Hi all of my wonderful TMJoiners! I’m Priya Mistry the TMJ doc and today I’m
going to be talking about disc displacement with reduction, which is basically a really fancy way
of saying “popping or clicking” inside the jaw joint. Does your jaw joint pop or click?
Is it painful? Does it annoy you or others around you while you’re chewing or while you're speaking?
Has it ever locked or gotten stuck? If so, this is the video for you! Be
sure to watch until the end so you can get the answers to those questions and more!
Before getting into it, be sure to check me out on TikTok,
my other social media, and be sure to check out my website for quick, efficient tips on TMJD
and more. There's tons of information in all of those resources. For those of you who don’t
know me, my name is Priya Mistry and I’m a general dentist with a practice dedicated to
taking care of patients with TMJ disorders. My practice is in beautiful Vancouver, Washington.
So let’s get right into it. Before I explain exactly what's happening with the popping and
clicking inside the jaw joint, it's important that we define some terminology and the anatomy of the
jaw joint. Let's start with the term "disc". What am I talking about when I say "disc"?
Inside of our jaw jaw joint, there's a little disc of cartilaginous tissue that
sits between the bony components of the joint serving as a shock absorber or a cushion.
This disc is also called the "articular disc" - that's the correct term for it. When I say
the word “displacement", I'm referring to the disc not being in its ideal or normal position. Lastly,
the term “reduction” is a medical term used to indicate when something is back in its proper
alignment or its proper position. In this case, “reduction” does not mean a removal or a decrease.
Next, let’s go over some anatomy. So like I mentioned before,
articular disc sits between the bony components of the joint, serving as a shock absorber
or a cushion. The bony components of the joint include the condyle, which is the little bony knob
that our jaw bone ends on within the jaw joint. And the other bony component is the temporal bone,
which is a skull bone. Behind the disc there is some very nervy tissue,
which is called the retrodiscal tissue. So, the articular disc, the condyle, the temporal bone,
and the retrodiscal tissue are the important anatomical components that we should know about
before we discuss the popping and clicking in more detail, which we'll do now.
When we open, when we go to open our mouths, the condyle actually rotates and then slides
down the temporal bone with the disc staying on top of the condyle in all the motions
on opening and closing. So in an ideal situation, there should be no popping or clicking on opening
or closing.=. Who would have thought? For many of you, the popping and clicking has
just become a part of normal, everyday life! It's turned into your "normal".
As a side note here, when I say "popping" and "clicking",
it's really referring to the same thing.
So you can use "'popping" and "clicking" - those terms - to describe the noise interchangeably.
When there is popping or clicking, that means that the disc is coming in and out of alignment.
This animation shows the disc in blue and it shows that it is not where it’s supposed to be.
It’s actually sitting forward of the condyle instead of sitting on top of it like a hoody.
An important thing to note is that when the teeth are together and mouth is closed,
THAT’s when the disc is actually OUT of alignment.
It’s too far forward and too far in toward the center of our heads. Then when we go to open,
the disc gets back in alignment if we have a "pop" or "click". And that pop or click sound
is actually the disc getting back in alignment. Then when we go to close our mouths again,
the disc gets back out of alignment - it goes back to that too forward and in position.
I really love this animation because it shows that so clearly - it shows the blue disc too far
forward and in with the mouth closed. Then when this animated skull goes to open, it shows that
pop or click - it shows the condyle and the disc getting back in proper alignment with each other.
And then when the skull closes again, you can see that disc is getting out of alignment again. So
many people don't realize that when the teeth are together, there's actually a problem in the joint
because the disc is not in alignment. So that's just something to take note of and know about.
Additionally, when the disc is too far forward, that means it’s not sitting between the bony
components of the joint, serving as a shock absorber or cushion. So what is then? Well,
if you remember the anatomy from the beginning of the video, what sits directly behind the
disc? That nervy, sensitive tissue - which is called the retrodiscal tissue. So many people
who have popping or clicking also have pain when they're chewing tough foods or sometimes even
at rest if these people are heavy clenchers. That’s because this nervy, retrodiscal tissue
is compressed between two bones and well.. That hurts! That will send pain signals to our brains.
So the reason this condition is called disc displacement with reduction is because
the disc is displaced - it's in the wrong position, too far forward and in. BUT it can
“reduce”. It can get back in proper alignment. When the mouth opens - "pop",
"click" - that disc is back in proper alignment for a short while until the
mouth closes again. And then it goes back to that too far forward and too far in position.
And sometimes people will even feel a reciprocal "pop" and "click". That means they'll feel a "pop"
or "click" on closing with the disc getting back out of alignment again. That one isn't felt as
commonly as the one that's felt on opening. And again, the term “reduction” in medical terminology
is referring to a body part going back to its initial or normal or ideal position.
Disc Displacement with Reduction can stay this way forever - so that means a person can pop and
click their entire lives without it ever progressing. Other people will have this
condition progress to Disc Displacement WITHOUT Reduction - which is typically much more painful
and much more difficult to treat successfully. It’s impossible to predict which way it will
go for any given individual at any given time, but I can say that more WOMEN experience Disc
Displacement Without Reduction than men. For more information on this, please watch my video
“Why TMJD is More Common in Women”, which I’ve linked above. For more information on a “Disc
Displacement Without Reduction”, please stay tuned for my next video!
So that’s really it my friends! Again, I’m Dr. Mistry and I hope you found this video helpful.
If so, please like, Subscribe, and share with your family and friends!
Questions and comments are welcome as always. Do you experience clicking or popping.. Is
that a part of your every day life and has that become your "normal"? I’d love to hear
from you! And remember, my friends, you can never have TMI about TMJ! Thank you!