Jaw Clicking and Pain: Could It Be a TMJ Disorder?

Jaw clicking with pain is often associated with a temporomandibular disorder (TMJ disorder), a group of conditions affecting the jaw joint and the chewing muscles. Clicking alone is common and may not need treatment. Pain, locking, or trouble opening your mouth is more likely to need an evaluation. This article explains what causes jaw clicking, how clinicians evaluate it, what can help at home, and which symptoms need urgent care.

Jaw clicking and pain: what a TMJ disorder is

You have a temporomandibular joint (TMJ) on each side of your face, just in front of your ears. Each joint connects the lower jaw to the skull and contains a small cushion of cartilage called a disc. MedlinePlus (NIH) describes temporomandibular disorders as problems affecting this joint and the muscles that control jaw movement (see the MedlinePlus page listed in Sources).

"TMJ" technically names the joint, but people use it for the disorder as well. A TMJ disorder can involve the joint, the muscles, or both. Clinicians often use the term "temporomandibular disorders" (TMD) for this reason.

Why does my jaw click?

Several factors can contribute, and the mechanism is not fully understood in every person. One well-described cause is disc displacement with reduction. In this pattern the disc sits slightly out of its usual position when your mouth is closed. As you open, the jaw slides over the disc and back onto it, which can produce a click or pop. A pictorial review of internal derangement of the temporomandibular joint in PubMed Central describes how this pattern can cause a painful clicking jaw.

Other things may contribute to clicking or noise:

• Changes in the joint surface or the disc over time
• Tight or overworked chewing muscles
• Habits such as clenching or grinding teeth
• Past injury to the jaw or a blow to the face
• Arthritis affecting the joint

Many people have joint noise without pain or limited movement. In that situation, clinicians often favor watching and reassurance over procedures.

Symptoms that often travel with jaw clicking

A TMJ disorder can look different from person to person. Common features include:

• Pain or tenderness in the jaw, in front of the ear, or in the cheek and temple
• Clicking, popping, or grating when you open or close your mouth
• Jaw stiffness, or trouble opening wide
• A jaw that catches or locks
• Pain while chewing, or a feeling that your bite is "off"
• Headaches, earache, or a sense of fullness in the ear

Pain near the ear can be confusing because the joint sits so close to the ear canal. If ear symptoms are your main complaint, our articles on clogged ears that won't pop and ringing in one ear cover those problems in detail. Headaches have many causes, and Causes of Headache and When to Worry explains how to sort them out. A study of temporomandibular disorders and headaches in a systematic review in PubMed Central reports an association between the two, although an association does not show that one causes the other.

Clicking with locking: closed lock and open lock

Two different problems can both be described as "my jaw locks."

• Closed lock: the jaw will not open fully, often because the disc is blocking the joint's movement. People sometimes notice that a previous click disappeared when the limited opening began.
• Open lock: the jaw stays open and will not close. This needs urgent attention if you cannot close your mouth.

Either pattern deserves an evaluation by a dentist or physician.

How clinicians evaluate jaw pain and clicking

Clinicians combine your history, an examination and, when needed, imaging. They commonly ask when the clicking began, whether you have pain, and whether you clench or grind your teeth. They may press on the chewing muscles, feel the joint as you open and close, and measure how far your mouth opens and whether the jaw deviates to one side.

Imaging such as an MRI can show the disc and soft tissues of the joint, and is often reserved for people with persistent pain or locking, or when the diagnosis is unclear. Not everyone with jaw noise needs a scan.

Because other conditions can cause jaw or face pain, a clinician may also consider dental problems (such as an abscess or cracked tooth), sinus problems, nerve-related facial pain, and arthritis. Fibromyalgia, a condition of widespread pain, can sometimes occur alongside jaw pain; MedlinePlus has a page on it. If your jaw pain comes with chest discomfort, see the emergency section below.

Treatment options for a TMJ disorder

For many people, symptoms are managed with conservative steps first. The MedlinePlus page on temporomandibular disorders notes that treatment often starts with simple self-care and non-surgical approaches. Outcomes vary from person to person.

Self-care that many clinicians suggest

• Eat softer foods for a while and avoid very chewy or hard items
• Avoid wide yawning, gum chewing, and biting your nails or pens
• Apply a warm compress or a cool pack to the sore area
• Notice and reduce daytime clenching; resting your teeth slightly apart can help some people
• Practice stress-reduction techniques, since tension can add to muscle clenching

Over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may ease discomfort for some adults. Follow the product label and ask your pharmacist or clinician whether they are appropriate for you, especially if you have kidney, stomach, liver, or heart conditions, take blood thinners, or are pregnant. Do not give children adult doses; ask a pediatrician or pharmacist about the right product and amount.

Counseling, jaw exercises and oral appliances

A randomized clinical trial in PubMed Central compared counseling alone with counseling plus jaw exercises in people with disc displacement with reduction. Findings from one trial do not settle the question, but it shows that exercises and education are studied options that a clinician or physical therapist can guide.

Dentists sometimes recommend an oral splint (a custom mouthguard). A meta-analysis in PubMed Central compared an anterior repositioning splint with other occlusal splints for disc displacement with reduction. Researchers continue to study which splint designs work best, so ask your dentist what they expect from one and how long you would use it.

Procedures and injections

If conservative care does not help, specialists may discuss injections or joint procedures. Some early studies have looked at intra-articular injections, including a preliminary controlled study of platelet-rich fibrin injections, but this is an area of ongoing research and results are preliminary. Surgery is generally considered only for selected people with significant, persistent problems. Tell your clinician about your goals and concerns so they can decide which options are reasonable for you.

Who gets TMJ disorders?

Temporomandibular disorders can affect people of many ages. Studies of clinic populations, such as a prospective study from the EUROTMJ database in Portugal, document joint sounds and pain as common findings among people seeking care. Anxiety, stress, and depression have also been linked with TMD symptoms in research, though the direction of the relationship is not always clear. If low mood or constant worry is part of your picture, mention it to your clinician, because treating those problems may help overall comfort.

When jaw pain is not the jaw

Jaw pain can occasionally come from the heart, particularly pain that spreads from the chest into the jaw or comes on with exertion, sweating, or shortness of breath. That pattern needs emergency care, and it is different from the pain of a sore, clicking joint that gets worse when you chew or open wide. Jaw or face pain that arrives with sudden face drooping, arm weakness, slurred speech, confusion, sudden vision loss, or double vision can be a stroke and also needs a 911 call. Pain with swelling, fever, or a bad taste can point to a dental or soft-tissue infection, which needs prompt evaluation. A jaw injury followed by a bite that no longer lines up can mean a fracture.

Another mimic deserves mention, especially if you are over 50. Giant cell arteritis is an inflammation of blood vessels in the head. It is much less common than a TMJ disorder, and one symptom alone does not establish it. It can cause new jaw pain that appears while chewing, often together with a new headache, scalp tenderness, fever, or vision changes. Because it can threaten eyesight if it is not treated, that combination needs same-day medical evaluation rather than waiting for a routine visit. Ear pain, ringing, or a headache by itself, without those features, can be raised at a routine appointment.

Preparing for your appointment

A dentist is often a good first stop for jaw clicking and pain, and a primary care clinician can also help. Before you go, note:

• When the clicking or pain began and whether it is getting worse
• Whether your jaw has ever locked, in the open or the closed position
• Any recent injury, dental work, or long dental procedure
• Habits such as clenching, grinding, or gum chewing
• Other symptoms, such as headache, ear fullness, scalp tenderness, vision changes, or neck pain
• Medicines you take, including over-the-counter pain relievers

When to Seek Medical Care