Jaw popping is a prevalent and common condition. There are a number of reasons why a jaw may start popping- almost all of those reasons are trauma related. It can be a big trauma- like an accident (car accident, hit to the face, falling on your chin) or can be microtrauma (orthodontic treatment, clenching/grinding your teeth, chewing gum frequently). If you live with someone who has a jaw that pops or you yourself have a jaw that pops, you may have self-diagnosed that you have a TMJ-Disorder. I would answer you and say– not so fast. We have other joints that pop and make noise upon movement and it causes no concern for us at all. Perhaps noise in the jaw is more bothersome because it is in close proximity to your ear and oftentimes you use your jaw frequently drawing unwanted attention to the noise. While aggravating, especially if you are someone that is sensitive to sound, a sound alone does not qualify you as being “disordered” or “dysfunctional.”
So now that we got that out of the way– let’s talk about what is actually happening. In the skull, you have two bones that come together- the lower jaw, called the mandible, and the skull. The lower jaw is held to the skull with ligament and muscle attachments. These two bones need protection from one another, so you also have a cartilage disc that sits between the two bones on the surfaces where movement takes place. As the mandible opens, moves sides to side, or pushes forward the disc keeps the friction from the two bones from destroying one another. In a normal healthy functioning joint, the jaw movements slide smoothly and function in harmony. Muscle contractions in the muscles that help move the jaw also help pull the disc forward and backwards. Over time with microtrauma or suddenly with major trauma, those muscles/ligaments that hold the disc in the proper place can become stretched or loose. The lowering of tension can allow the disc to be pulled too far forward and not as easily pulled back- and the disc becomes dislocated. When the disc moves into a dislocated position it sometimes pops into place when you open and pops out of place when you close. So in reality, the popping is putting the disc into the proper position; the problem is, when you close it slides right back out.
My disc is out of place and dislocated?? That sounds like a problem!!! Well, it is, and it isn’t. Just because the disc moves, it doesn’t guarantee that deterioration of the joint is inevitable. However, if we can identify and correct especially the microtraumas (clenching, etc) that are happening we can help minimize the progression of this condition. Sometimes it is possible through exam and history taking, I can point to several things that might be contributing to disc movement. Oftentimes, joint sound can be accompanied with pain which may require treatment. The disc can get pushed so far forward that the two bones can grate on one another causing pain and joint breakdown (arthritis). Or sometimes the disc is so far forward the bone of the lower jaw can sometimes push on a piece of tissue in the joint that has blood supply and nerves and impinging that tissue causes pain, swelling, and discomfort. In those cases, treatment absolutely makes sense. We still treat underlying causes and minimize the microtraumas that may be occurring, but we also treat the irritation by creating more space in the joint. We do this with TMJ orthotics. Not allowing the condyle (lower jaw bone) to fully seat allows the tissue to heal and the bone to not become further deteriorated.
This can be complicated. Certainly if there is a sound in your joint, especially if uncomfortable, schedule an appointment to receive a proper diagnosis. The appointment can also be to help identify certain causes that could lead to further breakdown of the joint space. Correcting those habits are typically all that is needed. Treatment doesn’t always have to be invasive to be appropriate. Our goal at Sleep & TMJ Co. is always to do the least amount of treatment for the maximum result and sometimes no treatment is the right treatment.