Latest / Oral Surgery Answers with Dr. Juan Lopez / Jaw Clicking: Here's What It Actually Means [When You Should Worry]

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Jaw Clicking: Here's What It Actually Means [When You Should Worry] · Oral Surgery Answers with Dr. Juan Lopez

• 0:00
  SPEAKER_00: When you should worry when you hear jaw clicking.
• 0:03
  SPEAKER_00: Remember, there are clickings that can be without any symptoms, and there are clickings that are going to be with symptoms like pain.
• 0:11
  SPEAKER_00: Clicking is just the interposition of the movement of the disc either forward or backward and not in relation in a synchronous way when you open your jaw, when you eat, etc.
• 0:25
  SPEAKER_00: etc.
• 0:26
  SPEAKER_00: So when you hear a click and suddenly when you're eating or when you're yawning or even opening your mouth, you have to understand that something is happening there.
• 0:36
  SPEAKER_00: That's the initial assessment.
• 0:38
  SPEAKER_00: I'm going to tell you five important points that are cavit points so you can understand a little bit about clicking or temporomandibular dysfunction.
• 0:48
  SPEAKER_00: The joint on the what we call temporandibular joint is the same as the knee or very similar.
• 0:55
  SPEAKER_00: It's a joint.
• 0:56
  SPEAKER_00: It has muscles, you have ligaments, and it has a disc or menisc.
• 1:00
  SPEAKER_00: And that disc or menisc, as in the knee, works to give you lubrication, to give you support, and to act as a shock absorber.
• 1:09
  SPEAKER_00: So your movements when you open, when you chew, when you swallow are smooth without pain.
• 1:15
  SPEAKER_00: Everything is based on the T.
• 1:16
  SPEAKER_00: So here it comes again.
• 1:18
  SPEAKER_00: If you miss a tooth or you don't replace a tooth that you lost, it's gonna affect your joint.
• 1:24
  SPEAKER_00: And everybody knows that when you're running, you do a lot of marathons, and suddenly you start feeling pain on that knee.
• 1:31
  SPEAKER_00: Well, everybody understands maybe it's because I'm wearing off this knee.
• 1:35
  SPEAKER_00: Well, the knee can have rest, but the joint on the temporal mandibular joint won't have rest.
• 1:42
  SPEAKER_00: And the first point that I want to make you aware is that at night, when you're sleeping, you might be grinding or you might be clenching.
• 1:51
  SPEAKER_00: Or in the morning, when you're sore in the angle and that pain translates into headaches or migraines, something is happening there.
• 1:59
  SPEAKER_00: That joint is not resting.
• 2:02
  SPEAKER_00: An easy way to see this is to go into your front mirror and see if you have shiny surfaces on the front of the teeth.
• 2:10
  SPEAKER_00: They are called wear facets.
• 2:12
  SPEAKER_00: And that will be an indication that you're grinding.
• 2:15
  SPEAKER_00: When we grind, we move the jaw side to side.
• 2:18
  SPEAKER_00: When we clench, we put extremely pressure into the surfaces of the teeth.
• 2:24
  SPEAKER_00: And that pressure accumulated overnight and night is gonna create a problem on the joint eventually.
• 2:30
  SPEAKER_00: Now, what happens when that menisc or disc doesn't go back to the original position?
• 2:36
  SPEAKER_00: Is when you start thinking, okay, something's happening with my mouth.
• 2:40
  SPEAKER_00: I cannot close my mouth or I cannot open.
• 2:43
  SPEAKER_00: It's called an open lock, a closed lock.
• 2:45
  SPEAKER_00: Something is happening with that menisc.
• 2:47
  SPEAKER_00: It's not doing the function, or maybe you don't hear that clicking anymore.
• 2:53
  SPEAKER_00: You just hear bone-to-bone contact.
• 2:55
  SPEAKER_00: Those are the worst cases.
• 2:57
  SPEAKER_00: Those are the cases that I treat on a daily basis.
• 3:00
  SPEAKER_00: Uh TMJ dysfunction can be resolved.
• 3:04
  SPEAKER_00: And it can be resolved if you adhere to several habits, to eliminate parafunctional habits, and to treat those before you try other ways of replacing teeth or implants, etc.
• 3:17
  SPEAKER_00: etc.
• 3:18
  SPEAKER_00: Remember, when you're awake and you're clenching, you will notice, oh, I'm clenching.
• 3:22
  SPEAKER_00: So you stop, you give it my rest.
• 3:24
  SPEAKER_00: When you're asleep, you don't know.
• 3:26
  SPEAKER_00: You're just clenching and clenching, you put in extreme pressure in the teeth, and that's why you're sore in the morning.
• 3:33
  SPEAKER_00: And one of the typical uh comments on patients is I think I never sleep well.
• 3:40
  SPEAKER_00: I had a lot of pain at morning, and then during the day I get better.
• 3:45
  SPEAKER_00: So if that clickin has turned into pain or is catching or is not moving, there's a link in the description to set an assessment.
• 3:54
  SPEAKER_00: I'm in South Florida.
• 3:56
  SPEAKER_00: My name is Dr.
• 3:56
  SPEAKER_00: Juan G.
• 3:57
  SPEAKER_00: Lopez.
• 3:58
  SPEAKER_00: I'm a diplomat of the American Board of Oral and Maxillofacial Surgeons.
• 4:02
  SPEAKER_00: So I can help you in this.
• 4:04
  SPEAKER_00: Now let's look at several things.
• 4:07
  SPEAKER_00: What happened when the joint starts moving?
• 4:11
  SPEAKER_00: In other words, you're in an open lock or a closed lock and you start trying to massage the area, but it's not opening.
• 4:18
  SPEAKER_00: Or you went to your dentist, they did a two-hour treatment, and suddenly the next day you cannot close.
• 4:25
  SPEAKER_00: So these are the things you have to start considering now.
• 4:28
  SPEAKER_00: And the most important thing that I can tell you is never lose a tooth.
• 4:34
  SPEAKER_00: Because once you lose a tooth, you're creating an extra problem to that joint.
• 4:40
  SPEAKER_00: Now, if that click starts or turns into a grind, like I was saying, bone-to-bone contact, maybe the disc is not there.
• 4:48
  SPEAKER_00: Those are the cases that I see on a daily basis.
• 4:51
  SPEAKER_00: And if the disc is not there, you're exerting pressure bone to bone, and that is extremely painful.
• 4:58
  SPEAKER_00: So you have to address this before it gets more complicated.
• 5:03
  SPEAKER_00: And although there are a lot of treatments for temporal mandibular dysfunctions, well, in my hands, I always start with a conservative therapy.
• 5:11
  SPEAKER_00: It can help a lot.
• 5:13
  SPEAKER_00: Physical therapy, artrosynthesis, which is basically a lavage, an irrigation of the joint, and you do this under ivisidation, application of substance that will regenerate the disc or will actually create a better environment of lubrication to that disc.
• 5:31
  SPEAKER_00: And believe me, it helps.
• 5:32
  SPEAKER_00: The splints, the diet modifications, the physical therapy, the lavage or artrosynthesis, and the application of regenerative substances in the joint will help you avoid surgery for at least 10-15 years.
• 5:47
  SPEAKER_00: There's another way to treat if that doesn't work.
• 5:50
  SPEAKER_00: Number two, you go through artroscopy.
• 5:52
  SPEAKER_00: Artroscopy is to do a small incision, go with a camera, and try to repair the minor affections that the joint has.
• 6:01
  SPEAKER_00: It's a less invasive, and we almost try to do those two procedures before jumping into a big surgery.
• 6:08
  SPEAKER_00: Who wants to jump into an open joint surgery or a TNJ replacement?
• 6:13
  SPEAKER_00: Those are the cases that I see when they have actually done anything to try to prevent the problem or to treat the problem when they first hurt the click.
• 6:23
  SPEAKER_00: Now, what happened if that patient cannot open the mouth?
• 6:27
  SPEAKER_00: Well, nutrition is going to be a problem, pain is going to be a problem, and eventually you're going to end on a temporal mandibular dysfunction treatment.
• 6:38
  SPEAKER_00: So, guys, it's important to realize what's going on.
• 6:42
  SPEAKER_00: Is because the menisc is giving you a problem, or is because it's a spasm of the muscles.
• 6:48
  SPEAKER_00: And they're two important muscles, masseter and temporalis.
• 6:52
  SPEAKER_00: Those are the referral areas where you wake up in the morning and you say, Oh, I have a migraine, I have a headache, because those muscles are very strong muscles that work in opening and closing the jaw.
• 7:04
  SPEAKER_00: Sometimes they have spasms because you kept your mouth open on a dental treatment for a long time.
• 7:11
  SPEAKER_00: Sometimes it's not the spasm of the muscle, it's the disc that is a problem.
• 7:15
  SPEAKER_00: And their 3D diagnostics to evaluate not only the structure of the bone of the mandible to see if there is any signs for arthritis or what we call MRI, where we will see if that disc is existent, inexistent, perforated, or luxated.
• 7:34
  SPEAKER_00: It's not in the right position because of lack of elasticity or amount of too much elasticity.
• 7:42
  SPEAKER_00: So the joint on the temporal mandibular dysfunction is something that you have to look into that because it's a serious problem.
• 7:49
  SPEAKER_00: And guys, I can tell you, it can be prevented.
• 7:52
  SPEAKER_00: There is different signs that you can see in your mouth, in the teeth, on the surfaces of those teeth that are showing me some problems that can arise from this.
• 8:04
  SPEAKER_00: Do the exercise.
• 8:05
  SPEAKER_00: As I was saying, go to a front mirror, dry your teeth, and see if you have shiny surfaces or maybe wear facets, meaning that you have slopes on those surfaces of the teeth.
• 8:18
  SPEAKER_00: Or maybe you have the experience of having a filling replaced several times until one day you say, Oh, the dentist doesn't know how to do the filling.
• 8:27
  SPEAKER_00: It's not the filling.
• 8:28
  SPEAKER_00: It's because you have what we call parafunctional habits, habits that are not normal, like for example, thumb sucking, objects in the mouth, grinding, clenching, using other devices in the mouth that can alter the position of the teeth.
• 8:45
  SPEAKER_00: So the ones that you have to really watch when you're dealing with TMJ is number one, locking.
• 8:51
  SPEAKER_00: Is your jaw getting locked?
• 8:53
  SPEAKER_00: Try it yourself.
• 8:54
  SPEAKER_00: If you can place three fingers in the mouth, probably you are in a normal aperture, a normal opening.
• 9:01
  SPEAKER_00: But if you cannot put more than two fingers in the mouth, there is a problem.
• 9:06
  SPEAKER_00: And that problem is called locking.
• 9:08
  SPEAKER_00: Why is the disc locking all the time?
• 9:12
  SPEAKER_00: Now you start to understand through all these videos that if you have grinding or clenching and you're missing a tooth, you cannot go and have an implant yet.
• 9:22
  SPEAKER_00: You will have it, but you have to treat the grinding and the clenching before so you don't have problems.
• 9:28
  SPEAKER_00: Remember, the implant doesn't move like it doesn't have a shock absorber.
• 9:32
  SPEAKER_00: So if you have a lateral force into that implant crown, you're probably gonna miss or you're gonna lose the implant.
• 9:39
  SPEAKER_00: So if you have more questions, that's what this channel is for.
• 9:43
  SPEAKER_00: And if you're in South Florida, there is a link in the description so you can set an assessment or consultation, and I can examine you and we can start a conversation that can save you thousands or moments of pain or embarrassment.