Volume 7 • 2020 • Issue 5

Managing Patients with Clicking Joints In this article, Dr. Tom Shackleton, a frequent CDA contributor and general dentist, shares his expertise and experience in diagnostics, treatment protocols and how to manage patients with clicking joints. In his own practice, Dr. Shackleton places significant focus on oral medicine and facial pain. A bout one-third of the population aged 18 to 55 experience clicking joints. In the majority of cases, clicking joints are asymptomatic and do not cause any pain or disfunction and are characterized only by a click on opening or closing the mouth, or both. Caused by either micro- or macro-trauma, a clicking jaw is often the result of displaced cartilage between the mandible and maxilla. Typically, that cartilage is displaced anteriorly but sometimes it is anterior/medially or less commonly, posteriorly. As the joint rotates and the disc begins to slide, the condyle pushes up against the disc until the discs snaps back or clicks into place. This is the reduction i.e., when two things are out of physiological alignment and then go back into alignment. Dr. TomShackleton is a general dentist inCalgary where he has been practising for the past 20 years. He is a graduate of NorthwesternUniversity Dental School. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. Disc Displacement With Reduction Many patients present with symptomatic or asymptomatic clicking joints often related to an internal derangement of the temporomandibular joint. This is known as disc displacement with reduction. Joint clicking is often the result of micro- or macro-trauma. • Micro-traumas are caused by daily repetitive strain such as jaw clenching, cheek biting, lip biting, constant gum chewing, or nighttime bruxism. • Macro-trauma is caused by a single event like a blow to the jaw, for instance an airbag to the face or jaw. S upporting Y our P ractice 26 | 2020 | Issue 5