Why does my Jaw Joint Click and Pop?

The temporomandibular joint (TMJ) is located directly in front of the ear. It is composed of a ball and socket separated by a cushion about the size of a nickel made of cartilage. It is somewhat unique in the body in that it has two separate types of motion. It has a simple rotation similar to the knee or hip, but also a translation (movement forward and backward.)

This is possible because the cushion moves within the joint along with the ball portion as it moves forward and backward. One can observe this type of motion in the mirror as you jut your jaw forward.  It is the combination of rotation and translation of the jaw that allows one to chew food.

In a healthy TMJ (TMJ is the name of the joint, not the disease. TMD, Temporomandibular Joint Disorder, is the proper name for the disease,) the cushion is supposed to have a slight and silent forward and backward motion as the lower jaw opens to its full extent and then closes. But in a diseased, inflamed TMJ, the tendons which hold the cushion in place get loose and allow the cushion to move well beyond the limits of normal. The edge of the cushion then glides over the ball beneath it and a clicking sound is heard.

When the jaw is closed, the ball glides over the edge of the cushion again as it fully seats in the socket and a second click or pop is heard. This type of reciprocal clicking, (click on opening and click on closing) is one of the first signs of TMD. Clicking is a sign of TMD and not a symptom. Many people can go for years with a clicking sound before they begin to have symptoms. (A symptom is pain or disfunction which substantially interferes with normal activities, while a sign, although not normal, does not substantially interfere with normal activities).

But when ignored, this reciprocal clicking can turn into any or all of the symptoms of TMD. (Headache, Earache, Jaw Pain, Neck Pain, Ringing in the Ears, A feeling of Fullness in the Ears, Vertigo, Shoulder and Arm Pain, Arm/Hand/Finger Tingling and Numbness and Locking—the inability to open the jaw fully).  All of these symptoms are directly caused by inflammation of the jaw joint. Clicking of the joint is one of the earliest signs that you may be developing TMD.

If clicking or popping of the jaw joint is the only sign present, I will usually tell the patient to return for further consultation when some of the symptoms appear. I have seen many people who click and pop indefinitely but never develop any of the other symptoms, especially in males.

On the other hand, I have seen many many patients who think clicking and popping is their only symptom, but on further questioning have had a long history of TMD headaches, earaches, neck pain that they attribute to having migraines, sinus problems and too much bending over the computer.

Clicking and popping of the TMJ is just a sign of impending problems. But if you have any of the other symptoms, a simple 30 second diagnostic test can rule in or out the existence of active temporomandibular joint disease.

Dr. Anthony P. Urbanek is a double degree Oral and Maxillofacial Surgeon. Dr. Urbanek received his dental degree from Indiana University and his medical degree from Vanderbilt University. Dr. Urbanek is board certified by the American Board of Oral and Maxillofacial Surgery and has served Williamson and Davidson counties for over 30 years. He currently specializes in treating TMJ/TMD with his non-surgical patented TMJ splint and is also a specialist in Dental Implants and Wisdom Teeth Removal. Learn more at www.drurbanek.com