Temperomandibular Joint ( TMJ ) is nothing but the joint where your lower jaw articulates with the skull. It is highly secured with strong masticatory muscles and its function pertains to mandibular movements. Although its location is in a secure environment, sometimes you might have heard the clicking sound while opening or closing the mouth, at one end or sometimes, at both the sides of the joint. You might have wondered what it could be! Well, here comes the most possible reasons for joint sound.
Reasons for clicking sound in the TMJ :
Wisdom tooth eruption :
The first and foremost reason could be the eruption of the last molar tooth. In general, this tooth will try to erupt between the age of 19-25 years. It could be upper or lower molar, in any case, and in most instance, it becomes difficult for the tooth to emerge out of the socket due to space constraint inside the jaw. As our jaw size has became reduced when compared to our ancestors’ due to the change in our food habits, it is common for the last molar tooth to get impacted inside the bone. Or sometimes, even with adequate space, thick coverage of muscles and bones would cause this eruption painful. In both of the condition, clicking sound in the joint is more likely to hear along with or without pain, swelling and jaw deviation.
Not necessarily this has to occur at early adulthood. If the tooth gets partially impacted and left unheard, it is possible to have joint pain and click sound now and then even at your thirties or forties. As the location of this tooth is pretty close to the joint, it tends to affect the jaw movement and kept on gives you trouble.
If your dentist says this could be the reason for your click sound, then it is better to go for wisdom tooth removal with minor surgical procedure. By following proper instruction after tooth removal for a week or so, your clicking sound and other joint discomforts would vanish. If you fail to follow the instructions as per your dentist after tooth removal, it might cause a dry socket and might require further interventions.
Bruxism or teeth grinding is another reason for the joint’s click sound. It could be habitual, functional or psychological. Most often, you by yourself don’t know that you are clenching your teeth and this even occur while sleeping. Stress can also impact your cognitive skills and amplify mental illness. Mental relaxation plays a pivotal role in curing bruxism. However, in severe cases, where it is accompanied by jaw deviation and terrible pain, you might require dental management like night guards.
Malalignment of teeth :
Teeth have to be in proper occlusion for the error-free condition. If you have too much of crowding or rotation or narrowed arch form in your skeletal structure, you may not have an ideal bite line. In this case, any excess force would directly fall on TMJ, making it weak and cause click sound. Orthodontic treatment with braces would be the best solution to rectify this condition.
Disc dislocation and derangement :
The weakening of muscles around TMJ would cause slipping of the joint while articulation. The constant wide opening of the jaw is another reason for disc displacement. In these conditions, the clicking sound is heard while opening and closing the mandible.
According to the severity, treatment modalities vary.
For milder dislocation,
- It is advised to stick on a soft diet and not to use heavy chewing items like chewing gums or chocolates
- Avoid wide opening of the mouth
- Warm compression for about a week or two
- Not to clench or brux
- Mild massage over the jaw muscular region now and then
For frequent dislocation,
Your physician would generally guide you for a minor surgical procedure, to hold the joint in a position.
Trauma and ankylosis :
Any hit in the mandibular region would cause disc displacement and its respective fracture could produce click sound. If the trauma had occurred at your young age, say around pre-school or school life, then there are more chances for the obliteration of the joint on the affected side. This is more likely to cause click sound on the opposite side along with jaw deviation while opening the mouth.
As a treatment, your doctor will either opt for an injection on the joint to release the fibrous connection or would prefer for surgical separation. In either way, treatment is purely based on the type of ankylosis you have and its level of fusion.
Rheumatoid arthritis (RA) :
As said by Dr Hugh Duckworth, MD, unlike osteoarthritis which affects joints according to its overuse, RA is an autoimmune disease and affects healthy joints, particularly TMJ. Joint pain and inflammation are invariable. In RA, thinning of TMJ with peculiar radiographic appearance called pencil-like appearance is seen. Click sound does occur and when this thinning process becomes extreme, it will lead to fracture.
It is highly recommended to consult a Rheumatologist. As it not only affects your joints and weaken them but also have indirect connections to other organs like a heart valve, blood vessels, etc.
Ear infection :
TMJ has a close link with the inner portion of the ear. Any infection in the ear region is refer to the joint, along with pain, swelling, and click sound. You can even hear the click sound while swallowing. Sometimes it can also cause restricted mouth opening.
Salivary gland infection :
Salivary glands particularly parotid gland is anatomically close to TMJ. Any disturbances in the gland, for instance, infection or inflammation or tumour, and the pain associated with it would likely to radiate to the TMJ and restrict its movements. When something disturbs the TMJ movement, it causes click sound.
Denture and restoration high-points :
While fabricating the denture, it is crucial to give utmost importance to the occlusion or bite-line. The same applies while filling a tooth as well. When the bite force is not evenly distributed, as, like the natural teeth, the entire force perhaps impact the TMJ and causes click sound.
If you had recently undergone dental filling or have placed crown or denture, and feeling click sound in a month or so, then you need to check with your dentist about any bite changes and rectify it ASAP.
Myofascial pain dysfunction syndrome :
This happens when any of the TMJ muscle contract and elicit pain now and then. It could be of various reasons; however, the repeated contraction of the muscle would pull TMJ and gives pain, discomfort and click sound in that region. TMJ muscle exercise, trigger point injection and medication are some of the treatment options.
To sum up,
Popping sound in the TMJ is of multiple reasons, and you need to carefully examine the cause to bring the best solution.