Should I Be Concerned If My Jaw Clicks?
You may have noticed that when you are eating or when you yawn, your jaw clicks. The good news is that most of the time, there is really absolutely nothing at all to worry about. Jaw clicking is quite common, and it may only occur sometimes or if when your jaw is really wide open. Jaw clicking can only be on one side and sometimes on both sides. It usually isn’t painful, but the noise of the click can be worrisome. There are however instances when the jaw clicking together with other signs (such as locking, pain etc.) can be problematic and you may need to do something about it.
The proper biological name for the lower jaw is the mandible and maxilla for the upper jaw. The mandible is the portion that moves during eating, talking and swallowing. The jaw joint itself is located just in front of the skin flap immediately in front of the ear.
You can feel the jaw joint moving easily by placing two fingers together and placing them just on the skin in front of the skin flap and opening/closing your mouth. The biological name for the jaw joint is known as the temporomandibular joint. It’s quite a mouthful (the pun is not intended) to pronounce, so it is abbreviated as the TMJ. The basic structure of the joint is much like other joints in that you have two bones separated by cartilage and synovial fluid fills the joint capsule.
Normal Functioning Jaw: Normal opening. The disc is in the proper position and it glides forward and back when the jaw is opened.
Symptoms To Be Aware Of
As previously mentioned, if your TMJ clicks, that is not something you immediately need to do anything about unless if you also notice other signs, then you should get it evaluated by your dentist or an orofacial pain specialist.
These signs are if your jaw locks, pain around the joint area, unexplained earache if there is pain on opening or closing, if you get frequent headaches especially on waking up in the morning and if you notice you unconsciously grind your teeth or clench your jaw. Once you experience pain or spasm around your TMJ, this then becomes a reason to visit an orofacial pain specialist. This condition is known as temporomandibular joint dysfunction.
Temporomandibular disorder or temporomandibular syndrome is frequently accompanied by clenching or grinding (bruxism). Even if the pain is not that severe, bruxism can seriously damage and crack the enamel of your teeth until it completely wears down. The enamel of your teeth does not have the capacity to grow back so once the enamel has worn down it will never grow back.
Once the enamel has disappeared, you are down to the underlying softer part of the tooth called dentin. If the clenching and grinding continue, the dentin will wear away much faster and before long, you will notice sensitivity as you get closer to the nerves inside your teeth. For certain, you will also definitely become aware of your teeth becoming shorter and flatter around the edges as they wear away. As your teeth become shorter this in itself places extra strain on your TMJ.
Popping or Clicking Jaw: The disc is forward of the jaw bone. When the jaw is opened, the disc clicks or pops, and then the jaw follows its normal opening. A pop or click can be heard when the jaw is closed.
Closed Lock: The disc is forward of its normal position, and it prevents the jaw from fully opening. This is called a closed lock or anterior displacement without reduction.
Available Treatment Options
The goal of any jaw pain or TMD treatment is to relieve the pain, restore normal function and to identify any underlying causes if present. Scientific evidence shows that nonsurgical conservative and reversible treatment options should be initiated first before considering any surgical options which are rarely needed. However, any clicking of the jaw will probably not go away (which is OK since clicking alone is not pathological). Recommended treatment modalities include the following:
1. Physical medicine (physical therapy, home self-care exercises, relaxation techniques, soft diet, heat/cold application, etc.)
2. TMJ orthotic (custom made night guard/splint specifically designed to unload the jaw joint)
3. Trigger point injection or dry needling to help alleviate painful tight muscles
4. Short term anti-inflammatory or muscle relaxants if indicated
5. Jaw joint injection or lavage if needed
6. Jaw joint surgery (last resort option)
So, in summary, there is no need to worry if your jaw clicks. If however there is pain, difficulty chewing/dysfunction or evidence of a clenching or grinding habit, then it should be evaluated by an orofacial pain specialist.
If you live in the Dallas-Fort Worth area, I invite you to make an appointment for a consultation at my office here. We are thorough, compassionate and have many tools at our disposal to help.
If you are located outside the Dallas-Fort Worth area, you can find a practitioner in near you on the website of The American Academy of Orofacial Pain. Choose a doctor who is listed as Diplomate.
Dr. Amrittej Virk is a Board Certified Orofacial Pain Specialist. His practice focuses on TMJ disorders, facial pain, persistent toothache pain, headaches and sleep-related breathing disorders. He is a Diplomate of the American Board of Orofacial Pain and a fellow of The American Academy of Orofacial Pain. Read more about him here.
