TMJ

What does it mean when my jaw is popping, and why does it do that:

for those of you who want an in-depth explanation.

(this information is for educational purposes only, please see a professional trained in TMD for a diagnosis and treatment)

Temporomandibular Joint Dysfunction (TMJ Dysfunction) or TMD:

KNOWING THE ANATOMY IS HALF THE BATTLE!

Some patients visit many different professionals when they are trying to figure out the cause of their TMD and associated pain.

Although it is not considered a specialty, a dentist with extra training in TMD can assess your joint, muscles, and habits to guide appropriate care.

Training in Sleep Apnea Therapy and currently taking a Master’s Degree in Orofacial Pain have allowed Dr Zacal to become educated and aware of the various TMD conditions that exist.

In addition to a comprehensive examination, the uses a series of questionnaires helps identify each person’s personalized factors that may contribute to their TMD.

What Is TMD?

“TMJ” as it is often called, or Temporomandibular Disorders (TMD) refers to problems affecting the joint, the disc, the ligaments, and the chewing muscles.

TMD may include:

Jaw popping or clicking
Jaw pain or tightness
Limited opening or pain on opening
Headaches or temple pain
Ear pressure or facial discomfort

TMD is the dysfunction of all mechanisms associated with this small but complex joint. This includes:

1, The upper joint “socket”

The in between “cushion” or disc

The lower joint “ball” (condyle)

The ligaments connecting all these components

2. The surrounding chewing muscles

3. The surrounding fluid filled compartments.

When any of these structures become strained, fatigued, or inflamed, the disc can start to shift slightly.

Why Does My Jaw Pop?

(it’s not what you think)

1. Ligaments That Surround the Joint, and Strain

The TMJ is kept stable by a network of ligaments called the joint capsule which surround the “ball” or condyle

Healthy ligaments stabilize the joint and keep the disc in place for smooth, painless function.
When they become stretched (from clenching, overuse, wide yawning, or trauma), the disc can slip forward.
When you open, the condyle moves forward, allowing the disc to snap BACK INTO POSITION — creating the popping sound.

This is the most common reason for jaw popping.

2. The Cartilage Disc Moving Out of Position

The disc is a piece of cartilage that acts like a cushion between the lower jawbone condyle and the socket in the skull, like a meniscus in the knee. If it is not sitting perfectly, movement can become noisy.

If the disc shifts in front of the condyle, it may “pop” back into place during opening or closing.
This is called disc displacement with reduction.
The pop is the disc popping into place — not the jaw popping out of place.

What is LOCK JAW?

If the ball of the lower joint is stuck in front of the disc it creates an OPEN lock

If the ball of the lower joint is stuck behind the disk (and it cannot pop back onto the disc, it is a CLOSED lock

3. Muscle Overuse or Tension

Your chewing muscles work all day long — talking, chewing, swallowing, yawning, singing.

When overused, tight or tired, they pull on the joint capsule ligaments and destabilize the disc.
This can start or amplify the popping frequency and discomfort..
These muscles also attach from the jaw to the temples, and may contribute to headaches.
Neck tension (stress, posture, trauma from whiplash) can make symptoms worse.

4. Inflammation & Synovial Fluid

Joints contain synovial fluid which lubricates movement. Inflammation inside the joint can cause synovial fluid buildup and will increase pressure inside the joint. This can:

Limit mouth opening
Make opening painful

The first line of treatment is always at least 6 months of relaxation, gentle exercises, manual TMJ therapy from a trained professional. If symptoms do not resolve in severe cases, an oral surgeon trained in TMD may perform arthrocentesis to flush the joint spaces and drain excess fluid — but only after image called an MRI for confirmation.

Daytime Clenching Versus Night Time Clenching

Why Daytime Clenching Matters

It was once believed that night time clenching was the main cause of TMD. New research shows daytime jaw bracing is often just as important.

Common times people brace their jaw:

Driving
Concentrating
Working at a computer
Feeling acute stress
Even unconsciously throughout the day as a result of chronic stress
Some medications also contribute to clenching during the day or night

This constant tension strains the ligaments and disc.

Increasing Awareness

A tool to help: the BruxApp (this is App is evidence-based)

The BruxApp was designed to help people identify subconscious daytime clenching patterns. This constant muscle tension pulls on the ligaments and disc, making popping more frequent. Most people don’t realize they’re clenching until symptoms appear. Now there is an App for that!

It sends 12 random reminders per day. Each time, you select an emoji describing what your jaw is doing: