Why is my Jaw clicking? How can I stop it?
With so many questions on this interesting joint, I’ve decided to answer common questions to help figure out what is normal, what is abnormal, what is meant by clenching and grinding, and when you shoulder get your jaw assessed! In medical terms, we use Temporomandibular Joint (TMJ) to describe the jaw. Physiotherapists work alongside dentists, Orofacial specialists and other health care providers to treat issues that arise, which are termed Temporomandibular Disorders (TMD). TMJs are extremely common (2 per person), whereas the disorder of these joints is much less common.
TMD is defined the presence of 2 of the following;
- Pain or discomfort in the jaw.
- Pain in muscles involved in mastication (chewing).
- Limitation of function (Including eating, talking, yawning etc.).
- Joint sounds. (Such as clicking, popping or clunking).
This means, a clicky jaw on its own technically isn’t a disorder, however if it associated with any other symptoms, it is.
There are other symptoms we as Physiotherapists monitor for TMD, including;
- Pain in not just the jaw, but also neck, face or headaches.
- Impaired movement, including locking (Lockjaw), restricted movement or instability.
- Ear symptoms (fullness in the ear, difficulty hearing).
- Other symptoms which are especially important for your dentist to monitor, are; Changes in the fit of the upper and lower jaw. Erosion of the teeth (possibly due to clenching and grinding).
What is clenching, what is grinding, and what’s the difference?
Clenching refers to the teeth compressing together, and grinding refers to this occurring during sleep. At rest, our natural head posture should be with the tongue on roof of mouth, breathing through the nose without the upper and lower teeth touching. Clenching refers to the teeth compressing together, and grinding refers to this occurring at night during sleep. Both are often involuntary. Postural deviations, stress, anxiety, medication usage and other factors can lead to the teeth compressing together. If this occurs during the day, being aware and consciously avoiding this position can help address this issue. If this occurs at night, you and your Physiotherapist may be able to work out strategies to implement to avoid this.
Your dentist may also recommend a special made splint to protect your teeth from further damage.
When should I seek treatment for TMD?
TMD can be a debilitating condition, and if you notice a crack, click or pop, this may not be immediate cause for concern. However, it can be worthwhile having this assessed. If these sounds are accompanied by, or you notice a combination of the other symptoms as mentioned before (pain in the face, jaw, issues eating, talking, yawning), it is recommended that you have your TMJ assessed by a healthcare professional.
Regular dental check-ups are recommended, and your dentist should check your TMJ function and teeth. If you are having the above symptoms of TMD, it is important to have a proper assessment and treatment plan to address the cause, with the goal of correcting function, reducing symptoms and preventing further damage.
South Perth Physiotherapist have 3 Physiotherapists (Suh, Karolina and myself) with an interest in treating TMD, which can involve;
- Manual therapy treatments including mobilization, massage and dry needling of the joints and muscles of the neck and jaw.
- Exercise rehabilitation including postural retraining, strengthening, or relaxation of particular muscles.
- Education regarding accurate diagnosis, prognosis (time expected to get better) and self-management advice, including things to be aware of, things to avoid, and treatments to perform at home.
If necessary, referral to specialists for splints, and other treatments such as injections may be warranted if Physiotherapy is not achieving the desired outcome. It is important to monitor symptoms, and have a tailored treatment approach to your individualised care!
Blog by Ashley Flynn, Physiotherapist at South Perth Physiotherapy.
