Your jaw has clicked for years, but now it's started to hurt

If your jaw only makes noise, just remembering the distinctions in this post is enough

Key points in 30 seconds

1. About one in three adults has some kind of jaw trouble. An analysis pooling 21 studies that used standard criteria put it at about 31%, and the most common type was "the jaw that makes noise."
2. A common cause of the sound is the cushion inside the joint slipping slightly out of place, then popping back in when you open your mouth. For many people, it never causes a problem in their lifetime.
3. So the equation "it makes noise = it's a disease = it needs treatment" doesn't hold.
4. Treatment becomes necessary at a different point: when pain starts, when how far you can open your mouth shrinks, or when your jaw catches and locks so it won't open.
5. Even then, we start with treatments that can be reversed. We don't recommend irreversible treatments from the start, such as grinding down teeth to change your bite.

What we often hear

• "Every time I open my mouth, it pops or clicks."
• "My jaw got stuck once during a big yawn, and now I'm scared."
• "It aches after I chew something tough, and lately it even hurts while I'm eating."
• "When I wake up, my jaw is stiff and my back teeth are clenched tight."
• "The more I search online, the scarier the stories get, and I wonder if it's something serious."

Half the people who come to us about their jaw start with this question: "My jaw makes a sound. Is it something serious?"

Let's start by answering that question.

The first step is telling noise apart from disease

About one in three adults has some kind of TMJ (jaw joint) trouble. An analysis pooling 21 studies that used standard diagnostic criteria put it at about 31% of adults, and the most common type was "the jaw that makes noise."

Here's a common cause of the sound. Inside the joint there's a disc that acts as a cushion. It sits slightly out of place, then slips back into position as you open your mouth, and that makes the sound.

It's very common, and for many people it never causes a problem in their lifetime.

So the equation "it makes noise = it's a disease = it needs treatment" doesn't hold. The real question is where, along this common spectrum, treatment begins.

Sort it into three groups

One: a jaw you can simply watch. It only makes noise, it doesn't hurt, and your mouth opens well. It doesn't need treatment. Just know the warning signs below and go about your life.

Two: a jaw that needs treatment. Pain has started, how far you can open has shrunk, or chewing or talking has become difficult. At this point, assessment and treatment are needed.

Three: a jaw to get checked promptly. Your jaw has caught and locked so it won't open. A detailed assessment comes first.

This distinction is the most important point in this post.

If you only have noise, remembering these three groups is enough, and you can come in when the signs below show up. Not starting unnecessary treatment is also part of good care.

We measure in millimeters

We measure how far your mouth opens in millimeters, not by feel. Normal is roughly 40 mm or more.

With this number, we have a baseline to judge whether things are getting better or worse. We compare before and after treatment using this number and your pain score.

We don't look only at the jaw

Clenching during the day and grinding at night, stress, sleep quality, and tension and posture in the neck and shoulders. These are the background factors that tighten the muscles around the jaw.

In particular, the alignment of the neck and the jaw joint are functionally connected. That's why we also use a posture analysis to look at the alignment of the head, neck and shoulders. We've written up the evidence on neck and posture separately.

Our head director, Dr. Jihun Kim, completed the specialist course of the FCST society for TMJ balance medicine and has applied the relationship between the jaw and whole-body balance in his practice.

We start with treatments that can be reversed

The international principle for managing TMJ problems is to use reversible treatments first.

We begin with reversible options like education, habit management, acupuncture and manual therapy. Recommending irreversible treatment from the start, such as grinding down teeth to change your bite, doesn't fit this principle.

For reference, in an analysis pooling 48 clinical trials, the combination estimated to work best wasn't a special device, but treatment combined with counseling: education that deals with habits and contributing factors.

In other words, half of TMJ treatment is about dealing with habits.

We tell you both sides of the evidence as they are

For acupuncture, good-quality trials have reported less pain and a better range of mouth opening.

But in an analysis that compared it strictly with sham acupuncture, there is also an assessment that the evidence is limited.

We tell you both sides as they are, and check the effect with measurements as we go. If you'd like to see it with the literature, we've written it up in the TMJ evidence post.

We know when to work with others

If teeth grinding is severe and a dental appliance is needed, we refer you to a dentist. If a lock doesn't release or a structural problem is suspected, we check in partnership with the radiology clinic on the 2nd floor of the same building, then refer you for a detailed assessment.

Treatment follows this order

First, we sort things out. We look at whether the pain comes from the muscles or the joint, how far your mouth opens, whether it has ever locked, your grinding and clenching habits, and your sleep and stress. If it only makes noise, we give you guidelines for watching it instead of treatment.

Second, we use reversible treatments. We use acupuncture and pharmacopuncture (herbal acupuncture) to ease pain and tension in the muscles around the jaw, and Chuna (Korean manual therapy) to work on the balance of the neck and jaw together. Alongside treatment, we work on noticing when you're clenching during the day, managing habits like chewing on only one side or resting your chin on your hand, and education about sleep and stress.

If poor sleep has made grinding worse, we work on the sleep problem too.

Third, we check in millimeters. At each reassessment, we compare your mouth opening and pain score with the ones measured before treatment. We don't repeat treatment that isn't working. If an appliance is needed, we recommend a dentist; if a structural problem is suspected, we recommend a detailed assessment.

What changes

A morning when you don't have to hold back a yawn. A lunch where you don't skip the chewy foods on the menu. And a night when a small click from your jaw no longer sends you searching online.

That ordinary day is what we're aiming for.

How things progress differs from person to person, depending on whether it's muscle- or joint-related, grinding habits and stress, and the state of your sleep.

Today's takeaway

If your jaw only makes noise, just remember the three groups in this post.

If your jaw has started to hurt, get a baseline measurement before your range of opening shrinks. That number is what lets you know later whether it has improved.

The order in which we examine the jaw is laid out in our treatment guide.

For questions or appointments, message us in English through the messenger at the bottom right of the page, or call +82-53-716-1175.