Prevalence and association of Temporomandibular Joint click patterns with lifestyle factors

Temporomandibular disorders (TMD) comprises of a group of conditions involving the TMJ, the muscles of mastication and the associated structures. They constitute musculoskeletal and neuromuscular conditions. TMJ sounds are one of the common TMJ complaints, the patients report to the dentist. These sounds may be associated with pain and / or limitation of mouth opening or may present with no symptoms. Many of these click sounds are soft and not heard by another person, but it can be felt during the jaw movements.  However, this can be annoying and patients may feel uncomfortable and anxious due to the sounds produced.

Pathophysiologically, the clicks occur due to anterior disc displacement of the articular disc. When the displaced articular disc tries to move to its original position, the friction between the bony components produces a snapping sound which is heard as a click or pop. The abnormal morphologic changes of the articulating components as well as perforations and adhesions in the TMJ compartment can result in TMJ clicks. Depending on the clinical presentation and pattern of the click, its severity is assessed and the decisions on treatment options are taken. Majority of the clicks are innocuous and self-limiting and do not need any active intervention.  However, in few instances, the clicks can progress to disc displacement without reduction and lead to restricted mouth opening and impaired quality of life.

The TMJ disorders are closely linked with various lifestyle factors like sleep pattern, chewing pattern (unilateral / Bilateral) parafunctional habits etc. Even though various studies are available in the literature regarding the TMJ disorders, studies on the prevalence and pattern of clicks are sparse. Being a common and annoying complaint, it is very important to understand the predisposing factors and the pattern of TMJ so that patients can be instructed to avoid such habits to prevent the progressiveTMDs.1 Hence, the present study was aimed to evaluate the various types of TMJ clicking sounds and their association with lifestyle factors.