I wrote off my clicking jaw as just one of those things I had to learn to live with. But it wasn’t until I visited the dentist I realised that the common ‘quirk’ could be linked to a host of problems… and there IS help

About six months ago, after a lot of umming and ahhing, I decided to book an appointment at the dentist’s to see if I needed Invisalign again. 

I’d had the teeth-straightening treatment before, ten years ago and, while I was a fairly diligent wearer of my night-time mouthguard, I could feel my teeth moving. Better nip it in the bud now, I thought, so I booked my consultation with Dr Arti Shah.

As I reclined on the chair, Dr Shah asked me to open my mouth.

‘Do you feel that?’ she asked.

I didn’t know what she was talking about.

‘Open your mouth again,’ she instructed. So I did, though I was still clueless.

‘Your jaw clicks when you open your mouth,’ she told me.

So I opened my mouth for a third time, now paying attention to what she’d told me.

‘Oh, that?’ I replied. ‘I thought it was normal. I’ve never not known how to do that.’

Before I knew it, my consultation about straightening my teeth had turned into a lesson on the temporomandibular joint, better known as the TMJ – the small joints on either side of your face, just in front of your ears, which connect your lower jaw to your skull and allow you to talk, eat and yawn. They’re also among the most frequently used joints in the body.

I’d actually heard of TMJ before, because I’d been treated for it in the past. What I didn’t realise was that it had returned. 

The term TMJ is often used when talking about problems with the joint, but the condition itself is more accurately called temporomandibular joint disorder, or TMD. It can affect the joint itself, as well as the muscles and other structures involved in moving your jaw. Symptoms can include jaw pain or tightness, clicking or popping, difficulty opening your mouth fully, headaches and facial pressure. And, perhaps more surprisingly, problems such as earache and tinnitus.

‘It is far more common than people realise and often goes untreated because people assume it is just tension or a bad night’s sleep,’ says Dr Shah. ‘It becomes normalised.’

Which is probably why so many of us might be walking around with a clicking, aching or tense jaw without ever thinking to have it checked.

So, what actually causes TMD?

There isn’t one single cause. According to Dr Shah, she sees TMD in people of all ages, from teenagers who grind their teeth during exam periods to adults who clench through stressful jobs. Teeth grinding, daytime clenching, long hours at a desk, phone use and poor posture can all play a role.

Stress is a particularly big factor.

Think about what you do when you’re concentrating, driving, working at your laptop or feeling overwhelmed. If you’re anything like me, there’s a good chance you’re clenching your jaw without even noticing.

‘People clench without realising, especially when concentrating or feeling overwhelmed,’ says Dr Shah. ‘Grinding at night is extremely common and puts a lot of pressure on the joint.’

And it’s not only your jaw that can feel the effects.

‘When your head sits forward, your jaw muscles tighten to stabilise your bite,’ she explains. ‘Over time, this creates strain that can affect the way you walk and hold your shoulders.’

Airway health can also be a factor, according to Dr Shah, who says people experiencing breathing restrictions or snoring can sometimes find their jaw comfort is affected too.

It’s not always about jaw pain

This is where things get interesting. When you think about a jaw problem, you probably expect, well, a problem with your jaw. But some of the symptoms associated with TMD can seem completely unrelated.

‘The surprising symptoms are the ones that do not feel connected to the jaw at all,’ says Dr Shah. ‘Earache, tinnitus, dizziness, neck pain, shoulder tension and even changes in posture.’

Some patients, she says, report feeling off balance or notice that their bite feels different from one day to the next.

There’s a reason for this, she explains. The muscles around your jaw are connected to your head, neck and shoulders, so when the joint is strained, the surrounding muscles can work harder to compensate. Dr Shah says this can affect the way the upper body holds itself and can sometimes influence posture, gait and breathing patterns.

She also regularly sees patients who come to her with jaw pain but mention other symptoms such as poor sleep, tension headaches, pressure behind the eyes or a feeling of heaviness in their neck.

That doesn’t mean your jaw is necessarily the explanation for every headache, sore neck or bad night’s sleep. But if you’re experiencing several of these symptoms together – particularly alongside jaw clicking, tightness or clenching – it may be worth mentioning to your dentist.

Could your headache actually be coming from your jaw?

Headaches are one of the more common symptoms Dr Shah sees in people with TMD. The location and timing of your pain can sometimes provide clues.

‘If your headaches sit around the temples, behind the eyes or across the jawline, TMJ may be involved,’ she says.

An unexplained earache can also be a sign, particularly if there’s no infection. Dr Shah says some patients describe a deep ache in front of the ear or a feeling of fullness, while others experience tinnitus, or ringing in the ears.

And if the pain becomes worse when you’re chewing or talking for long periods, or you notice it particularly when you wake up in the morning, your jaw may be part of the picture.

Why does stress make it worse?

It’s not just that stress makes you feel tense. It can change what your jaw is physically doing, too.

Many people clench their teeth subconsciously during the day, while stress can also contribute to grinding at night. That repeated pressure puts extra strain on the muscles and joint. Dr Shah’s patient guidance notes that the connection between stress, anxiety and TMD is well established, while poor sleep and insomnia are also more common among people experiencing TMD.

Which is why looking after your jaw isn’t necessarily about your jaw alone. Improving sleep, finding ways to manage stress and becoming more aware of when you’re clenching can all be part of managing the problem.

Dr Shah’s advice is simple: ‘Your jaw is not designed to carry tension.’

If you catch yourself clenching, she recommends gently relaxing your tongue so that it rests against the roof of your mouth. Her patient guide has another useful mantra: ‘Lips together. Teeth apart.’

What happened with my jaw?

In my case, my TMD was mainly muscle- and stress-related. It wasn’t particularly painful and, had Dr Shah not pointed it out, I probably would have continued to think the clicking was completely normal.

What I had noticed was that I had to move my jaw slightly to the right to open my mouth fully. What I hadn’t realised was that the uneven forces and muscle tension were also affecting my bite alignment and contributing to my teeth shifting out of position.

But there’s an important distinction here: I didn’t get Invisalign to treat my TMD. I went to see Dr Shah because I wanted to straighten my teeth.

She prescribed an initial 13-week course of Invisalign Lite, followed by a second 13-week course, which I’m now coming to the end of. The aim was to straighten my teeth and improve my bite. But, as a rather nice side-effect, I found that my jaw symptoms improved, too.

As part of the treatment, the aligners slightly separate the teeth, which can give the muscles a little more room to relax. And while treating my teeth wasn’t intended as a treatment for my TMD, my clicking has now basically disappeared.

It’s made me realise how easy it is to get used to something your body does every day. I’d had that click for so long that I’d stopped noticing it. I’d also never considered whether the tension in my jaw might be connected to stress, my bite or the headaches and neck tension I occasionally experienced.

So, what can you do to protect your jaw?

The good news is that managing TMD doesn’t necessarily mean invasive treatment. Dr Shah recommends starting with simple changes to your everyday habits, with treatments such as bite splints, muscle therapy and physiotherapy used where appropriate.

First, become more aware of clenching. Pay attention to whether your teeth are touching when you’re not eating. If they are, consciously relax your jaw and tongue. 

Next, look at your posture. If you spend hours at a desk or looking down at your phone, take regular breaks and try to keep your head stacked over your shoulders. Dr Shah says even small changes to your alignment can help reduce the strain placed on your jaw.

It’s also worth giving your jaw a break. Dr Shah’s patient guidance recommends minimising habits that place additional strain on the joint, including chewing gum, biting your nails, chewing pens and regularly eating particularly hard, crunchy or chewy foods.

And finally, don’t underestimate the role of stress. Relaxation techniques, deep breathing and mindfulness can all be useful ways to manage the tension that may be feeding into your jaw. Dr Shah also recommends prioritising good-quality sleep.

A warm compress can also help if your jaw muscles feel tense or uncomfortable. Dr Shah recommends applying moist heat to the affected muscles for around 15 minutes, twice a day.

When should you get your jaw checked?

So, should you panic if your jaw clicks? Probably not. A click on its own doesn’t necessarily mean there’s a serious problem, particularly if you don’t have pain or difficulty moving your jaw.

But if your symptoms persist, it’s worth getting them checked.

‘If symptoms last for more than a couple of weeks, keep returning, or start affecting your daily life, it is worth getting checked,’ says Dr Shah.

A dentist is usually the best place to start, as they can assess your jaw joint, bite, muscles and any signs of grinding. If necessary, they can also work with a physiotherapist or other medical professional to address factors such as posture and stress.

As for me, I’m now much more conscious of my jaw than I ever was before. I notice when I’m clenching. I notice when I’m hunched over my laptop. And, perhaps most importantly, I no longer think that little click is just something I have to live with.

It turns out, sometimes the things you’ve always assumed are ‘normal’ are worth asking about.

Find Dr Arti Shah at Artistry Dental