Clicky Jaw (Internal TMJ Derangement)

TMJ dysfunctionThe jaw or temporomandibular joint (TMJ) is an unusual joint. If you look at some insects, you might see that their mandibles have not fused, which can be a useful image when trying to understand the dysfunctions of the TMJ- it’s a ball and socket joint capable of complex movement.

Additionally, the TMJ has a cartilage disc within it, similar to the meniscus in a knee; but a lot more mobile. If the disc is dysfunctional it might catch or fold during opening or closing the mouth, causing pain, locking, or clicking. Because the disc is attached to some of the muscles that open the mouth (lateral pterygoids), tight jaw musculature can be a cause of dysfunction. This in turn can come from a number of causes, like grinding your teeth or chewing gum a lot. It’s important to know that clicking alone is not a cause for concern- most people will have some noise within the jaw in some movements.

Osteopaths can use a range of techniques to treat a clicky jaw, working on the muscles and joint itself. Intra-oral techniques are an option, but techniques that involve the patient resisting a force and relaxing are effective without being so invasive. For patients with TMJ dysfunction, there may be some involvement from the neck, so this may also be assessed and treated.

Below is a video of a real TMJ with disc displacement that might help clarify my diagram. It is fairly graphic so be warned!

Of course there are other causes of jaw pain, and symptoms may not include any clicking.

 

Merck Manual, NIDCR.NIH.gov,

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