Movement of the joint is known as articulation and is usually a silent process. However, sometimes there may be abnormal sounds and sensations emanating from a joint during movement. One of the common such occurrences involves the jaw joint known as the temporomandibular joint or TMJ for short. This is the joint between the lower jawbone (mandible) and skull (temporal port) where articulation between the two bones occur.
Clicking of the jaw joint is a fairly common occurrence and sometimes becomes a chronic problem. Sometimes there may be resistance with a sudden pop during jaw movement. Clicking and popping are symptoms of some underlying problem of the jaw joint referred to as temporomandibular joint dysfunction.
How does the jaw click or pop?
Reasons for Audible TMJ Dysfunction
Most joint have only one type of orientation and action like the ball-and-socket joint of the hip. However, the TMJ has two actions – it is both a hinge joint and a sliding joint. It also can move in several planes whereby the jaw can move up and down to close and open the mouth, or side to side to assist with chewing.
It is also a unique joint due to the presence of an articular disc which lies between the two ends of the bone that form the joint. The tissues that make up the TMJ is also different from other joints that have to bear a lot of force and coupled with the complex movements, it is prone to several problems.
Not all TMJ dysfunction will give rise to sounds – sometimes there may be stiffness of movement, swelling and pain with no sound. When abnormal jaw sounds are present as a symptom, it is usually sounds like a click or a pop. The problem may lie in the joint tissue, the muscles that move the bones at the joint or other disturbances that causes the movement at the jaw joint to be abnormal.
In most of these instances, there is force or resistance at the joint with movement of the jaw and this can be audible in the form of a clicking or popping sensation, amongst other symptoms. However, cracking in a joint is not unique to the jaw joint. It can happen with many other joints, like a clicking neck, yet there is no underlying problem. It is believed to be due to popping of gas bubble is the joint fluid when there is stress place on the jaw. This is known as a cavitation.
What is there clicking or popping of the jaw?
Causes of a Clicking Jaw or Popping Jaw
We may all experience TMJ symptoms if we strain the joint by trying to bite into a very had object with all the force we can muster, chewing on hard foods, chewing for too long or trying to open the mount wider that it normally would. Sometimes this may cause the odd episode of jaw clicking or popping, usually with pain and tenderness at the joint. However, people who experience persistent clicking or popping of the joint usually have some underlying pathology – either of the TMJ itself or the muscles of the jaw.
- Bruxism is a condition where there is persistent clenching of the jaw and often grinding of the teeth. It strains the muscles that move the jaw, the TMJ and even the teeth which are constantly pressing together and wearing down.
- Dislocation of the joint is where the two articulating surfaces of the TMJ slip out of its normal position. It may occur frequently and then slip back into place but a major dislocation can jam the jaw joint until there is medical attention.
- Displacement of the articular disc can also occur with certain types of TMJ dysfunction. Similar with a dislocation, the disc may return to its normal position and then slip again with movement.
- Arthritis of the TMJ may be of two types – osteoarthritis (OA) or rheumatoid arthritis (RA). These are chronic conditions where the cartilage and bone degenerates (OA) or the joint linings become inflamed (RA). Sometimes injury to the joint may cause short lived arthritis (traumatic).
- Injury to the mouth, especially to the joint bones, can also cause a clicking or popping sound but it is usually short lived. Symptoms resolves once the inflammation associated with the injury eases provided that it does not lead to a chronic condition mentioned above.
- Muscle spasm or tightness may restrict jaw movement and when the jaw is forced, it can lead to strain on the joint which may result in dislocation of the joint or displacement of the disc.
- Myofasical pain is a condition where there is pain in the muscle and surrounding tissue associated with overuse, injury or stress. The pain may cause abnormal movements which can strain the TMJ.
What are the other symptoms of a clicking joint?
Associated TMJ Dysfunction Symptoms
A clicking jaw or popping jaw is a symptom of some underlying condition, usually involving the temporomandibular joint (TMJ). These sounds are not a disease on its own. Sometimes a clicking or popping may be associated with other symptoms, depending on the underlying cause.
- Jaw pain felt just underneath the ear. It is possible to have associated ear pain.
- Facial pain usually in the cheeks with associated tenderness of the masseter muscle.
- Headaches typically felt at the sides (temples).
- Grating sensation when moving the jaw.
- Difficulty opening the mouth fully which hampers eating, chewing and sometimes even talking.
- Lock jaw due to restriction of movement at the TMJ.
- Enlargement of the face often on one side only. When present on the cheeks it is usually due to enlargement of the masseter muscle (hypertrophy) but when isolated close to the joint it may be tissue swelling or even an abscess.
- Abnormal salivation – excess or deficiency. This occurs with conditions that involve the large salivary gland known as the parotid gland. There may also be swelling of the gland.
How is a clicking jaw or popping jaw treated?
Treatment for Clicking Jaw
The treatment for clicking or popping of the jaw depends on the causative condition.
- Anti-inflammatory drugs are helpful in reducing inflammation associated with jaw trauma and TMJ arthritis.
- Analgesics (painkillers) help with pain management.
- Anti-anxiety drugs can be helpful in people who clench and grind their teeth.
- Bite guards are useful for clenching, particularly at night during sleep.
- Botox injections can ease muscle stiffness and spasm if it is restricting joint movement.
- Surgery known as occlusal adjustment is sometimes needed to realign the distortion in the way the teeth sits.
Reducing joint strain is helpful in most cases irrespective of the cause. Avoid strain with gum and tobacco chewing. Try not to the open the mouth too wide or leave the jaw hanging. These are simple measures that can reduce joint stress but the underlying problem must still be diagnosed and treated.