Jaw clicking
A 'click' when opening or closing the mouth may be related to a change in the position of the articular disc. Clicking alone, without pain or catching, is common and does not necessarily get worse.
Core care
TMJ (Jaw Joint)Jaw discomfort,examined through how the jaw moves.
Sounds from the jaw or the jaw moving to one side as you open your mouth may be related to many factors. At MODNI we check your symptoms and movement together and, based on the examination, explain what assessment and care you may need.
Last updated Medical review in progress
At a glance
Temporomandibular disorders (TMD) is a collective term for pain, joint sounds and limited mouth opening affecting the temporomandibular joint (TMJ) and the chewing (masticatory) muscles. Clicking without pain or catching is common, and not all of it needs treatment. At MODNI, after checking how wide the mouth opens, the path of the chin, joint sounds, and tension in the chewing muscles, neck and shoulders, we choose or combine acupuncture, pharmacopuncture and Chuna therapy according to your condition, and also consider an oral appliance where needed.
Where is the jaw joint, and how does it move?
The jaw joints are a left and right pair located just in front of the ears, where the temporal bone of the skull meets the lower jaw (mandible). Between the mandibular condyle — the upper end of the lower jaw — and the glenoid fossa of the temporal bone sits the articular disc, which helps the movement run smoothly.
When you begin to open your mouth, the condyle rotates in place; as you open wider, it moves forward beneath the articular eminence. Because both joints are connected through a single lower jaw, movement on one side affects the other. The illustration above is an explanatory drawing showing the location of the jaw joint and the direction of this movement.
Concerns we look at
Jaw joint pain
Pain in front of the ear, at the temples or around the jaw when chewing or opening the mouth. It is often pain in the surrounding muscles rather than the joint itself, so we check these separately.
Jaw shifting to one side on opening
The chin may shift to one side midway and then return, or stay shifted as the mouth opens. Which side it shifts to, and at what point, gives clues for assessment.
Limited mouth opening
The mouth opens less than usual or feels as though it catches midway. If you suddenly cannot open or cannot close your mouth, prompt medical care is needed.
Chewing muscle discomfort
Clenching or grinding, or habits of chewing for long periods, can tire the masseter and temporalis muscles. This may show up as a stiff jaw in the morning or heaviness around the temples.
Neck and shoulder tension
Jaw discomfort sometimes occurs together with neck and shoulder tension. We also look at your sitting posture and head position.
If you notice these changes, have them checked rather than waiting
Jaw discomfort is easy to get used to in daily life. If you notice any of the changes below, it is worth having your current jaw movement and muscle condition checked once. If the examination shows that monitoring is enough, we will tell you so.
- When clicking now comes with pain
- If your jaw used to click without pain but now hurts when you chew or open your mouth, the condition of the joint and muscles may have changed.
- When you cannot open as wide
- Your jaw catches when you yawn or eat something large, or feels as though it opens less than before.
- When your jaw feels stiff every morning
- Clenching or grinding during sleep may be involved, so it is worth having it checked.
- When you find yourself chewing on one side only
- Chewing on one side to avoid discomfort can lead to differences in how the muscles on each side are used.
Typical movement and movement worth checking
Seen from the front, the chin generally comes down along the midline as the mouth opens. Small departures from this path are common.
A path that shifts to one side midway and returns at the end (deviation) and a path that stays shifted all the way open (deflection) may involve different factors. Whether pain, catching or reduced opening are also present is an important criterion for deciding whether treatment is needed.
- 01Straight · opens along the midline
- 02Deviation · shifts, then returns
- 03Deflection · opens while shifted
Assessing jaw joint movement
- Symptom history
- What we checkSince when and with which movements it is uncomfortable, the character of sounds and pain, and habits such as clenching or grinding
- Opening range
- What we checkThe distance between the upper and lower front teeth at comfortable and maximum opening. Maximum opening in adults is generally reported to be about 40 mm or more
- Opening path
- What we checkThe path of the chin as the mouth opens and closes, and the direction and timing of any shift
- Joint sounds
- What we checkWhich side the sound comes from and when (on opening or closing), and whether it comes with pain
- Muscle palpation
- What we checkTension and tenderness in the masseter, temporalis, and the muscles around the neck and shoulders
| Item | What we check |
|---|---|
| Symptom history | Since when and with which movements it is uncomfortable, the character of sounds and pain, and habits such as clenching or grinding |
| Opening range | The distance between the upper and lower front teeth at comfortable and maximum opening. Maximum opening in adults is generally reported to be about 40 mm or more |
| Opening path | The path of the chin as the mouth opens and closes, and the direction and timing of any shift |
| Joint sounds | Which side the sound comes from and when (on opening or closing), and whether it comes with pain |
| Muscle palpation | Tension and tenderness in the masseter, temporalis, and the muscles around the neck and shoulders |
Relationship with facial asymmetry
Jaw joint discomfort and left–right differences in the face sometimes occur together and sometimes do not. We do not assume in advance that they are related. If left–right differences in your face also concern you, we carry out a facial asymmetry assessment and a 3D facial record as well, and explain whether the two are related.
What actually happens at the first visit
First-visit time
About 60 min
The director personally carries out the assessment, explanation, treatment plan, treatments and follow-up assessments. For simple jaw joint pain, the 3D facial surface scan can be skipped.
StandardIf needed
01Symptom history
We ask where it is uncomfortable, when it started, the character of any sounds or pain, your habits, and past dental treatment.
02Movement assessment
We check how wide the mouth opens, the path of the chin, and joint sounds.
03Muscle palpation
We check tension and tenderness in the chewing muscles and the muscles around the neck and shoulders.
043D facial surface scanIf needed
Performed when left–right differences in the face are also a concern.
05Explanation by the director
The director explains what was found, which factors appear to be involved, and whether care is needed.
06Treatment plan and first treatment
We decide on treatment methods and when to reassess, and the first treatment is carried out if you agree.
The time required may vary with your history and the scope of the examination.
Treatment methods
Acupuncture, pharmacopuncture and Chuna therapy are chosen or combined according to your condition. Not every jaw sound needs treatment, and responses to treatment differ from person to person.
Acupuncture / electroacupuncture
What is it?
Acupuncture is applied to tense chewing muscles, around the neck and shoulders, and to related acupoints, with a mild electrical stimulus added if needed.
When is it considered?
The basic treatment when muscle tension and pain are the main issue.
Pharmacopuncture
What is it?
A small amount of a solution extracted and refined from herbal medicinal ingredients is injected into acupoints in the uncomfortable area. It is a different procedure from an intravenous (IV) injection or a vaccine.
When is it considered?
Considered when localized tenderness is clear; whether to use it is decided after the examination.
Chuna therapy
What is it?
A Korean medicine manual therapy in which the Korean medicine doctor uses the hands to assess and adjust the movement of the jaw joint, the joints of the neck, and the surrounding muscles.
When is it considered?
Used alongside other care when limited opening or a shift in movement appears to be involved.
Oral appliance
What is it?
An appliance fitted to the teeth and worn inside the mouth.
When is it considered?
Considered together with other care when needed, such as when clenching or grinding appears to be involved. It is not a treatment applied to every patient.
When treatment is needed and when to watch and wait
WhenWhat we do
- There is clicking only, without pain or catchingSelf-care guidance and monitoring are often enough.
- It hurts to chew or the chewing muscles are knottedCare centres on acupuncture and electroacupuncture, with pharmacopuncture added if needed.
- The mouth opens less or catches midwayChuna therapy is added based on the movement assessment.
- Clenching or grinding is suspectedWe review habits together and, if needed, also consider an oral appliance.
Daily care
Things you can try in daily life alongside care.
- 1Cut down on hard or chewy foods and on chewing gum for long periods.
- 2At rest, a comfortable position is lips closed with the upper and lower teeth slightly apart. Try to notice from time to time whether you are clenching.
- 3Avoid resting your chin on your hand and sleeping face down.
- 4When yawning, gently support the underside of your jaw with your hand so you do not open too wide.
- 5When the jaw feels stiff, a warm compress may help. If there is swelling or a feeling of heat, please have it examined.
Symptoms that need medical assessment first
- Jaw pain and swelling after a fall or a blow — a medical facility where imaging is available
- Suddenly being unable to open or close the mouth — prompt medical care
- Fever, ear pain or facial swelling occurring together
- Suspected tooth pain or gum problems — a dentist
Frequently asked questions
My jaw clicks but does not hurt. Do I need treatment?
Clicking alone, without pain or difficulty opening, is common, and monitoring is often enough. If the clicking becomes more frequent or pain or catching develops, we recommend an examination.
How long does the first visit take?
It is planned at about 60 minutes. For simple jaw joint pain the 3D facial surface scan can be skipped, so the time may differ.
Are jaw joint problems related to facial asymmetry?
Sometimes they are and sometimes they are not. If both concern you, we check them together in one examination and explain whether they are related.
Do I have to use an oral appliance?
No. An oral appliance is an option we consider together with other care when needed, and it is not a treatment applied to every patient. If you already use an appliance from your dentist, please let us know and we will take it into account in the care plan.
About how many treatments will I have?
It depends on your symptoms and response, so it is not fixed at the start. We check changes through reassessment and decide together.
References
- Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications. J Oral Facial Pain Headache. 2014;28(1):6–27.
- Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. St. Louis: Elsevier; 2019.
- National Institute of Dental and Craniofacial Research. TMD (Temporomandibular Disorders). www.nidcr.nih.gov
Related medical articles
All topics- TMJJaw clicking: when should you seek care?In preparation
- Daily careEveryday habits that ease the jaw jointIn preparation
Related pages
Your doctor
Director Oh Kyung-seok, KMD
Graduate, College of Korean Medicine, Gachon University · The director personally provides care, from assessment through follow-up.
Last updated Medical review in progress
Jaw discomfort: first, find out where it comes from.
Have your current condition checked before the discomfort becomes something you simply live with. We check how wide and along what path your mouth opens, joint sounds and muscle tension, and explain the results and the scope of care you may need.
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+82-2-6205-1236 · 2F, K Building, 626 Samseong-ro, Gangnam-gu, Seoul, Republic of Korea · Location & hours