Jaw Clicking: Causes, Symptoms, and Treatment Options

Why does my jaw click when I open my mouth?

Jaw clicking, medically known as crepitus, often stems from an issue within the temporomandibular joint (TMJ), most commonly due to the displacement of the articular disc that cushions the joint, or less frequently, from degenerative changes or muscle imbalances.

Understanding the Temporomandibular Joint (TMJ)

The temporomandibular joint (TMJ) is one of the most complex joints in the human body, facilitating crucial functions like chewing, speaking, and yawning. It acts as a hinge connecting your jawbone (mandible) to your skull (temporal bone) just in front of your ear. Understanding its intricate anatomy and biomechanics is key to comprehending why it might click.

• Anatomy: The TMJ is comprised of several key components:

  • Mandibular Condyle: The rounded end of the jawbone.
  • Articular Fossa (Gelnoid Fossa): A depression in the temporal bone where the condyle articulates.
  • Articular Disc (Meniscus): A small, oval-shaped piece of cartilage located between the condyle and the fossa. This disc acts as a shock absorber, ensures smooth joint movement, and helps distribute forces evenly across the joint surfaces. It is typically biconcave, thicker at its posterior and anterior aspects, and thinner in the middle.
  • Ligaments and Muscles: A network of ligaments stabilizes the joint, while surrounding muscles (masseter, temporalis, medial and lateral pterygoids) control jaw movement.

• Normal Function: During normal mouth opening, the mandibular condyle rotates within the articular fossa and simultaneously glides forward, with the articular disc maintaining its position between the two bones. The disc moves in harmony with the condyle, ensuring a smooth, frictionless motion.

Common Causes of Jaw Clicking

When the delicate balance of the TMJ is disrupted, various issues can lead to an audible click or pop.

• Articular Disc Displacement (Most Common Cause):

  • Disc Displacement with Reduction: This is the most frequent reason for jaw clicking. The articular disc, instead of staying perfectly aligned with the condyle, slips forward or to the side when the mouth is closed. As you begin to open your mouth, the condyle "reduces" or snaps back onto the disc, producing the characteristic click or pop. Conversely, a second click may occur upon closing the mouth as the disc displaces again.
  • Disc Displacement Without Reduction (Locked Jaw): In some cases, the displaced disc may prevent the condyle from fully returning to its normal position, leading to a "closed lock" where the mouth cannot open fully. This is typically accompanied by significant pain and lack of clicking, as the disc is no longer moving in and out of place.

• Hypermobility or Ligamentous Laxity: If the ligaments supporting the TMJ are overly stretched or naturally lax, the condyle might move excessively within the joint. This can lead to the condyle "popping" out of its normal resting position and then "popping" back in, creating a click. This is often seen in individuals with generalized joint hypermobility.

• Osteoarthritis or Degenerative Joint Disease: Like other joints in the body, the TMJ can be affected by osteoarthritis, which involves the breakdown of cartilage and bone remodeling. This can lead to rough joint surfaces, causing grinding, popping, or clicking sounds as the bones rub against each other. Pain, stiffness, and reduced range of motion are common accompanying symptoms.

• Myofascial Pain and Muscle Imbalance: Tension or spasm in the muscles surrounding the jaw (e.g., masseter, temporalis, pterygoids) can alter the mechanics of the TMJ. Chronic clenching (bruxism), teeth grinding (especially at night), or even sustained stress can lead to muscle fatigue and imbalance, indirectly affecting disc position and joint movement, resulting in clicking.

• Trauma or Injury: A direct blow to the jaw or head, whiplash injury, or even prolonged wide mouth opening (e.g., during dental procedures) can damage the TMJ components, including the disc, ligaments, or bone, leading to clicking, pain, or limited movement.

• Malocclusion or Dental Issues: An improper bite (malocclusion) or missing teeth can alter the way the jaw closes and puts uneven stress on the TMJ, potentially leading to disc displacement and clicking over time.

When to Seek Professional Help

While occasional, painless jaw clicking is relatively common and often benign, certain symptoms warrant professional evaluation:

• Pain: If the clicking is accompanied by pain in the jaw, face, ear, or head.
• Limited Range of Motion: Difficulty opening or closing your mouth fully.
• Locking: If your jaw gets "stuck" in an open or closed position.
• Grinding Sensations (Crepitus): A grating or crackling sound, which can indicate more significant joint degeneration.
• Impact on Daily Activities: If the clicking or associated symptoms interfere with eating, speaking, or sleeping.
• Persistent Symptoms: If the clicking is constant, worsening, or does not resolve on its own.

A healthcare professional, such as a dentist, oral surgeon, physical therapist, or TMJ specialist, can accurately diagnose the cause of your jaw clicking and recommend appropriate treatment.

Self-Care Strategies and Management

For mild or infrequent clicking without significant pain, some self-care measures can help manage symptoms:

• Soft Diet: Avoid hard, chewy, or sticky foods that require excessive jaw effort.
• Heat or Cold Therapy: Apply a warm compress to tight jaw muscles or an ice pack to the joint area to reduce pain and inflammation.
• Stress Management: Practice relaxation techniques (meditation, deep breathing) to reduce jaw clenching and teeth grinding.
• Avoid Excessive Jaw Movement: Limit wide yawning, prolonged chewing gum, and nail-biting.
• Gentle Jaw Exercises: Your healthcare provider might recommend specific exercises to improve jaw mobility and muscle function, but always consult a professional before starting.

Professional Treatment Options

Depending on the underlying cause and severity of your symptoms, professional interventions may include:

• Physical Therapy/Manual Therapy: A physical therapist specializing in TMJ disorders can provide exercises to improve posture, strengthen jaw muscles, increase range of motion, and use manual techniques to mobilize the joint and reduce muscle tension.
• Dental Splints or Oral Appliances: Custom-made mouthguards or splints can help reposition the jaw, reduce clenching and grinding, and protect the teeth from wear.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, muscle relaxants for muscle spasms, or tricyclic antidepressants for pain and sleep.
• Injections: Corticosteroid injections into the joint or Botox injections into jaw muscles may be used for pain relief and muscle relaxation.
• Surgery: In rare, severe cases where conservative treatments fail, surgical options (e.g., arthrocentesis, arthroscopy, open-joint surgery) may be considered.

Conclusion

Jaw clicking is a common phenomenon often linked to the intricate mechanics of the temporomandibular joint, primarily involving the articular disc. While many instances are benign, persistent clicking, especially when accompanied by pain, stiffness, or functional limitations, warrants a professional evaluation. Early diagnosis and appropriate management, ranging from self-care to specialized medical interventions, are crucial for preserving jaw health and improving quality of life.