A crunching sound in the ear when moving the jaw, often called crepitus or clicking, is common. While it can be concerning, it is frequently not indicative of a serious problem. This article explores common reasons for these sounds, when to seek medical attention, and how they are managed.
Understanding the Causes
The temporomandibular joint (TMJ), connecting the jaw to the skull, is a common source of these sounds. This complex joint involves bone and a cushioning cartilage disc. Issues within the TMJ, known as temporomandibular disorders (TMD), frequently lead to sounds like clicking, popping, or grinding. If the disc displaces or cartilage wears, bones may rub, producing a grinding sound (crepitus). Arthritis, involving joint inflammation and degeneration, can also contribute.
Ear-related issues can also cause jaw sounds. Earwax buildup (cerumen impaction) can cause or amplify crackling, especially when jaw movement alters ear canal pressure. Eustachian tube dysfunction (ETD), where tubes connecting the middle ear to the throat don’t open or close properly, can also lead to ear popping or crackling perceived as jaw-related.
Muscle spasms or imbalances in the muscles surrounding the jaw can also contribute. Chewing muscles, like the masseter and temporalis, can become tense or spasm, leading to altered jaw mechanics and noise. Stress, clenching, or grinding teeth can exacerbate this tension. Loose ligaments within the jaw joint might also allow for excessive movement, resulting in clicking or popping sounds as components shift.
When to Consult a Doctor
While isolated jaw sounds might be benign, certain accompanying symptoms indicate a medical evaluation is advisable. Persistent pain in the jaw, ear, face, or head alongside the crunching sound should prompt a visit to a healthcare professional. This pain may intensify with activities like chewing.
Significant indicators for seeking medical attention include:
Difficulty opening or closing the mouth fully, or if the jaw feels locked or stuck.
Headaches, earaches, ringing in the ears (tinnitus), or changes in how teeth fit together (bite).
Jaw sounds and related symptoms that interfere with daily activities like eating, speaking, or sleeping.
Sudden onset of the sound, worsening existing symptoms, or if it started following a jaw or head injury.
How Doctors Diagnose the Issue
Diagnosis begins with a comprehensive medical history. The professional will inquire about when the jaw sounds started, any associated pain, other symptoms, and relevant past medical conditions. This helps understand the nature and duration of symptoms.
A physical examination of the jaw and surrounding areas is a subsequent step. The doctor will feel the jaw joint and muscles while the patient opens and closes their mouth, assessing for tenderness, swelling, or abnormal movement. The ear canal may also be examined to rule out ear-related causes.
If a detailed assessment is necessary, imaging tests may be used. Dental X-rays provide images of teeth and jawbones. CT scans offer detailed views of TMJ bony structures, while MRI evaluates the joint’s soft tissues, such as the disc and ligaments. Depending on findings, a doctor might refer the patient to a specialist, such as a TMD dentist, oral and maxillofacial surgeon, or ENT specialist.
Managing and Treating the Sound
Managing jaw sounds often begins with home care and lifestyle adjustments. Eating softer foods reduces jaw strain, and avoiding hard or chewy items is advisable. Applying warm heat or an ice pack can help alleviate muscle tension and pain. Gentle jaw exercises may improve jaw function and reduce discomfort.
Stress management, including relaxation exercises, can help reduce clenching or grinding habits that contribute to jaw tension. Avoiding habits like gum chewing, nail biting, or wide yawning can also prevent overworking jaw muscles. Over-the-counter pain relievers, such as NSAIDs, can provide temporary relief from pain and inflammation.
If a temporomandibular disorder is diagnosed, medical interventions may be recommended. Oral appliances (splints or mouthguards) can be worn, often at night, to prevent clenching and grinding and help position the jaw. Physical therapy involves exercises to improve jaw mobility, strengthen muscles, and reduce pain. Medications like muscle relaxants or antidepressants may be prescribed for pain and spasms.
For severe cases, injections of corticosteroids or botulinum toxin might be considered. Surgery is generally a last resort for severe structural problems, including arthroscopy or open-joint surgery. If earwax buildup is the cause, professional earwax removal can resolve the issue.