Can Uneven Jaw Length Cause Clicking Sounds When Opening Mouth?

Q: Can Uneven Jaw Length Cause Clicking Sounds When Opening Mouth?

Hello： The primary treatment goal of orthodontics should be to achieve proper alignment of the teeth. <br>Other related issues (such as facial appearance and joint clicking) may improve as well, but if expectations are set too high, the outcomes may not meet those expectations. <

Asymmetrical length of the right and left sides of the mandible can cause a clicking sound when opening the mouth to its maximum extent?

Hello, Doctor.
I am 20 years old and visited a dentist when I was 11, during which X-rays were taken.
The doctor's findings were as follows: 1.
The upper jaw is developing slowly (as indicated by the lateral X-ray), and it can be corrected (though it seems to only address the issue of the crossbite, the doctor did not specify).
2.
The doctor measured the right side of the lower jaw at an angle of 74.19 mm and the left side at 71.55 mm, with a difference of 2.6 mm (measured on the X-ray screen).
3.
The doctor stated that the angle of the upper and lower jaw misalignment would not change; however, as my facial structure grows, the lateral distance of the misalignment will increase.
Recently, in September 2023, I consulted an orthodontic specialist who took a full-mouth X-ray and a 3D scan.
The doctor indicated: 1.
The upper dental arch is V-shaped due to nasal allergies.
2.
The front incisors have a normal occlusion, but there is an internal bite on the upper right canine.
3.
The upper and lower incisors are aligned (though there was a slight misalignment of about 0.3 teeth distance in childhood).
4.
The orthodontic plan is as follows: (1) first, to place a palatal expander to widen the upper dental arch into a U-shape to reduce the internal bite on the upper right canine; (2) then extract the upper and lower wisdom teeth; (3) proceed with braces.
I have noticed that when my mouth is closed, my face appears symmetrical, but when I open my mouth, it gradually tilts to one side, and at maximum opening, there is a popping sound before it returns to a neutral position.
(Note: There is no popping sound if I do not open my mouth fully.)
I would like to ask:
1.
Is the asymmetry in the lengths of the right and left sides of the lower jaw causing the gradual tilting when opening my mouth and the popping sound at maximum opening?
2.
Will the orthodontic plan proposed by the specialist resolve the issue of the gradual tilting and popping sound when opening my mouth?
3.
Or is the gradual tilting and popping sound not caused by the difference in lengths of the right and left sides of the lower jaw, but rather due to damaged or displaced articular discs, ligaments around the discs, or other reasons?
4.
What treatment options are available for the causes mentioned in question 3?
Thank you for your guidance.

Hao, 20~29 year old female. Ask Date: 2023/09/19

Dr. Lin Jiayong reply Dentistry

Hello: The primary treatment goal of orthodontics should be to achieve proper alignment of the teeth.
Other related issues (such as facial appearance and joint clicking) may improve as well, but if expectations are set too high, the outcomes may not meet those expectations.
If temporomandibular joint (TMJ) issues are significantly troubling you, consider visiting a clinic or hospital that has both oral and maxillofacial surgeons and orthodontists for coordinated treatment, which may even include orthognathic surgery, to better achieve your goals.

Reply Date: 2023/09/19

More Info

The clicking sounds you experience when opening your mouth, particularly when it is accompanied by a gradual deviation to one side, can indeed be related to the uneven length of your jaw. This phenomenon is often associated with temporomandibular joint (TMJ) disorders, which can arise from various structural and functional issues within the jaw and surrounding muscles.

1. Jaw Length Discrepancy and Clicking Sounds: The difference in length between the right and left sides of your mandible (lower jaw) can lead to an imbalance in how the jaw functions. When the jaw opens, if one side is longer, it may cause the jaw to deviate to the shorter side. This misalignment can create tension in the muscles and ligaments around the TMJ, leading to the clicking sound you hear when you fully open your mouth. The clicking often occurs when the articular disc within the TMJ moves out of its normal position during jaw movement, which can be exacerbated by uneven jaw lengths.

2. Orthodontic Treatment Plan: The orthodontic treatment plan proposed by your specialist aims to address the underlying issues contributing to your symptoms. By using a palatal expander to widen the upper dental arch, the goal is to create a more balanced occlusion (bite) and reduce the internal bite discrepancies, such as the overbite on the right upper side. Following this, the extraction of wisdom teeth and the application of braces will further align your teeth and improve jaw function. If the treatment is successful, it should help alleviate the clicking sounds and the deviation of your jaw during opening.

3. Other Causes of Clicking Sounds: While the uneven jaw length is a significant factor, other potential causes for the clicking sound include damage to the articular disc of the TMJ, ligamentous laxity, or muscle tension. If the disc is displaced or if there is inflammation in the joint, these conditions can also lead to similar symptoms. It is essential to consider these factors, as they may require different treatment approaches.

4. Treatment Options: Depending on the underlying cause of your symptoms, treatment options may include:
- Physical Therapy: Exercises to strengthen the jaw muscles and improve flexibility can help alleviate tension and improve jaw function.

- Occlusal Splints: These are custom-made devices that can help stabilize the jaw and reduce strain on the TMJ.

- Medications: Anti-inflammatory medications or muscle relaxants may be prescribed to manage pain and inflammation.

- Surgical Options: In severe cases where conservative treatments fail, surgical intervention may be necessary to reposition the disc or repair damaged structures within the joint.

In conclusion, your symptoms of jaw clicking and deviation during mouth opening are likely related to the uneven length of your jaw, but other factors such as TMJ dysfunction may also play a role. The orthodontic treatment plan you are undergoing should help address these issues, but it is crucial to monitor your symptoms and communicate with your healthcare provider about any changes or concerns. Regular follow-ups will ensure that your treatment is on track and that any additional issues can be addressed promptly.

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