There are multiple reasons you can hear a noise in the jaw region, but the most common is due to a displaced disc. The temporo-mandibular joint, or TMJ, is made up of a temporal bone, a mandibular condyle (also a bone), and a disc in between it. The disc in between the two bones helps to provide stability to the TMJ.

Unfortunately, when closing and opening the mouth, especially wide opening, the disc may displace anteriorly/forward causing a click. Another click may then occur when the disc goes back in, or reduces. This problem where the disc slides in and out of its proper placement is called “anterior disc displacement with reduction.”

There may also be instances where the disc stays displaced, which we refer to medically as “anterior disc displacement without reduction.” When this happens, the clicking stops, but there is significant tightening of the jaw muscles and limited joint motion due to the disc in the wrong position. This can be also be referred to as “closed lock.”

Both of these pathologies are much more common in young females due to the looser ligaments generally found amongst females. Fortunately, both problems have great expected outcomes with the proper care. The ideal care for the most common type of clicking, or anterior disc displacement with reduction, is manual mobilization of the surrounding muscles, along with strengthening of the postural muscles and muscles surrounding the TMJ. Typically, manual mobilization for this primarily involves massage to the soft tissue with or without gentle mobilization of the TMJ.

The proper care for “closed lock” is manual mobilization of the muscles and joint. This mobilization is often more aggressive, but still comfortable. This is also accompanied with ROM and stabilization exercises. The ultimate goal is to reduce the disc back into its original location, then stabilize the muscles via exercise to maintain that correct positioning.

If you have any painful clicking with chewing or opening your mouth, seeking the assistance of a physician is recommended. Dr. Natarajan can evaluate your TMJ and recommend exercises, physical therapy and/or obtaining a night splint.

The author of this article is Ryan Perry, PT, DPT, OCS, CSCS, MTC, FAAOMPT from Novacare at Fitness Formula Club – North Ave.