Jaw clicking when you chew usually comes from the disc inside the jaw joint slipping, and without pain it needs no treatment. Clicking with pain or locking is worth an exam; our page on TMJ treatment in San Diego explains what that involves. This blog will walk you through why jaws click, TMJ versus ordinary jaw pain, and treatment.
What the TMJ is and what TMD means
The temporomandibular joints, or TMJs, connect your lower jaw to your skull, one in front of each ear. You can feel them move if you put your fingertips just in front of your ears and open your mouth. Each joint has a rounded end of the jawbone, the condyle, and a small disc of cartilage that cushions it as it glides forward and back.
TMD, short for temporomandibular disorder, is the name for problems with those joints and the chewing muscles that move them. The NIDCR's guide to TMD describes more than 30 conditions in three groups: joint and disc disorders, chewing muscle disorders and headaches linked to TMD. It affects about 5% of US adults and is twice as common in women, especially between 35 and 44. Many cases last a short time and go away on their own.
Why your jaw clicks when you chew
A jaw clicks when something inside the joint shifts suddenly instead of gliding. Chewing opens and closes the joint over and over, so any small shift shows up as a click with each bite.
A disc that slips forward
The most common cause is disc displacement with reduction. The disc sits slightly in front of the condyle when your mouth is closed. As you open, the condyle slides forward and jumps back under the disc, which makes the click. Some people hear a second, softer click on closing as the disc slips forward again.
This is far more common than most people think. A systematic review of 167 papers in the Journal of Oral Rehabilitation found disc displacement in 18% to 35% of the general population, and described it for most people as "a pain-free, lifelong lasting, 'noisy annoyance'".
A joint that opens very wide
Some jaws click only on a big yawn or a wide bite. The condyle glides further forward than usual and passes over a ridge of bone at the front of the joint, then clicks back. A jaw that sticks open after a yawn needs same-day care.
A grating sound rather than a click
A grinding or grating noise, called crepitus, sounds different from a clean click. It can mean the joint surfaces have roughened through wear or arthritis, and NIDCR lists grating with pain among the signs of TMD. A grating jaw is worth an exam even if it does not hurt much.
Clenching and grinding
Clenching loads the joint and tires the chewing muscles. In a study of 260 teenagers by Kalaykova and colleagues, a jaw that caught or locked from time to time was linked to clenching during the day. Grinding at night does the same work while you sleep; our guide to teeth grinding at night explains the signs.
When jaw clicking is normal and when it is not
NIDCR states that clicking or popping sounds in the jaw joint, without pain, are common, are considered normal and do not need treatment. The research on what happens next is reassuring. The Journal of Oral Rehabilitation review found that a clicking disc is mostly stable and pain-free. In only a small minority does the disc stop slipping back into place, and only rarely does that cause a locked jaw. When it does, the stiffness tends to ease and often resolves within months.
A click is no longer just a noise when:
- it hurts, or the joint aches after meals
- the jaw catches partway open and you have to wiggle it to open fully
- a click you have had for years stops and your mouth suddenly will not open as wide
- the jaw locks open or closed
- your bite feels different, as if the teeth no longer meet the same way
- the clicking started after a blow to the jaw
The third point matters most. When a long-standing click disappears and opening becomes limited, the disc may no longer be slipping back into place. That is the form of disc displacement the review says needs active treatment.
How to tell TMJ pain from regular jaw pain
TMJ pain and other jaw pain can feel alike, but they usually differ in a few ways:
- Where it hurts. TMJ pain sits in front of the ear, at the temple or over the cheek muscles. Other jaw pain usually points to one tooth, one area of gum or one side of the face.
- What sets it off. TMJ pain gets worse when you chew, yawn or talk for a long time. Tooth pain gets worse when you bite on one tooth or eat something hot, cold or sweet.
- Sounds. TMJ pain often comes with painful clicking, popping or grating. Other jaw pain rarely does.
- Movement. TMD can limit how far you open or make the jaw catch or lock. Other jaw pain usually leaves movement alone.
- Ears and head. TMD can bring ear fullness, ringing or temple headaches with no ear infection. Other jaw pain rarely affects the ears.
- How long it lasts. TMD pain tends to come and go over weeks or months. Other jaw pain usually settles once the cause is treated.
Common causes of jaw pain that are not TMD
Several dental problems feel like TMJ pain at first. A tooth infection or abscess can spread pain along the jaw, often with swelling, a bad taste or pain when you bite. Gum disease, sinus pressure over the upper back teeth and soreness after a long dental appointment are other common causes, and each settles once the cause is treated.
A wisdom tooth coming through can cause pain at the very back of the jaw and a headache on one side; if you can't tell whether it is a wisdom tooth or TMJ, our comparison explains the differences.
One cause of jaw pain is an emergency. The National Heart, Lung, and Blood Institute lists pain in the jaw, neck, back or arms among the symptoms of a heart attack, alongside chest pain, shortness of breath and sweating. Jaw pain with any of those needs a 911 call, not a dental appointment.
Signs your jaw pain may be TMD related
TMD affects the joint, the chewing muscles or both. NIDCR lists these signs:
- pain in the chewing muscles or the jaw joint, the most common symptom
- pain that spreads to the face or neck
- jaw stiffness
- limited movement or locking of the jaw
- painful clicking, popping or grating when you open or close
- ringing in the ears, hearing loss or dizziness
- a change in the way the upper and lower teeth fit together
Headaches at the temples are common too, because the temple muscle is one of the main chewing muscles, and NIDCR counts headaches linked to TMD as one of its three groups. Some people take them for tension headaches or migraines before the jaw is checked.
How a dentist checks a clicking jaw
There is no single test for TMD, NIDCR says, so diagnosis starts with your history: where it hurts, when it started, what makes it better or worse and whether you have headaches or other pain. The examination checks the head, neck, face and jaw for tenderness, clicking or popping and limits on movement.
The international DC/TMD criteria, published in 2014 by Schiffman and colleagues, give dentists a validated way to structure that exam for the most common painful forms of TMD. Confirming exactly where a disc sits takes imaging. An X-ray, CT scan or MRI may follow when the dentist suspects a problem inside the joint.
Pain in the jaw or face is not always TMD, so the dentist also looks for a tooth, gum or sinus cause before settling on a diagnosis.
Treatment for a clicking jaw and TMD
A clicking jaw with no pain needs no treatment. When there is pain or stiffness, NIDCR recommends starting with conservative care and avoiding anything that permanently changes the joints, the teeth or the bite.
Start with self-care
Many jaw problems are temporary and do not get worse, so the first steps are simple:
- Eat softer food for a while and cut food into small pieces.
- Stop chewing gum and avoid very wide yawns or bites.
- Use heat or cold on the face, with gentle stretching exercises for the jaw.
- Take an over-the-counter anti-inflammatory painkiller such as ibuprofen if it suits you.
- Notice daytime clenching and let your teeth rest apart.
Physical therapy and habit support
Manual therapy, in which a physical therapist stretches the muscles and soft tissue around the joint, can improve function and relieve pain, NIDCR reports. Relaxation techniques, cognitive behavioural therapy and biofeedback help people who clench under stress.
Night guards and splints
A custom night guard, or occlusal splint, covers the teeth to protect them from grinding and can help break a clenching habit. NIDCR notes the evidence on whether it reduces TMD pain is limited, and advises that a splint should not be designed to change your bite permanently; stop wearing it and see your dentist if it causes pain. Our comparison of TMJ disorder and teeth grinding shows when a guard is the right tool.
Treatments to question
Ask for simpler treatment first, and a second opinion, before agreeing to:
- Bite adjustment, crowns or orthodontics to treat TMD. NIDCR says research does not support a bad bite as a cause of TMD, and these treatments can make it worse.
- Botox. Botulinum toxin is not FDA-approved for TMD, and NIDCR describes the study results as mixed.
- Joint procedures or surgery, which NIDCR keeps for cases where simpler treatment has not worked.
If treatment at the dental office does not settle the pain, our guide to what kind of doctor treats TMJ explains when an orofacial pain specialist, an oral surgeon or a physical therapist comes in.
When to see a dentist about jaw clicking
Book an exam if:
- the click hurts, or the jaw aches after eating
- the jaw catches, locks or will not open fully
- a long-standing click stops and opening becomes limited
- jaw pain lasts several weeks or keeps coming back
- you have temple headaches or ear fullness with a normal ear exam
- your bite feels different
- you wake with a sore jaw or worn teeth
A jaw stuck open or closed, or jaw pain after a blow to the face, needs same-day care.
TMJ care at our Carmel Mountain Ranch office
A TMJ evaluation at Smiles By Design checks how your jaw moves, the sounds the joints make, tenderness in the chewing muscles, how your teeth meet and signs of grinding. Imaging is added when a problem inside the joint is suspected. Conservative care comes first, including custom splints and jaw exercises. Dr. Dan Javaheri, a graduate of the NYU College of Dentistry with more than 17 years in general, cosmetic and implant dentistry, leads the practice with Dr. Cody Cohen.
Frequently Asked Questions
Is jaw clicking normal?
Jaw clicking without pain is normal. NIDCR states that clicking or popping in the jaw joint without pain is common, is considered normal and does not need treatment. Disc displacement, the usual cause, is found in 18% to 35% of people. See a dentist if the click hurts, catches or comes with limited opening.
Why does my jaw click when I chew but not hurt?
A painless click when you chew usually means the disc in the joint sits slightly forward and snaps back under the jawbone each time you open. This is disc displacement with reduction. For most people it stays stable and pain-free for life, and no treatment is needed.
Will jaw clicking go away on its own?
Jaw clicking often stays for years, but it rarely gets worse. A systematic review found that a clicking disc is mostly a stable, lifelong condition and only rarely progresses to a locked jaw. Painful TMD often improves without treatment. A click that suddenly stops with limited opening needs an exam.
How can I tell if my jaw pain is TMJ or muscle strain?
TMJ pain centres on the joint in front of the ear and the temple, often comes with clicking or limited opening and tends to come and go over weeks. Ordinary muscle strain, after a tough meal or a long dental visit, is temporary and settles once the jaw rests.
How long should jaw pain last before I see a dentist?
See a dentist if jaw pain lasts several weeks, keeps returning, or comes with limited opening, frequent headaches or painful clicking. Do not wait if the jaw locks, the pain follows an injury, or a tooth is swollen or tender to bite on. Jaw pain with chest pain or breathlessness needs 911.
Can a tooth infection cause jaw pain that feels like TMJ?
A tooth infection can cause jaw pain that feels like TMJ, because an abscess spreads pain along the jaw and towards the ear. Infection pain usually points to one tooth, hurts when you bite and may bring swelling or a bad taste. It settles once the tooth is treated, unlike TMJ pain.
Does jaw locking always mean TMJ disorder?
A jaw that catches or locks partway open usually points to the joint, often a disc that has stopped slipping back into place. Difficulty opening because of swelling after a wisdom tooth infection or extraction is different: that is muscle spasm, and it eases as the area heals.
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