Clicking jaw, right side only, probably chewing gum related

[TooManyFillings]

A few weeks ago I started to notice that my jaw was clicking a lot on the right side, not when talking but when eating or chewing gum.

I tend to chew gum (sugar free) a LOT and have been doing so for years - I suffer with IBS and get a dry mouth and many unpleasant tastes and the gum helps.

For the past few weeks I've only been chewing gum on the right side only because I have a tooth issue on my left side which is due to be treated soon.

I've stopped chewing gum now (as of today!). I suck a sugar free sweet instead if required.

The right sided click occurs as I close my mouth, not when opening it. It can also sometimes occur if my jaw is closed and I move my lower jaw left to right.

As a rule there's no pain when this happens - the click is mild to moderate in terms of the feel of movement and the sound it makes (coincidentally my right ear is also bunged up with wax at the moment - this occurs yearly and I'm due to have that wax sucked out this week - I think that the bunged up ear is also perhaps magnifying the sound of the click?). A few weeks ago I did once experience a noticely louder click/crack when yawning particularly widely - this was moderately painful but that's not happened since.

Sometimes there is a very slight ache in the right side of my face, around the top of the cheekbone. Sometimes a mild ache mid cheek.

A couple of weeks ago I saw my dentist about the clicking but on that particularly day it was easing off. She did though recommend that I stick to using my custom made mouth guard at night - I've had this for months but initially gave up using it after a few days as I couldn't get used to the feel of it in my mouth (no discomfort, it was just unusual). This helped when I used it again recently, as did me stopping chewing gum for a few days, but a few days ago I stopped using the guard again and started chewing the gum once more ........ my fault entirely as a combination of those two has caused the clicking to return, and this time it's more persistent.

Any recommendations or advice please?

Any exercises that I should do?

Obviously no chewing gum, use the mouth guard at night, stick to soft food for a while, avoid yawning widely (place hand under jaw when about to yawn), etc. Anything else?

My main concern is that I may dislocate my jaw, but I assume this is very unlikely?

 

[Gordon]

Obviously no chewing gum, use the mouth guard at night, stick to soft food for a while, avoid yawning widely (place hand under jaw when about to yawn), etc. Anything else?

No, that's about it. Avoid taking big bites of food if you can and try to eat more with a chopping action than a grinding one if you can manage it. Not very important that you do though, the main things would be the guard, then the gum.

My main concern is that I may dislocate my jaw, but I assume this is very unlikely?

Doesn't work like that, so not a problem. Dislocation is due to over opening and the condyle (the ball bit of the ball and socket joint) sliding too far forward and out of the socket.

 

[TooManyFillings]

Thanks for the advice. I will be extra careful about yawning too.

Meant to also add that I sometimes feel a little pain around the jaw hinge when moving the jaw side to side.

Is the clicking sound 'bad' in the sense that every time it clicks some extra wear is occurring in the joint?

What exactly is the cause of all this though? I mean yes, obviously the chewing gum, but am I basically experiencing a kind of muscle strain on the right side and due to the muscle not working correctly the condyle is moving around too much (or too little?) in the socket?

 

[TooManyFillings]

Something that I forgot to mention - the right side of my jaw only clicks (intermittently) if I close it 'normally', in other words where my upper incisors are slightly overlapping the lower teeth. However, if I close my mouth with my upper and lower incisors perfectly aligned (as if trying to bite something in half) then there's never a click, the same applies if I push the lower jaw forward a bit so that the lower incisors are in front of the upper.

I can also temporarily get rid of the clicking (when closing my mouth normally) by briefly and carefully pressing upwards on my lower jaw with my thumb or fist. I will then often hear a brief click but after removing my thumb or fist then no other clicks for maybe seconds or sometimes minutes whenever I close my mouth.

So I assume that there does seem to be some slight misalignment in the right jaw joint, almost as if it's ever so slightly too far back perhaps (a millimeter or two at a guess?) due to how I can relieve it as outlined above?

Not sure if any of that is relevant.

 

[Gordon]

Is the clicking sound 'bad' in the sense that every time it clicks some extra wear is occurring in the joint?

No, it's harmless.

So I assume that there does seem to be some slight misalignment in the right jaw joint, almost as if it's ever so slightly too far back perhaps (a millimeter or two at a guess?) due to how I can relieve it as outlined above?

Maybe, maybe not.

You're risking falling into the TMJ rabbit hole here Be careful what you believe from Dr Google, there's an awful lot of quackery associated with TMJ issues!

One of the issues with TMJ problems is that they can often heal up spontaneously so it's hard to be sure what actually works and what doesn't, add in the fact that it attracts the "alternative" healthcare crowd for some reason and it's a bit of a perfect storm.

Basically, I suggest that you give the splint/cutting down the parafunction (the gum chewing) a try, then see what happens

 

[TooManyFillings]

Thanks again Gordon for the advice.

Noted regarding the TMJ rabbit hole!

I've not had any chewing gum for a few days, also been wearing the custom mouth guard at night. I've not been chewing any food either, sticking to a liquid/soft food diet for now. This morning when I got up there was no clicking at all, then as soon as I started to be more active (doing minor jobs around the house) it started back up again.

Bit of an ache still at times in the cheek/upper cheek area, sometimes when I open my mouth a bit wider (been avoiding that for a few days) but that's muscular I guess? No pain at the joint though.

 

[Gordon]

Bit of an ache still at times in the cheek/upper cheek area, sometimes when I open my mouth a bit wider (been avoiding that for a few days) but that's muscular I guess? No pain at the joint though.

Maybe, the muscles and joint are very tightly integrated and share the same nerve supply so...

The TMJ is a really interesting joint actually, it's totally unique in the body being able to slide and rotate, other joints can only do one or other. The chewing muscles (muscles of mastication to be technical!) are also unique in that the motor control for them is delivered by a sensory nerve, all other muscles in the body are controlled by motor nerves or the autonomic nerves.
See that's me falling into the rabbit hole now!

 

[geos]

A dentist once told me when we have a sore ankle, we rest it until it feels better and then slowly get back to using it. For TMJ and the muscles related to the jaw, it’s impossible to fully rest since we need to use them daily. So the best thing to do is reduce the stress on them. The other thing to remember is that it took time before you started noticing the issues. It will also take time to get back to a full normal. Once you find what makes you feel better, you will have your own tool box of methods to use and it will be quicker to get the pain under control.

 

[TooManyFillings]

Maybe, the muscles and joint are very tightly integrated and share the same nerve supply so...

The TMJ is a really interesting joint actually, it's totally unique in the body being able to slide and rotate, other joints can only do one or other. The chewing muscles (muscles of mastication to be technical!) are also unique in that the motor control for them is delivered by a sensory nerve, all other muscles in the body are controlled by motor nerves or the autonomic nerves.
See that's me falling into the rabbit hole now!

Rabbit holes can be fun - thanks for the extra info, these things always interest me.

 

[TooManyFillings]

A dentist once told me when we have a sore ankle, we rest it until it feels better and then slowly get back to using it. For TMJ and the muscles related to the jaw, it’s impossible to fully rest since we need to use them daily. So the best thing to do is reduce the stress on them. The other thing to remember is that it took time before you started noticing the issues. It will also take time to get back to a full normal. Once you find what makes you feel better, you will have your own tool box of methods to use and it will be quicker to get the pain under control.

Good point - very difficult to rest the jaw completely (without having it forced closed, and that in itself would cause other issues - liquid diet (food through a straw), muscle's stiffening up, etc).

 

[TooManyFillings]

So, for the second morning there's been no clicking at all. Yesterday that lasted for about an hour and when I started doing to minor chores around the house it started back up again.

Today I didn't do anything for the whole morning and there was no clicking at all, but as soon as I started doing some minor house chores it started back up again.

I wonder what mechanism is causing the clicking to start up when I do minor house chores (often involving some bending down, etc)?

 

[Gordon]

Are you aware of any clenching of your jaw when you're doing these chores?
Sounds like a great excuse to get out of doing the dishes to me

 

[TooManyFillings]

Bit of an update on this if it's of any interest - the clicking did mostly ease off for about a week but then I went back to chewing gum a little bit again (but not much, think of it as a test) and it's come back. As mentioned above it's completely absent in the morning until either:

a) I start eating anything that requires a moderate amount of chewing (or chewing gum)

b) As noted above, once I start doing a number of chores (inside or outside) it starts up again and then lasts the rest of the day, easing off again overnight.

So the solution seems to be to exist on a liquid diet and not to do any chores or physical work .....

Note that when it's clicking this only happens as I close my mouth with a normal bite, therefore the top teeth slightly in front of the bottom teeth. If I push my lower jaw forward slightly (or just bite close the jaw to get the front teeth directly above the lower teeth) the click doesn't occur.

 

[Kml1998]

The clicking sound is just the sound of salvia moving in between your teeth

 

[Gordon]

Have you started wearing your nightguard again?

Pushing your jaw forward is putting more strain on your joints. Don't!