What’s the Jaw Got to Do With It? Understanding, Assessing, Treating, and Managing TMJ-Related Dizziness

Overview

Dizziness is one of the most diagnostically demanding complaints in manual therapy — and one of the most commonly misattributed. While vestibular and cervical causes receive routine attention, the temporomandibular joint and its associated neuromuscular networks remain a critically under-recognized contributor.

This course, led by Jules Poulin, a Registered Massage Therapist with over two decades of specialized TMJ practice and founder of North America's first clinic dedicated exclusively to jaw and head rehabilitation, presents a four-pillar clinical framework for understanding, assessing, treating, and managing TMJ-related dizziness. Through shared anatomical and neurological pathways, practical screening strategies, and an interprofessional management lens, participants will leave with a structured approach to a clinical problem that too many practitioners are currently unprepared to address.

Learning Objectives

By the end of this course, participants will be able to:

1. Understand the anatomical and neurological relationships between the TMJ, cervical spine, and vestibular system — including the trigeminal nerve's role in transmitting proprioceptive and nociceptive information that influences spatial orientation and postural control.
   
   
2. Assess key subjective and objective indicators suggesting a TMJ contribution to dizziness, including how to distinguish the characteristic "floaty" disequilibrium of TMJ-related dizziness from classic vestibular vertigo, and how to use jaw and cervical movement to mechanically reproduce or modulate symptoms as a diagnostic tool.
   
   
3. Treat TMJ dysfunction within physiotherapy and massage therapy scope as part of a broader care plan, targeting muscular hypertonicity in the masseter, temporalis, SCM, and suboccipitals, and improving jaw-neck coordination to reduce somatosensory system overload.
   
   
4. Manage patient expectations, recognize absolute red flags requiring urgent referral (including sudden vertigo with neurological signs such as dysarthria, diplopia, or drop attacks), and navigate interprofessional collaboration with vestibular physiotherapists and other providers.

Audience

This course is designed for manual therapy professionals who encounter dizziness, headaches, and neck pain in their caseloads and want to expand their differential reasoning to include the TMJ. That includes vestibular, orthopaedic, and neurological physiotherapists; registered massage therapists; chiropractors; and any clinician working at the intersection of jaw, neck, and balance dysfunction. Given that TMJ-related dizziness is a diagnosis of exclusion, the framework taught here is equally valuable for clinicians who need to confidently rule it out as for those who will treat it directly.

Why This Course Matters

The nervous system integrates vestibular, visual, and somatosensory inputs to maintain balance — and dysfunction anywhere in that network, including the TMJ, can produce dizziness without a single positive vestibular test. Yet most dizziness assessment protocols stop at the cervical spine. This course addresses that gap directly, offering a structured clinical framework grounded in the trigeminal-vestibular-cervical interaction that explains why patients with bruxism, jaw parafunctions, and forward head posture so often present with unexplained imbalance and "floaty" sensations. Beyond assessment, the course makes the case that treating TMJ contributors can actively enhance the effectiveness of vestibular rehabilitation — meaning this knowledge benefits not just TMJ specialists, but any clinician involved in vestibular care.

This course is part of the Let's Talk Vestibular series on Embodia.