Newsletter September 2025

Closed Locking of the TMJ: A Positive Spin on a Difficult Problem

Dear Colleagues,

One of the most concerning situations for many patients with TMJ disorders is when their joint “locks” and they cannot open fully. While many cases of joint clicking or intermittent catching can improve once clenching-related muscle pain is managed, a true closed-lock that persists beyond a month often requires a different clinical approach.

The good news is that closed-locking can often be reframed as a positive:

• Once locked, the troublesome popping that so many patients find embarrassing is gone.
• Limited opening can usually be restored to a comfortable range (42 mm) with a straightforward mobilization protocol.
• With effective splint therapy, joint remodeling often occurs, replacing an unstable disc with a stable “pseudodisc” that functions generally well.

In short, what begins as a worrisome problem for patients can, with proper management, lead to lasting relief and stability.

If you encounter a patient with persistent closed-locking and limited opening, I’d be glad to evaluate and discuss options for turning this into a successful long-term outcome.

Warm Regards,