Like most joints, things pop, click, grind, and tell us we’re still alive! The jaw joint or TMJ (Temporomandibular Joint) is no different. It may start to make noises or feel differently when opening your mouth. But what are those noises? And when are they bad?
In a normal joint, there is an articular disc that lies between the condyle of the mandible (jaw bone) and the temporal bone (skull). This disc acts as a cushion so the bones can hinge smoothly and painlessly upon jaw movement. It’s quite brilliant, actually.
Jaw popping most likely happens when the articular disc has shifted from its normal position. The most common form of disc displacement is anterior (towards the front of the joint). Keep in mind that medial, lateral and posterior displacements are still possible.
Disc displacement results from abnormal jaw mechanics, trauma, and sustained or excessive joint loading. Anterior displacement causes laxity to the disc’s posterior attachment allowing the disc to move further forward from where it should normally sit. Still following me?
When the disc is stuck in a forward position, it no longer sits between the condyle and the skull. Therefore, when mouth opening is initiated, the condyle will move onto the disc and this is when a pop is heard and felt. Another pop may or may not be heard upon closing when the condyle rolls back off the disc. Popping may or may not be painful, but it is ALWAYS heard by the person.
If you have a popping or clicking jaw that isn’t painful and doesn't keep you from opening your mouth all the way while chewing and talking, then don't fear! Besides the annoyance, people live long and happy lives with a popping jaw. Although, it’s important to seek treatment if you notice that the jaw clicking or popping is new, painful, or limiting your ability to eat or talk. Without treatment, a displaced disc may get worse and cause jaw locking upon opening the mouth, or it may limit your ability to open the mouth all the way.
Disc displacement is the most obvious of noises. However, there are other types of noises that mean different things. For example, a grinding sound coming from the joint is an indication of degenerative joint disease or osteoarthritis. A quieter “click” that accompanies lots of pain with jaw movements is an indication of joint inflammation. A click at the very end of maximum mouth opening or the very beginning of mouth closing is an indication that the joint is moving too much, and that a subluxation (or worse, a dislocation where the jaw locks open) may be in your future.
No matter what sound the jaw is making, the same rule applies. If you’re experiencing pain and/or there is limitation in jaw function or range of motion, then it’s important to see a physical therapist trained in TMJ disorders. If the jaw is making noises but it’s not giving you pain, changing, or limiting you from doing anything, then the jaw is fine and life will go on.
To learn more about TMJ disorders, check out my previous blog entitled My Jaw Hurts. Where Does This Pain Actually Come From.
ABOUT THE AUTHOR:
Tia Totura is a Doctor of Physical Therapy (DPT) who specializes in swimming injuries and TMJ disorders. She works at Activcore in Denver, Colorado, located just one mile from the popular Cherry Creek Shopping District.
As a former Division I swimmer and captain of the Women's Swimming and Diving Team at the University of Denver, Tia has a special interest in treating swimmers and other overhead athletes. She holds a Bachelors degree in Natural Sciences from the University of Denver, graduating with distinction on the honor roll and Dean's list. She holds a Doctorate degree in Physical Therapy from Pacific University, ranked among the top 50 PT schools in the country. She also has advanced post-graduate training in sports rehabilitation with a focus on swimming, as well as specialized training in the evaluation and treatment of TMJ disorders (TMJD) like jaw pain, neck tightness and headaches. [READ MORE]