My jaw clicks, should I be concerned? TMJ Physiotherapy

Have you ever noticed your jaw “clicks” when you open your mouth or chew your food?  You’re not alone! Although it can be quite disconcerting, jaw “clicking” is actually quite common and most of the time if it doesn’t cause you discomfort or pain, then it’s not something you need to worry about.  There can be many reasons your jaw “clicks”.

For a better understanding, its worth looking at the anatomy of the jaw and the structures that can contribute. 

Your jaw, otherwise known as your Temperomandibular Joint, is the articulation between the condyle of the mandible (jaw) and the mandibular fossa of the temporal bone (skull).  In between these two surfaces lies a cartilaginous disc, which acts as a cushion between the jaw and facilitates smooth movement when you open and close your mouth, chew and talk.  The lateral pterygoid muscle attaches at the front of the disc and at the back of the disc is the retrodiscal tissue, a highly vascular and innervated tissue.

So what causes the “click”?

We’ll look at one of the most common causes in more detail…….

Disc displacement with reduction

Normally as you open your jaw the lower condyle of the jaw rotates and then slides forward.  The lateral pterygoid muscle simultaneously pulls the disc forward so that it sits between the 2 bones and reduces any friction.  On closing the mouth this muscle relaxes and the disc is pulled back by the elastic tissue. 

If the lateral pterygoid muscle becomes tight or shortened, due to excessive clenching, grinding or prolonged opening of the mouth, such as with lengthy dental procedures, the disc now sits anterior to the joint at rest.  When the mandible slides forwards the disc relocates backwards to sit between the 2 bones, creating that “clicking” sound you hear.  As you close your mouth the disc returns to its anterior position in relation to the joint.   The jaw will normally deviate to the affected side.

This becomes a problem if the click is occurring more frequently or is associated with pain. 

The retrodiscal tissue may become elongated and have a reduced ability to pull the disc backwards.  The disc doesn’t reduce it can cause limited opening (closed lock) and the retrodiscal tissue becomes inflamed as it sits between the 2 bones, causing severe pain. 

So what can you do at home to help?

Gentle massage- massage around the temples, facial and neck muscles can help to relax tension in the muscles.

Heat- a warm hot-pack placed on the side of the face for 10 minutes at a time, every couple of hours can also help with relaxation of the jaw.

Jaw positioning-keeping the teeth slightly open, lips together, tongue on roof of mouth and breathing through the nose is the relaxed position of the jaw.  At rest try and adopt this position as much as possible to stop you clenching. 

Posture- Forward head posture can alter the biomechanics of the jaw, pulling the mandible backwards in relation to the skull and irritating the retrodiscal tissue.  If you tuck your chin and grow long through the back of the neck, this will improve your posture.

Avoid chewy foods- Eating a soft diet, for a short period, if the clicking is causing you pain, may be helpful in reducing irritation around the jaw. 

How can physio help?   

Physiotherapists can utilise techniques including massage, trigger pointing (including intra-oral myofascial techniques), dry needling and joint mobilisations of the upper cervical and jaw joint to treat muscle spasm associated with clenching and grinding. 

They can give advice about stress management and help with strengthening exercises of the neck, scapular and shoulder muscles to improve your posture.