TMJ Disorder in Horses

Temporo-mandibular joint and muscle disorders, often simply referred to as TMJ, are defined as “a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement.”  A more accurate acronym is actually TMD (temporomandibular dysfunction).  But for this post, I’ll refer to it as TMJ since most of us are more familiar with that term.

TMJ is a condition I know about all too well.  I’ve dealt with jaw pain of some form for most of my life–even having to go to a TMJ specialist after my jaw began locking up when I was in my early twenties.

Horses can suffer from TMJ disorder as well, as I’ve recently come to realize with my mare, Lee Lee.  She’s displayed some classic symptoms from a young age, but I  just didn’t put two and two together.  Probably one of those ‘missing the forest for the trees’ situations. . .

Years ago, I began to worry when Lee Lee started holding her head to one side while eating her feed.   The fact that she would also toss her head frequently when being ridden bothered me as well.  I took her to several different vets to have her teeth checked, but nothing out of the ordinary was found.  So I chalked it up to just being sensitive.  I assumed these were quirks I would just have to put up with.

That is until last fall when I started working  with her again after several years off.

I immediately noticed that the head-tossing had gotten significantly worse (even in a bitless bridle).  Her gaits seemed off as well.  It was apparent that something more serious was going on.  I made an appointment with Spencer LaFlure , who specializes in balancing the TMJ as well as the teeth.

Spencer mentioned that it may take more than just getting her bite aligned to correct the problem though.  The muscles and ligaments had been strained for so long, it would be hard for them to relax.  This makes sense of course, since TMJ disorder can involve more than just the joint.


The Horse’s TMJ

The TMJ joint resides just below and in front of the base of the ears on either side of the head.  It’s where the lower jaw (mandible) of the horse articulates with the temporal bone.  The horse’s temporo-mandibular joint is a bit more complex than ours because of the fact that horses have moveable ears and teeth that erupt throughout their lifetime.   It also articulates with the hyoid bone, which is attached to other structures extending down the neck.

tmj horse

Of course there are several different muscles surrounding the TMJ joint and palpation of tightness or a display of sensitivity in these muscles can be a good indicator of pain.

According to this informative article written by Cranio-sacral therapist, Maureen Rogers, “In the event of these muscles tightening and shortening, the body then negatively compensates for the imbalance. The proper function of the TMJ Mechanism therefore plays an important role in the whole function of the horse, including leads, gaits, balance and equilibrium.’

Everything in the horse’s body is connected. An imbalance in one location can lead to imbalances in other areas as well. . .


Symptoms of TMJ Disorder in Horses

There are several different symptoms (many of which Lee Lee has) that can indicate that your horse is suffering from a TMJ disorder.  They include:

  • uneven wear of the teeth (your vet or equine dentist may notice this);
  • head tossing, especially when pressure is applied with a bit or hackamore;
  • cribbing;
  • ear sensitivity;
  • difficulty taking or wearing a bit;
  • difficulty with certain leads or gaits;
  • difficulty flexing at the poll; and/or
  • head shy or sensitive in jaw area.


Causes of TMJ Disorder in Horses

I can trace my own TMJ problems back to grade school, when my dentist put me in a special retainer to correct my overbite.  Then I believe the problem was worsened when I wore braces for nearly five years.   Apparently, aggressive dental work with horses can be a trigger for TMJ dysfunction as well.

In another excellent article, Dr. Heather Mack, a holistic veterinarian and advocate of TMJ Awareness Dentistry said,  “I feel equine dentistry has advanced too far toward the comfort of the dentist and less toward the comfort and safety of the horse. The overuse of power dental instruments is the primary reason I see and treat so many TMD horses.”

Personally, I would be very cautious of who you use to float your horse’s teeth.  I will not allow power tools to be used on Lee Lee again. (Natural Balance dentists, like Spencer Laflure only use hand tools and make the comfort of the horse a priority.)

Aside from dentistry, other possible causes of TMJ disorder in horses include:

  • eating out of raised hay racks;
  • use of bits and/or restrictive nosebands;
  • improper saddle fit;
  • ‘hard’ hands of rider;
  • improper gaits caused by faulty hoof care or conformational defects;
  • emotional stress;
  • injury sustained while ‘pulling back’; and/or
  • lack of pasture grazing.


Treating TMJ Disorder in Horses

So what can be done to address TMJ disorders in horses?   After you’ve examined and hopefully eliminated factors that may be contributing to the problem such as bits, dental issues, hoof trimming, feeding practices, etc., body work and/or holistic treatments may be your best bet  (aside from joint injections, which makes me cringe to think about. . .)

There are many different types of body work that can be used to relax the muscles, ligaments, and tendons in the jaw and TMJ area.  Massage, acupressure, acupuncture, myofascial release, and cranio-sacral work are a few.

For the last several weeks, I’ve been using acupressure, red light therapy, and massage with Lee Lee.  Here are a few of the acupressure points that can benefit TMJ disorder in horses.  Lee Lee’s jaw is so sensitive that sometimes, I can only use my red light (holding it about an inch away from her face).  I am noticing some small improvements though.


TMJ points


Stomach 1: (bilateral) located just beneath the center of the eye.  Aids in relieving jaw pressure.

Bladder 10: (bilateral) located just behind the atlas and in front of the first cervical vertebrae on the upper neck.  Relieves neck pain.

Gallbladder 21: (bilateral) located just above the last cervical vertebrae and in front of the scapula.  Softens tense muscles.

Lung 7:  (bilateral) located just in front of (toward the horse’s head) the large vein that runs down the inner leg, even with the bottom of the horse’s chestnut.  Master point for the head and neck.

Large Intestine 4: (bilateral) located just below the inner carpal bones, at the head of the inner splint bone.  Master point for the face and mouth.


Also, if the actual TMJ joint is known to be involved, joint supplements may be beneficial.  Otherwise natural anti-inflammatory supplements such as Devil’s Claw can likely help (temporarily).  See these posts for more information on those:

Comparing Joint Supplements for Horses

Natural Alternatives to Bute

The final point I’d like to make is this:  when your horse is behaving in an unnatural manner, don’t always assume he’s just being difficult.  A head shy horse or one who is fussy with the bit likely has valid reason to be acting the way he does.   This is something that took me a while to realize, but now, I always search for a physical or psychological cause for these behaviors in my horses.




Sources and Further Reading

TMJ and TMD: Exploring the Whole Body Connection

Temporomandibular Joint Disease

 The TMJ is the Master Link

Temporo-Mandibular Joint Pain–Hyoid Muscles as the Source

The Temporomandibular Joint: More than a Pain in the Mouth!


Hi! My name is Casie Bazay. I'm a mom, a freelance writer, and a certified equine acupressure practitioner.

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9 Responses

  1. Holly Carlile says:

    My mare had TMJ and I used a natural progesterone called Progessence Plus. It works in a matter of days. It is an essential oil made from wild yams formulated by Young Living. Just apply behind the ears close to the joint. Amazing results and lasted about 6 months then just reapply.

  2. Brian Stuarr says:

    I agree with Dr. Mack’s assessment of todays power horse dentistry…”injurious to horses and easy on the practitioner.”
    As for “natural dentist’s” musing regarding the equine tmj. They are the fantasies of a guy who spent a little time at a diploma mill out west for horse dentists who then opened a school of his own. There is zero research that backs up claims that the equine tmj can be benefitted by changes made to the incisors. The claim that equine incisors should be kept at the length and angle of a five year old is the cornerstone of this groundless and dangerous approach to caring for horses teeth. So many horses will be left to suffer as this unfounded theory is taught to more uneducated caregivers. The equine tmj is understood to be a more rugged joint than ours and rarely has dysfunction unless it is traumatized. All the symptoms described in the article are typical issues for horses whose teeth need to be well floated. By promoting this drivel you have now joined those who do a disservice to horses.

    • Casie says:

      Hello Brian, I appreciate your comment and I don’t pretend to be an expert on the horse’s mouth or teeth. I simply know what has and hasn’t worked for my horses. And the horse mentioned in this particular post was examined by several vets and had her teeth traditionally floated (with power tools) several times and it made no difference for her. Just as there are many ideas on ‘properly’ trimming the hoof (even within natural trimming circles), there are bound to be different ideas on how to correctly balance or float the teeth (or whatever you may call it). That doesn’t necessarily mean one is right and one is wrong though. I have only used a natural balance dentist once, but I was quite impressed with his horsemanship skills with my ‘difficult’ horse. I’m open to other ideas though and believe that all shared knowledge can lead us to a better understanding of the horse’s mouth.

  3. Brian Stuart says:

    Misinformation isn’t knowledge, it’s only misinformation.

  4. As a vet with a specific interest in equine dentistry and teh teporomandibular joint in particular I totally agree with your final point …
    ” when your horse is behaving in an unnatural manner, don’t always assume he’s just being difficult. A head shy horse or one who is fussy with the bit likely has valid reason to be acting the way he does.”
    I often see horses who have been dismissed as being “difficult” only to find dental issues, back or neck pain, gastric ulceration or rarely temporomandibular joint arthropathy/pain. I would echo Brian’s point regarding “natural balance dentistry”. the research they talk about has never been published, not subjected to peer review and when I have requested a copy several times I have had no answer.
    please don’t “cringe” at the thought of joint injections – the only way to truely diagnose the TMJ as the cause of the symptoms is with diagnostic analgesia (or joint blocks as they are commonly called) and corticosteroids injected directly into an inflammed joint can give marked and almost immidiate relief to these horses who have often been in pain for years. Then using all the management changes you have discussed to keep the condition under control is really helpful but you are starting with a comfortable horse. I saw a gelding this morning who has been showing marked symptoms on the bit (both ridden and none ridden). We injected both of his TMJ’s and then the owner rode him – I left her almost in tears as he has been unridable for months and he trotted around the school this morning without an issue.
    Thanks for bringing this often unrecognised condition to horse owners attention.

    • Casie says:

      Hi Stuart,

      Thanks for your comments. And the ‘cringing’ part probably has to do with my thoughts about having injections in my own sore jaw. I’m sure it can be helpful for some horses. Certainly glad to hear that it helped the horse in the case you cited.

  5. Shelly says:

    I read your article with interest as I have a horse that is very head shy for no known reason. I stopped reading, however, when you suggested a pressure point for the gall bladder as horses do not have one. Oops.

    • Casie says:

      Hi Shelly, I’m well aware that horses don’t have a gallbladder. There is, however, a gallbladder meridian on the horse, which is more of an energetic pathway than anything. It’s still called the gallbladder meridian, just as it is in people. I do hope you’ll finish reading the article, as I believe these points can be very useful for horses with jaw pain. Thanks.

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