Do the joints in your jaw bother you?

In the course of your dental visit, your dentist may ask if you hear clicking noises when you open or close, and they may also feel just in front of your ear while asking you to repeat the open/close motion. What is the dentist doing? They are checking your jaw joints for signs of a disease known as TMD.

We are built with two very unique joints that connect our lower jaw to the rest of our skull. These joints are called TemporoMandibular Joints, or TMJ for short. Many patients who have discomfort or clicking in the joints have been told that they “have TMJ,” but what they really mean is that they have TemporoMandibular Dysfunction, or TMD.

A healthy TMJ is essentially a ball-and-socket joint that is designed to “dislocate” or translate along a bony surface. The joints are cushioned and lubricated by cartilage, and guided and kept in place by various muscles and ligaments.

Through aging, trauma, inflammatory joint disease, misaligned teeth or habitual clenching/grinding, the cartilage and ligaments can be abused. The clicking or popping noises are usually caused by the cartilage not following the ball-and-socket movement properly and then “snapping” back into position. Some people will experience this noise with or without pain. Over a long period of time, the cushioning and lubrication can be damaged to the point that you have bone-on-bone contact which can be extremely painful. This is similar to injuries that many of us have in the knees or hips that require treatment.

I frequently see patients that, through evidence in their teeth and bite pattern, indicate they are clenching or grinding in their sleep and they may not even realize it. This is probably the most frequent cause or initiating factor for TMD. Many cases of TMD can be alleviated or even eliminated by altering habits, medications, and the use of a properly fitted and adjusted nightguard. In more serious cases, a TMJ specialist may need to be seen where the options can range from incrementally adjusted mouthpieces to surgery.

If any of these symptoms sound familiar to you, I recommend you discuss them with your dentist or physician at your next checkup.