Jaw Popping and Clicking (TMJ): Causes, Symptoms, Risk Factors Treatment and Prevention 

Jaw popping and clicking happen quite often. Temporomandibular joint (TMJ) disorders are very common and their causes are often multifactorial.

Jaw

Jaw. Image Courtesy of Jmarchn

What is TMJ?

The jaw is made up of two bones: the maxillary bone and the mandibular bone. The lower jaw is connected to the skull bone (jaw bone) at the top by the temporomandibular joint (TMJ). This joint is located on both sides of the face, just in front of the ear, and has a fibrocartilaginous articular plate that prevents friction between the mandible and the skull bone during various jaw movements (swallowing, chewing, speaking, yawning). When the mouth is open, the condyle rotates towards itself and moves forwards; the articular disc follows this movement and moves forwards. Around this joint, the jaw moves in three dimensions thanks to different muscles: forwards and backward, left and right, and up and down.

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Symptoms

The clicking of the jaw is the sound of the joint. When the mouth closes, the disc is no longer between the jaw and the skull; when the mouth opens again, the disc returns to its place between the condyle and the skull. The jaw popping corresponds exactly to the condyle passing under the articular disc.

The jaw pops, clicks or squeaks when you open your mouth. It may be just a sound, but it can also be a sensation of “movement” of part of the jaw.

This phenomenon can occur sporadically, without pain or discomfort, or regularly. It may also be accompanied by other symptoms: pain in the front of the ear, difficulty opening the jaw wide, headache, various ear symptoms, etc.

Risk factors

Stress can consciously or unconsciously cause hyper contraction of the jaw muscles, which puts a lot of stress on the joint and can cause it to tear.

Temporomandibular joint disorders are more common in young women, mainly due to hyperlaxity (too loose ligaments).

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Causes of jaw clicking and popping

Bruxism

Bruxism (teeth grinding), i.e. sideways rotation of the teeth (eccentric bruxism) or clenching of the teeth (centric bruxism), can cause jaw cracking due to hyperextension of the joint.

Dental defects

Misaligned teeth or missing teeth prevent the correct positioning of the upper and lower jaw and therefore the optimal functioning of the joint.

Trauma

Trauma or fracture to the face, especially the jaw, can cause damage to the temporomandibular joint, which can lead to jaw fracture.

Anatomical abnormalities of the jaw

The mandible may be too far back (retrognathia), too far forward (prognathia), or deviated to one side (laterognathia).

Postural disorders

Some experts believe that jaw disorders are often caused by postural imbalances. The jaw joint can act as a pendulum to compensate for incorrect posture and ensure head stability.

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Risk of complications

Regular jaw popping can cause temporomandibular joint disorder (TMJ). Due to dysfunction between the cranial bone and the mandibular bone, TMJ presents with a number of symptoms: pain in the joint when opening and closing the mouth, reduced jaw mobility, headaches, jaw clicking, or even locking. ENT problems are not uncommon: cramping, tinnitus, chronic sinusitis, etc. It can also have distant consequences: back, neck, hip, knee pain, etc.

In the long term, there is a risk that the jaw may become blocked, making it impossible to take food in.

Treatment and prevention

For isolated and painless popping and clicking treatment of temporomandibular joint inflammation is not necessary.
If jaw clicking is frequent, causes discomfort, or even interferes with daily life, and is associated with other disorders, treatment is necessary. Depending on the associated symptoms and the severity of the syndrome, treatment may be based on:

  • Dental treatment (e.g. dentures or implants if teeth are missing)
  • Orthodontic treatment if there is malocclusion or bruxism (wearing a mouthpiece, especially at night)
  • Jaw physiotherapy to learn how to relax the jaw muscles and swallow
  • Orthognathic surgery for jaw malposition
  • Correction of postural dysfunctions.

Manual techniques such as osteopathy can also help not only to remove certain obstacles but also to restore the body’s overall balance through intra- or extra-oral manipulation.

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As stress is often the cause of jaw clicking, it is important to learn how to manage it better. Several methods can be used for this purpose: mindfulness meditation, yoga, acupuncture, phytotherapy, cognitive behavioral therapy, etc.
Prevention is based on stress management and regular dental care.

References

https://www.nidcr.nih.gov/sites/default/files/2017-12/tmj-disorders.pdf

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