In the context of temporomandibular joint (TMJ) disorders, a “click” refers to a sound or sensation that occurs when the jaw moves. This clicking sound is often a sign of an internal derangement within the TMJ, most often a displacement of the articular disc.
Initial Closure
What happens in a click is that as the jaw begins to close, the condyle and disc move back and up, and the disc remains in its recaptured position on top of the condyle initially. This movement is typically silent and does not cause discomfort.
Full Closure
During the last part of closure, if the teeth are not touching together yet, and so do not support the mandible with the condyle in seated position, there is no stability within the surrounding muscles as a result, and the muscles contract further in order to get the teeth to touch. This results in the condyle moved more posteriorly, resulting in it slipping off the articular disc, which produces a click as the condyle falls off the disc.
Initial Opening
The disc remains displaced until the next jaw opening movement, where the mandible moves to open and the condyle clicks back onto the disc in order to continue further opening.
Characteristics of TMJ Click:
TMJ clicking can be accompanied by pain, difficulty in opening or closing the mouth, and other symptoms of TMJ disorders. It is NOT a variation of “normal” and should not be ignored. TMJ click, referred to as disc displacement with reduction, can lead to permanent disc displacement, known as disc displacement without reduction, and result in significant limitation to opening, pain, muscle tension, causing significant impact on your quality of life. Check out the next part of this series to learn more about disc displacement without reduction. Many patients we see in our office have suffered for many years in pain, on all kinds of medication, and trying all types of remedies only to find out that it all started with a click that could have been treated early on.