Clicking jaw, also referred to as popping jaw or TMJ (temporomandibular joint) syndrome/dysfunction is a symptom associated with inflammation of the temporomandibular joint or uncoordinated action of the facial muscles.
Place your cursor over selected (red outlined) areas for a further explanation of the diagram.
The mandible (lower jaw) is the movable section of the skull that articulates (movement at the joint) with the temporal bones of the skull at the tempromandibular joint (temporal – mandible). The maxilla (upper jaw) is fixed to the skull and both the upper and lower jaws work together to assist with biting, chewing and eating. Under certain conditions, the tempromandibular joint (TMJ) articulation is affected often leading to a range of symptoms like jaw pain, clicking jaw (audible), popping jaw (sensation) and headaches. These symptoms are most often caused by inflammation of the joint although the main muscles of chewing can also cause the abovementioned joint symptoms.
The pain in the jaw is usually at the back of the jaw, near the ear or around the area of the wisdom teeth. This pain may radiate to the ear, temples of the head or neck. Refer to the image above for areas most affected by TMJ dysfunction. Before diagnosing any jaw pain as TMJ dysfunction, it should be investigated if other possible causes could be the source of pain in this region.
Other causes of jaw pain include a dental abscess, impacted wisdom teeth, mumps, parotiditis, otitis media (infection of the middle ear), otitis externa (infection of the outer ear) or spasm of the facial or neck muscles. It is advisable to seek professional medical help if you are experiencing TMJ pain as can be associated with angina or even a heart attack.
Clicking Jaw Symptoms :
- Pain, tenderness and/or swelling of the jaw
- ‘Clicking’ sound when opening and closing the mouth
- ‘Popping’ or grinding of the TMJ when opening and closing the mouth
- Temporofrontal headaches (headaches of the forehead or temples – refer to image above)
- Aching pain in or around the ear
- ‘Locked jaw’ when opening or closing the mouth
- Visible or palpable (can be felt) erosion of some teeth
- Difficult chewing or discomfort when chewing
- Hearing disturbances (rare)
Causes of Clicking Jaw:
Causes can be broadly divided into those that affect the anatomical structure of the temporomandibular joint itself and those that affect the muscle responsible for movement of the jaw or other facial muscles.
Temporomandubular (Jaw) Joint :
These causes affect the articulating surfaces of the joint, damages the joint cartilage or causes inflammation of the joint.
- Bruxism (constant clenching of teeth) when sleeping (parasomnia) or awake (often due to stress and anxiety)
- Impact or trauma to the face and/or lower jaw area
- Rheumatoid arthritis or osteoarthritis
- Congenital deformity of the facial bones
- Infection resulting from secondary spread from a dental abscess
Muscles of the Skull :
- Lax muscles or ligaments
- Tetanus and other infections that affect muscles
- Paralysis of the facial muscles
Diagnosis of Clicking Jaw:
Diagnosis is usually based on the symptoms reported by the patient. Further examination by a medical professional may reveal pain on palpation (deep physical examination with the hand) of the affected area. A distinct “pop” or slip may be felt at the joint upon opening and closing the mouth. An x-ray can be useful in highlighting any joint swelling, bone degeneration or incorrectly articulating joint surfaces.
Treatment of Clicking Jaw:
- A dental guard (also referred to as a bite or mouth guard) can often reduce the impact of constant clenching (bruxism) which will assist with your clicking jaw. A dental guard will not resolve the symptoms associated with temporomandibular joint inflammation but it will significantly improve the severity of the symptoms that one is experiencing.
- Anti-inflammatory drugs will reduce the swelling and pain associated with temporomandibular joint (TMJ) inflammation but is not a long term option.
- Corticosteroids are effective for a more prolonged reduction of the joint swelling and can be injected into the joint. This will only be of assistance if the causative factors are addressed to prevent further inflammation.
- Restorative orthodontic procedures can be useful if the cause of the clicking jaw is related to a disturbance with bite or other jaw deformities.
- If your clicking jaw is caused by osteo- or rheumatoid arthritis, appropriate treatment is important to treat your arthritis.
Conservative Management :
- Avoid excessive use of the temporomandibular joint caused by chewing gum.
- Chewing on hard foods like nuts can aggravate the condition further.
- Resting the jaw and applying warm compresses may also assist but the condition will recur if tha causative factors are not addressed.
- A bite guard may be useful but has to be used constantly to assist with bruxism.
- Stress is often known to be a major contributing factor to constant clenching of the teeth (bruxism). When stressed, it is a natural tendency to clench the teeth and periods of prolonged clenching can cause TMJ symptoms like a clicking jaw. To assist with your clicking jaw, it is advisable to address stress. Stress management or anti-anxiety drugs can prove to be useful in these instances.
- Certain exercises may be useful in treating muscle disorders that contribute to clicking jaw but should only be implemented with the advice of a medical practitioner. Excessive exercises of the affected area may further aggravate joint inflammation and exacerbate a clicking jaw.
Clicking Jaw Complications :
If left untreated, a clicking jaw can complicate to cause erosion of the joint lining or articulating bones. While this is rare, it should be considered in long term TMJ dysfunction. Consult with your dental practitioner or a maxillofacial specialist if you notice that your symptoms are persisting or aggravating.