A 4 year and 6 months old girl who complained of temporomandibular joint sound on both sides, was referred to the clinic of Pediatric Dentistry, Asahi Univ. Hospital. The functional examination of the patient disclosed that reciprocal clicking sounds at the opening and closing phases of the jaw were heard. The clicking sound was audible and intensified at the jaw closing. Oral findings showed that the lower right first primary molar was amalgam filled, the lower left first primary molar was restored with preformed primary crown and the bilateral lower 2nd primary crowns were inlay restored. There was no sign of occlusal interferences caused by those restorations. However, the midline of the mandibule deviated lateraly to the right, as the patient had a sucking habit of index and middle finger.
The treatment was focused on giving instructions as to how to stop the habit and an occlusal adjustment was performed as well. With these treatments, the clicking sounds were greatly diminished but not entirely. An occlusal adjustment, therefore, through renewed restorative work was accomplished, and the entire diminishing of the clicking sounds was apparent.