temporomandibular joint (TMJ) is one of the most frequently used joints in the body. Its surface is covered with avascular, non-innervated fibrocartilage, harbouring a strong capacity for regeneration. However, ligament and muscle connections between the TMJ and the cervical area have led to speculation that posture problems can increase the risk of TMD.[iii] This could include unilateral mastication, leading to an unbalanced masticatory cycle that can jeopardise the body’s equilibrium.
Research on TMD patients has found that they are likely to have an overly forward head position, accompanied by the shortening of the sternocleidomastoid and posterior cervical extensor muscles.[iv] This impacts gait stability and changes how gravity acts on the body, shifting the centre of pressure on the feet.[v] Along with higher reported levels of neck pain, TMD patients may also have worsened jaw pain or stiffness as changes in cervical curvature may influence muscle tension in the neck, inhibiting mandible and muscle movement.[vi] This can have a negative impact on a patient’s quality of life, making eating, speech and everyday activities a hardship.
Making matters worse
Exacerbating issues around posture is the growing epidemic of ‘text neck’. The pervasive forces of phones, sedentary jobs and working from home may have made life easier, but the toll on the spine can be just as damaging as those in more exhaustive, manual jobs.[vii] ‘Text neck’ develops from craning the head to look down, something that is becoming increasingly more common in younger generations. When the head is held in line with the shoulders, it weighs around 4.5kg. For every inch forward the head is tilted, the weight on the spine nearly doubles to keep it supported – this is as true for sitting at a desk as it is standing at one.[viii] For TMD patients, the anteriorly positioned head can be further aggravated by a lifestyle of staring down at phones or computers.
However, posture is affected by many factors, including age, profession, pregnancy, and daily choices like the weight of the bag you carry or the amount of exercise you do.[ix] The research around posture as a factor for TMD is still growing, and the correlation does not yet support a definitive connection, but treatments with an oral splint for TMD patients have reported improvements in jaw pain and spine mobility, as well as a significant reduction in cervical spine discomfort.[x] This indicates that the two are associated and managing one may help manage the other.
Perfect positioning
To encourage patients to look after their posture, dental practitioners should highlight correct spinal alignment in both sitting and standing positions. For those who work seated, a 90-degree angle for the shoulders and arms is recommended, with the computer straight ahead at eye-level.[xi] Mobility is also crucial, such as standing up and swaying where possible. Reduced phone time, or holding the handset higher up, and regular exercises can also improve posture and strengthen the neck muscles.
TMD is a great disruptor of everyday life, causing discomfort and pain and lowering self-esteem. To support affected patients, recommend the OraStretch® Press Rehab System from Total TMJ. An at-home physical therapy solution, it stretches the orofacial tissues to restore mobility and strength to the TMJ. Diligent use of the OraStretch® Press treats TMD and trismus, as well as preventing scarring and fibrosis from radiation therapy or surgery. With the support of Total TMJ, quality of life can be improved for afflicted patients.
The rise in poor posture as a result of phones, computers and sedentary jobs has an enormous impact on overall body health. As its association with TMD becomes increasingly apparent, managing poor posture is vital for prevention and management.
For more details about Total TMJ and the products available, please email info@totaltmj.co.uk
Karen Harnott: Total TMJ Operations Director
[i] Tsantili, A.-R., Chrysikos, D. and Troupis, T. (2022). Text Neck Syndrome: Disentangling a New Epidemic. Acta Medica Academica, 51(2), p.123. doi:https://doi.org/10.5644/ama2006-124.380.
[ii] www.grandviewresearch.com. (n.d.). Posture Correction Market Size & Share Report, 2022-2030. [online] Available at: https://www.grandviewresearch.com/industry-analysis/posture-correction-market-report.
[iii] Minervini, G., Franco, R., Maria Maddalena Marrapodi, Crimi, S., Almir Badnjević, Cervino, G., Bianchi, A. and Cicciù, M. (2023). Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. Journal of Clinical Medicine, 12(7), pp.2652–2652. doi:https://doi.org/10.3390/jcm12072652.
[iv] Minervini, G., Franco, R., Maria Maddalena Marrapodi, Crimi, S., Almir Badnjević, Cervino, G., Bianchi, A. and Cicciù, M. (2023). Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. Journal of Clinical Medicine, 12(7), pp.2652–2652. doi:https://doi.org/10.3390/jcm12072652.
[v] Minervini, G., Franco, R., Maria Maddalena Marrapodi, Crimi, S., Almir Badnjević, Cervino, G., Bianchi, A. and Cicciù, M. (2023). Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. Journal of Clinical Medicine, 12(7), pp.2652–2652. doi:https://doi.org/10.3390/jcm12072652.
[vi] Xiao, C.-Q., Wan, Y.-D., Li, Y.-Q., Yan, Z.-B., Cheng, Q.-Y., Fan, P.-D., Huang, Y., Wang, X.-Y. and Xiong, X. (2023). Do Temporomandibular Disorder Patients with Joint Pain Exhibit Forward Head Posture? A Cephalometric Study. Pain Research and Management, 2023, pp.1–11. doi:https://doi.org/10.1155/2023/7363412.
[vii] Tsantili, A.-R., Chrysikos, D. and Troupis, T. (2022). Text Neck Syndrome: Disentangling a New Epidemic. Acta Medica Academica, 51(2), p.123. doi:https://doi.org/10.5644/ama2006-124.380.
[viii] Cleveland Clinic (2021). The Health Effects of Poor Posture. [online] Cleveland Clinic. Available at: https://health.clevelandclinic.org/health-effects-of-poor-posture.
[ix] Wein, H. (2017). Getting It Straight. [online] NIH News in Health. Available at: https://newsinhealth.nih.gov/2017/08/getting-it-straight.
[x] Minervini, G., Franco, R., Maria Maddalena Marrapodi, Crimi, S., Almir Badnjević, Cervino, G., Bianchi, A. and Cicciù, M. (2023). Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. Journal of Clinical Medicine, 12(7), pp.2652–2652. doi:https://doi.org/10.3390/jcm12072652.
[xi] Cleveland Clinic (2021). The Health Effects of Poor Posture. [online] Cleveland Clinic. Available at: https://health.clevelandclinic.org/health-effects-of-poor-posture.
