Temporomandibular joint dysfunction (TMD, TMJ, TMJD) is a term which describes the dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints.  

TMJ Symptoms:

The most common symptoms that a patient can develop are pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (like pops or clicks) during jaw movement.  Other symptoms that most do not associate with TMD can be tinnitus (ringing of the ears), clogged or congested ears, headaches, neck pain, grinding, clenching, fracturing of teeth or restorations, and neck pain.  It is important to understand that patients may experience one or all symptoms when suffering with TMD.  Temporomandibular joint dysfunction is a complex disorder that is thought to be caused by multiple factors.  Although TMD is not life-threatening, it can definitely effect a person’s quality of life due to the symptoms becoming chronic and difficult to manage. 

SYMPTOMS EXPLAINED:

Jaw Popping and Clicking:

Most patients associate a TMJ problem with noise.  “My jaw pops and clicks.  I know I have a TMJ problem”, is what most patients say to me.  In order to understand why you jaw pops and clicks, you must first understand what a “normal joint” looks like.

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Definition from Wikipedia: “The TMJ is a bilateral synovial articulation between the mandible and temporal bone.  The name of the joint is derived from the two bones which form the joint: the upper temporal bone which is part of the cranium (skull), and the lower jawbone or mandible.”

The TMJ has a disc between the condyle of the mandible and the cranium called the articular disc.  Defined by Wikipedia: “The disc is composed of fibrocartilaginous tissue that is postioned between the two bones that form the joint.  The TMJs are one of the few synovial joints in the human body with an articular disc…”

It is very important to understand that you can still have a temporomandibular disorder without sound (no popping and clicking)

Now, l will try and answer your question: “Why is my jaw popping and clicking?”

  1. TMJ Disc Displacement with Reduction

TMJ Disc Displacement with Reduction

 

Definition:           Displacement of the TMJ articular disc when a persons back teeth are closed together and reduction (mandibular condyle back underneath the disc) of the disc on mouth opening.

Signs and Symptoms

1)      May click on mouth opening

2)      May click on mouth closing

3)      May or may not have pain

 

  1. TMJ Disc Displacement with Reduction with Intermittent Locking
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Definition:           Displacement of the TMJ articular disc when in centric occlusion and reduction of the disc on the mouth opening with intermittent inability to reduce the disc.

Signs and Symptoms

1)      May click on mouth opening

2)      May click on mouth closing

3)      May or may not have pain

4)      Intermittent inability to open mouth normally

5)      Intermittent deflection of mandible to affected side (lower jaw shifts to one side when opening…it does not open and close straight)

 

  1. TMJ Disc Displacement without Reduction – ACUTE

 

without reduction

Definition:           Displacement of the TMJ articular disc when in centric occlusion and in all movements of the mandible with restricted range of motion and deflection of the mandible to the effected side.

Signs and Symptoms:

1)      May click on mouth opening

2)      May click on mouth closing

3)      May or may not have pain

4)      May have reduced range of motion (how much your lower jaw can open and move side to side and forward)

5)      May have mandibular midline deflection (lower jaw moves to side that is injured when opened) to affected side

6)      May have crepitus (crunchy/scratchy sounds when opening and closing)

 

 

  1. TMJ Disc Displacement without Reduction – CHRONIC

 

chronic

Definition:           Displacement of the TMJ articular disc when in centric occlusion (back teeth touching and together when closed) and in all movements of the mandible with or without restricted range of motion and deflection of the mandible to the affected side.

Signs and Symptoms:

1)      May click on mouth opening

2)      May click on mouth closing

3)      May or may not have pain

4)      May have reduced range of motion

5)      May have mandibular midline deflection to the affected side

6)      May have crepitus

Ringing in the Ears:

Many patients who have TMJ pain also have ringing or congestion in their ears.  It is important to know that you may be experiencing ringing/congestion in the ears without TMJ pain too.  Why is this?  And how is it related to your joint?

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Normal TMJ Position

Notice the hole behind the joint in the picture.  This is your ear canal.  When your joint is in it’s proper anatomical position, it is not pressed up against your ear canal.  Therefore, you do not hear ringing in the ears or feel like you have congestion or an ear infection that your medical doctor keeps telling you that you do not have.

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Compressed Joint

When you are experiencing Temporomandibular Joint Disorder, your joint can be compressed against the fossa upon which it exists.  This compression pushes on your ear canal which can cause symptoms such as ringing in the ears, congestion, or ear pain.

By decompressing your joint, you will be able to decrease the pressure on your ear canal.  Therefore eliminating, or significantly reducing, the ringing in the ear, congestion, or pain.