By Sereina Urech, physiotherapist and Head of Operations, Kineo Seefeld
Clicking when you open your mouth, chew or yawn
Many people hear or feel a clicking in the jaw joint, for example when biting, chewing or yawning. This is common and often harmless on its own. What matters is what else comes with it.
Where does the clicking come from?
In the temporomandibular joint (TMJ), a small disc of cartilage, the articular disc, lies between the condyle and the joint socket. It glides along every time you open your mouth. If it is displaced slightly forwards, the condyle jumps over it as you open, and it clicks. On closing, the disc slips out again, sometimes with a second, quieter click.
Harmless or in need of assessment?
Usually harmless if:
- the clicking is painless
- you can open your mouth normally wide
- it has been unchanged for a long time
Get it checked if:
- pain in the joint, at the temple or in front of the ear comes with it
- your jaw briefly gets stuck or locks
- you can't open your mouth as wide as before
- the clicking suddenly stops and at the same time opening is restricted
- headaches, ear pressure or neck tension become more frequent
Common contributing factors
- Teeth grinding and jaw clenching
- Tense chewing muscles
- Forward head posture at the screen
- Stress
- Previous injuries to the jaw or whiplash
What you can do yourself
- Avoid opening very wide, for example when yawning, place your tongue against the roof of your mouth
- Reduce hard and tough food, leave out chewing gum
- Keep your jaw in its resting position: teeth not touching
How we treat the jaw joint
Whether clicking needs treatment depends on the accompanying symptoms: pain, restricted opening or a jaw that gets stuck. We work according to the CRAFTA concept, a specialist physiotherapy concept for the jaw, head and face.
1. Assessment: what we examine in your first session
- Measuring mouth opening: We measure the opening between the cutting edges of the teeth in millimetres. Around 40 to 50 mm is normal. Less suggests a blockage in the joint or tense chewing muscles.
- Observing the opening path: Does the lower jaw deviate to one side when opening and return to the centre, or does it stay at the side? The pattern shows whether the joint disc or the muscles are more involved.
- Identifying the sounds: If it clicks at different points on opening and closing, this suggests a displaced joint disc that jumps back into place. Grinding suggests changes to the joint surfaces.
- Palpating the chewing muscles: Masseter, temporalis and, from the inside, the lateral pterygoid muscle. We check which points trigger your familiar pain.
- Testing the cervical spine: With the flexion-rotation test we check the mobility of the upper neck vertebrae, and with the cranio-cervical flexion test the endurance of the deep neck flexors.
- Asking about habits: Clenching during the day, grinding at night, sleep, stress and headache patterns are part of the assessment.
2. Treatment in phases
- Clicking without pain and with free opening: Education, the right resting position and a few exercises are usually enough. We check again after a few weeks.
- Clicking with pain: First we ease the muscles and joint, then we train a guided, straight opening with the tongue staying on the roof of the mouth. This teaches the joint to work without a deviating movement.
- Jaw gets stuck or no longer opens fully: Acting quickly is important here. With targeted mobilisation, opening can often be improved considerably. We measure progress in millimetres.
- In the long term: Recognising clenching and grinding, training posture and neck, and if needed a splint with your dentist.
3. Kineo services we use
- Manual jaw therapy: mobilisation and gentle traction of the jaw joint, treatment of the chewing muscles including from the inside
- Manual therapy of the cervical spine, because head posture changes the position of the lower jaw
- Trigger point treatment on the chewing, neck and shoulder muscles
- Dry needling of the masseter, when the muscle is very tense
- Medical massage for the neck and jaw muscles
- Craniosacral therapy: Gentle hand techniques on the skull, neck and jaw, which help many people lower their baseline tension
If your bite or teeth are involved, we work together with dentists and orthodontists.
Self-test in front of the mirror
- Slowly open your mouth as wide as you can. Do three fingers stacked on top of each other fit between your front teeth?
- Check whether your lower jaw moves straight down or deviates to one side.
- Place your fingers in front of your ears and feel whether and when it clicks.
Opening of less than two fingers, a clear deviation or pain are good reasons to get it checked.
Train your posture, don't just correct it
If you push your head forward at the screen, you change the position of the lower jaw and increase tension in the chewing and neck muscles. A constant "sit up straight!" helps little. It is more effective to strengthen the muscles that hold your head well by themselves:
- Chin tuck: While sitting or against a wall, slide your chin slightly back as if making a double chin. Hold for 5 seconds, 10 repetitions. This strengthens the deep neck muscles
- Mobilise the thoracic spine: A mobile upper spine makes an upright head position easier, for example with rotations on all fours
- Activate the shoulder blades: Rowing with the resistance band keeps the shoulders back and takes strain off the neck
These are exactly the elements that are central to Pilates: a stable core, an upright spine and a relaxed neck. In the classes at Kineo Fitness in Zollikon and Thalwil, you can practise this under guidance.
From our practice
We see the most common mistake again and again: many people wait too long and only come when the jaw locks or hurts constantly. If you come at the first signs of pain, you usually need far fewer treatments.
Jaw therapy at Kineo Seefeld
At Kineo Seefeld, Seefeldstrasse 83 in 8008 Zürich, treating the jaw joint is one of our specialities. We examine the opening movement closely and, if needed, work together with dentistry. You can easily reach us from the Feldeggstrasse stop.
At other locations too: Seefeld is our jaw therapy centre of expertise. But you will also find specialised physiotherapists for jaw therapy in Wipkingen, at Stauffacher, in Escher Wyss, in Thalwil and in Zollikon. This way you can get treatment close to where you are.
Frequently asked questions
Can a clicking jaw joint go away on its own?
Yes, that happens. As long as it is painless and you can open your mouth normally, treatment is usually not needed.
What should I do if my jaw locks?
Don't force it open. Get it checked promptly; physiotherapy can often improve mobility well.
Do I need a prescription?
To claim through health insurance, you need a doctor's prescription. Ask your GP.
How long does an appointment last?
A physiotherapy appointment at Kineo lasts 30 minutes. In the first session we clarify the cause and start straight away with treatment and first exercises.
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Book an appointment
Is your jaw clicking and hurting? Book your appointment at Kineo Seefeld.
