docWhy Is My Jaw Locking and Catching?
Do your jaws pop or click when you open or close your mouth? Or maybe you’ve noticed that it clicks sometimes and other times it doesn’t pop at all. Is it a bad sign when you pop your jaw joints or when the joints lock up? These are some of the questions we’ll be answering. But before we get to that we need to understand the joints and what makes them unique.
The Jaw Joint – TMJ
The jaw joints are located immediately in front of our ear canals. And just like we have two ears, we have two jaw joints. The medical term for the jaw joint is the Temporo-Mandibular Joint, or TMJ for short. This joint has 3 components: 2 bony neighbors and a soft disc (made of cartilage) in the middle. And the TMJ is involved in all forms of jaw movement like opening or closing our mouths. Some examples include chewing food, swallowing, and yawning. But the TMJ is unlike any other joint in the human body.
What sets this joint apart from other joints in our body (i.e. fingers, wrists, knees, etc.) is that the jaw joints are more than a “hinging” joint. They are also a “moving” joint. This means that the joint can slide alongside the neighboring bone. And it is because of this sliding movement that we can open our mouths wide.
The disc component of the TMJ is made up of cartilage. And it is what keeps the joints operating smoothly. It also acts as a cushion to prevent bone-to-bone contact. Even though the TMJ is very unique in its functions, it behaves like other joints in the body. It can suffer in a number of ways including being dislocated. Let’s look at some of the ways that TMJ develops.
What Causes TMJ Problems
There are a number of ways that our jaw joints can get injured. And sometimes, it’s a combination of events that overcomes a healthy jaw joint. Although it can affect anyone, women tend to have more problems with their TMJ compared to men. Genetics also seem to play a role in this disease. It is not uncommon to see the same TMJ problem in the patient’s parents or siblings.
TMJ Caused by Medical Problems
Certain diseases affect the bone and the cartilage in the jaw joint like osteoarthritis. This disease can affect any joint in the body however the hips, hands, and knees are the most common victims. Another disease that can damage the jaw joints is rheumatoid arthritis. This is an auto-immune disease meaning the body’s immune system starts attacking parts of the body. This disease can cause inflammation of the joint and it can also affect other body parts (i.e. skin, eyes, etc.) This inflammatory disease eventually leads to the destruction of the bone and the cartilage in the joint.
Fibromyalgia, which is widespread musculoskeletal pain, can also cause TMJ. Another disease that can lead to painful joints is Gout. However, gout mostly affects the big toe.
Although not very common, tumors can invade the jaw joints causing pain and TMJ symptoms.
TMJ Caused by Injury or Trauma
The TMJs can be impacted by physical trauma and injury. Auto accidents, sporting accidents, slips and falls, physical altercations, or any event that places a sudden force on the head and neck area can cause TMJ problems. In these cases, the pain and discomfort typically start off right away. However, sometimes the patient notices the problems only after a while.
Some of these patients may already have problems associated with their TMJ, and the trauma is enough to put them over the edge. In other cases, there may be no joint issues preceding the accident, but the accident is enough to overcome a healthy joint structure.
TMJ Caused by the Dentition
Another source of TMJ pain is the teeth. More specifically the alignment of the teeth is very important. When the teeth are in the right place they support a “healthy” jaw position. Therefore, the jaw joint is in a healthy position when the teeth come together. When teeth are out of alignment they may not provide a healthy and stable position for the jaw joints. This condition over time can lead to the development of jaw clicking or locking.
Other than alignment issues, a tooth of incorrect proportions and size can cause TMJ problems. A crown that is of the wrong dimensions (e.g. too big or small) or a filling that is not contoured properly, can cause the jaw joints to develop issues as well. A “high bite” after a filling or crown should be adjusted as soon as possible.
TMJ Caused by Excessive Loads
TMJ symptoms like clicking and locking can also stem from excessive and prolonged force loads on the teeth. Some people like to chew gum all the time. This places a great load and a lot of wear and tear on the jaw joints, especially in people who really chew their gum. Nail-biting is another example of how excessive loads can develop. Some people clench or grind (or both) their teeth. This by far is the most common culprit when it comes to developing jaw issues like jaw pain, popping, and locking. Some patients do this while awake and some while sleeping, and others all day long.
TMJ Caused by Oral Surgery
Some patients with locking and clicking joints attribute the symptoms to having their wisdom teeth removed. And while oral surgery may contribute to the development of acute TMJ, these symptoms are usually self-limiting and often go away on their own. However, some patients have TMJ already, but the symptoms are so mild that they are not aware of it. After the surgery, since their jaw joint was overworked and pushed to its limits, symptoms become noticeable to the patient. So in the patient’s mind, it was the surgery that caused the problem. While in reality, the surgery was simply “the last straw that broke the camel’s back.”
TMJ Caused by Orthodontics
Sometimes orthodontic treatment (e.g. braces, Invisalign) is viewed as the culprit of jaw clicking and locking amongst other symptoms. For most people, orthodontic therapy will not affect their TMJ in one way or another. However, someone with an undiagnosed TMJ condition may develop symptoms during orthodontic treatment. Also, some orthodontic treatments place a greater load on the joints than others. Furthermore, braces are an ongoing therapy. The patient may have had other changes over time that place them at a higher incidence of TMJ.
TMJ Caused by Missing Teeth
When we lose teeth, our chewing ability is affected. To a certain extent, our “chewing” is compromised as a result of a missing tooth or multiple teeth. The lost teeth cause the jaw joint to function differently. This can lead to the development of locking and clicking jaws as the jawbone and the disc in the jaw joints start changing shape.
TMJ Caused by Snoring or Sleep Apnea
Some patients snore and some patients suffer from sleep apnea. These problems relate to the patient’s breathing while they sleep. In an effort to get better sleep, some of these patients develop strange habits unconsciously which can lead to the development of TMJ symptoms.
TMJ Caused by Stress – Indirectly
People deal with stress in different ways. In most people, stress leads to the tenseness of the muscles in the head and neck. These same patients can be clenching or squeezing their teeth together without realizing it. These patients develop TMJ indirectly because of their stress levels. Stress drives them to clench more, which leads to the development of excessive forces.
Clicking Jaw Joints
So why do joints click and make noises? The clicking sound occurs when the disc slides on or off its normal position. This may be hard to visualize. So, let’s talk about the popping jaw joints by making an analogy to 3 people sitting next to each other. If the 3 people sit right next to each other with no room to wiggle, it makes for a tight fit. Now imagine the 2 people on the end starting to lean in towards the center. This will make the space much tighter for the middle person. At some point, the middle guy here is going to get up out of the seat. You can imagine the popping sound occurring as the middle person gets up. Now imagine the 2 people leaning away opening up more space. So, as the middle guy sits back down there will be another “popping” sound. The same thing happens with the jaw joints. The 2 bones (lower jaw bone and the base of the skull) are the two people sitting on either side with the disc being the middle guy. When the lower and upper jaw bones get too close together, that’s when the disc will “pop” off. And vice versa, when they get far enough from each other the disc will “pop” back on. So now that we know the reason behind the jaws clicking, let’s see how that can cause a problem.
Clicking Jaw Joints – Is It Unhealthy?
Does it matter if your jaw joints pop? And the answer is “It depends”. In some cases, this popping is not very frequent and for the most part harmless. But in other cases, the popping indicates further problems causing irreversible damage. A TMJ dentist can properly evaluate the case to determine the cause and the best course of action. Popping jaw joints occur for a variety of reasons.
Overall though, popping jaw joints pose several problems. One is the disc dislocating permanently. What happens over time is that the disc becomes more and more used to being dislocated. As a result, it will start changing shape and adapting to its new location. This in turn causes a major reduction in the range of motion. You know this is happening when you no longer hear popping sounds but you cannot open as wide. Another problem that occurs is the joints locking and preventing free movement. It feels like the jaw is stuck and cannot be moved. And these are only some of the problems that are caused by clicking jaw joints. Follow this link to learn more about TMJ disorders.
Treatment for Jaw Clicking, Locking, and Pain
To properly treat TMJ we need to find the root cause of the problem. Another factor that will impact the outcome is whether the TMJ symptoms are acute or chronic. Acute cases are easier to treat with more stable outcomes. Chronic cases are harder and more time-consuming due to the extent of the damage.
Treatment for Acute vs Chronic Jaw Clicking
Acute TMJ symptoms like jaw clicking and popping in an otherwise healthy TMJ can be treated with over-the-counter pain meds, cold packs, a soft diet, limiting the range of motion, massage, and relaxation exercises. Acute TMJ symptoms are usually due to some form of trauma. Having a long dental appointment, chewing gums at a basketball game, or trying to bite through a hard candy are all examples of how a patient gets acute TMJ.
Untreated TMJ symptoms over time lead to the development of chronic TMJ symptoms. These types of problems require the help of a dental professional who specializes in these types of disorders. Some patients need dental appliances to keep their jaws in a healthy position during the day. Others require a mouthguard for nighttime use to prevent damage while the patient sleeps. Some patients need treatment aimed at reducing an inflamed joint or muscles that are out of control. Some patients can benefit from behavior modification exercises.
Treatment – What Not to Do
Some patients learn that they can control their symptoms by using medications. These medications can range from over-the-counter to prescribed medications. And while these may be helpful for the short term, long-term uses lead to a host of other problems. And that is because the medications don’t treat the problem, but rather mask the symptoms. And let’s not forget that all medications have unwanted side effects.
Oftentimes patients are told that they have TMJ and they need a mouthguard. In an effort to save on the cost of treatment, the patient buys a mouthguard from a sporting store. It’s important to realize that mouthguards have different designs to treat different problems. A mouthguard made for use during sports is different than a mouthguard for treating TMJ. Similarly, your dentist can make you a mouthguard, but those are used to protect the teeth and not the joints. These kinds of treatments will lead to a worsening of the symptoms and further problems. So if you have a “mouthguard” and your symptoms are persisting or getting worse, chances are the mouthguard is not the correct one for your problems.
More about TMJ therapy in San Marcos, California
If you have TMJ symptoms you can find out what can be done to help treat your conditions by setting up an in-person consultation with Dr. Eslampour. Our doctor has over 15 years of experience in treating TMJ disorders. Contact us now to schedule your consultation.