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Yes, your neck can affect your temporomandibular joint (TMJ) in a multitude of ways.  Our body is a kinetic chain and if you change how one part of your kinetic chain is functioning you will change how the adjoining parts function first and then it ripples out from there.  The top cervical vertebrate’s (C1) transvers process (TP) sits right under your TMJ.  If this cervical vertebra is misaligned it will change how your TMJ moves.  Realigning your C1 will cause some people’s TMJ pain to go away.  This can be a really elegant solution for TMJ pain. The narrative people present with that make me want to look at C1 as a cause for TMJ pain is when there was a sudden onset of pain not caused by chewing.  The longer there is pain the more likely other parts of the body will compensate so it is important to get jaw pain addressed quickly.  For example, if your C1 goes out of alignment and is left to stew then the muscles attached to this vertebra will start to become tight and pull.  This will cause your suboccipital muscles to become tight which then causes headaches.  The muscles around your jaw will set up new muscle memory around your jaw movement the longer it is left unattended. The longer this goes on the longer it will take to retrain these muscles later.

How often is C1 misaligned in TMJ patients?

I haven’t seen any research papers on this but I would love for that research to be done.  In my practice about 90% of my TMJ patients have chronically misaligned C1 vertebra as well.  I cannot tell you if C1 being misaligned causes the TMJ problem or vice versa for these patients.  It would be fun information to know which problem usually starts the problem but ultimately it doesn’t matter for treatment because you have to treat both problems in order to make long lasting changes to jaw pain.