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‘Clicky’ or Clicking Jaw (TMJ)

Many people experience a clicking noise or sensation when opening or closing their mouth. This can be very loud and noticeable to others near you while you are eating or even talking. This noise can be very disconcerting and may or may not be associated with the experience of pain. Before we can understand what makes the clicking noise, we need to have a basic understanding of the make –up or anatomy of the TMJ.

The Basic Make-up Of The TMJ

The jaw (TMJ) is made up of the jaw bone or mandible and the temporal bones of the skull. The anatomical term for the jaw joint is the temporomandibular joint or TMJ. You would have a left and right TMJ. The jaw joint (TMJ) is surrounded by a capsule or envelope. Separating the mandible bone from the temporal bones in each joint is a disc. This serves to cushion the bones and prevent wear and tear of the bone surfaces.  Keeping the disc and joint in a stable position are a series of ligaments. The jaw functions by virtue of many muscles as they open close and move the jaw in the necessary movements required for normal function such as eating & speaking.

What Makes The Noisy Clicking Sound In The Jaw (TMJ)

FIG 1 – showing the disc clicking out (2nd picture) and then back into position (3rd picture)

Remember from the description of the jaw above that we said that there was a disc separating the mandible bone (the lower jaw) from the temporal bone. This disc can become displaced forwards due to a number of factors. When this disc re-locates back to its normal position a clicking noise is heard.  Clicking thus indicates that there is an issue with the disc position.

What Causes Problems With The Disc Resulting In Clicking?

The back of the disc is secured to the joint by a ligament.  If this ligament becomes stretched as a result of excessive forces on the joint from clenching, grinding, or extended mouth opening or trauma, then then disc may become dislodged forwards. Another reason the disc can become dislodged forwards is that a muscle that attaches to the disc (the lateral pterygoid muscle), can become over active or go into spasm. When this happens it pulls the disc into an incorrect position. The relocation of the disc into the correct position results in the click. Clicking that occurs on both opening and closing of the mouth is called a reciprocal click. As the disc problem becomes more severe, the disc may not be able to be relocated and will result in a loss of opening of the mouth (jaw locking). When this occurs your clicking will have stopped as the disc is unable to click back into place. This is a much more severe problem and requires immediate treatment. Medical conditions such as rheumatoid arthritis can cause structural problems in the TMJ and may then result in a disc issue and associated click.

Other Associated Symptoms

Patients with clicking jaws (and thus disc problems) may also be experiencing:
  • headaches (especially on waking),
  • neck pain
  • jaw clenching
  • teeth grinding,
  • ear pain or blocking
  • ringing in the ears
  • dizziness

Treating a Clicking Jaw

It is important to establish what the cause of the click is in your jaw and to address these causes. If your jaw makes clicking noises but is not accompanied by pain this may still indicate the beginnings of a problem developing. If the clicking become louder, more frequent or associated with pain, this indicates a progression of the problem. Jaw locking and loss of the click indicates that the disc is not able to be relocated into the correct position and requires immediate treatment. Treating jaw and face pain conditions is a specialised field of treatment. At Melbourne TMJ & Facial Pain Centre, our experienced physiotherapists are specially trained to asses and treat clicking jaws and associated conditions. The earlier you address these issues, the more likely you are to prevent them from progressing into more severe problems. Call us today on 03 98248868 to address your jaw (TMJ) related problems.