Jaw pain: Causes, diagnosis and treatment

Jaw pain is an extremely uncomfortable condition. The pain can be accompanied by other locations, affecting daily activities. Causes of jaw pain can be due to: tooth infection, sinus, musculoskeletal, neurological, vascular diseases... In which, the most common is temporomandibular disorder (TMJ).

Jaw pain can be mild and does not require treatment. It can also be intense, persistent pain, which indicates serious underlying problems that need treatment. In this article, we will learn about the causes of jaw pain and the treatment options available.

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• 1. Causes of jaw pain
• 2. Symptoms associated with jaw pain
• 3. When does jaw pain need treatment?
• 4. Examination and diagnosis of jaw pain
• 5. Treatment of jaw pain

1. Causes of jaw pain

The most common causes of jaw pain are dental problems and disorders affecting the temporomandibular joint.

1.1. Temporomandibular joint disorder (TMJ)

The most common signs and symptoms of temporomandibular joint disorders include:

• Jaw pain (which can feel like a toothache ).
• Headache.
• Ear hurt.

The pain may be worse when chewing food and a clicking and/or crunching sound may be heard and/or felt with movement of the jaw.

In addition, the condition can be associated with stiffness and pain in the neck, shoulder pain that radiates down the arm.

Jaw pain due to TMJ

1.2. Chatter

Teeth grinding can cause jaw pain. This condition often occurs during sleep, so many people may not know they have it.

Symptoms of bruxism include: jaw, face and neck pain; headache; dental problems, including broken and worn teeth.

In addition to bruxism, other muscle overactivity such as two excessive chewing gum can also cause jaw pain.

1.3. Toothache

There are many dental problems associated with jaw pain. For example, a cracked tooth can cause intermittent, dull, or sharp pain when biting or eating. Cavities can cause ongoing pain that is aggravated by hot or cold stimuli. Other dental problems such as tooth abscesses and wisdom tooth inflammation can also cause jaw pain.

1.4. Infection

Infections in the head and neck area, specifically sinus or ear infections, can cause jaw pain. In addition to jaw pain, other symptoms of sinusitis may include:

• Fever.
• Headache.
• Toothache.
• Cheek pain.
• Stuffy nose.

Likewise, in addition to jaw pain, other symptoms of an ear infection can include: difficulty hearing, dizziness, nausea, and sometimes a watery ear.

Jaw pain can be caused by an ear infection

1.5. Injury

Injuries to the jaw or face, including a gaping or broken jaw, can cause significant pain.

Other rare causes

While jaw pain is often associated with a TMJ problem, an infection, or a dental problem, there are other causes that we need to consider.

Heart attack

Jaw pain can signal a heart attack , a potentially life-threatening condition that requires immediate medical attention. In addition, a feeling of heaviness in the middle left side of the chest may travel to the jaw, neck, or shoulder. Potential symptoms of a heart attack include: shortness of breath, sweating, dizziness, nausea and vomiting, and weakness.

1.6. Autoimmune-related conditions

Autoimmune conditions such as rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus can also cause jaw pain. In particular, the symptoms mimic those of a TMJ disorder.

1.7. Arthritis

Osteoarthritis and other types of arthritis can cause the smooth surfaces between the joints and eventually the bones to wear down. Bone pain can develop as a result of this condition.

In addition, inflammatory conditions such as bursitis, rheumatoid arthritis , and psoriatic arthritis cause inflammation in the joints. If these conditions affect the jaw joint, pain can occur.

1.8. Osteomyelitis

In rare cases, osteomyelitis can affect the jawbone and related tissues. This is a rare complication of dental surgery.

1.9. Tension headaches

Research has found that some people with TMJ pain also experience headaches, but there doesn't seem to be a link between the two conditions. For this reason, it remains unclear whether or not there is a link between jaw pain and headaches.

1.10. Trigeminal neuralgia

Trigeminal neuralgia is a severe pain condition that affects the nerve that helps you detect sensations in your face and jaw movements. This condition causes sharp pain; like electric shock to the lips, eyes, nose, jaw, forehead and scalp. The pain is often triggered by eating, speaking, or exposing your face to cold air.

Nerve pain 5 can cause you jaw pain

1.11. Jaw bone necrosis

Necrosis occurs when the blood supply to the bone is interrupted and the bone begins to die. It can cause severe pain. Causes of osteonecrosis include: drinking too much alcohol, using corticosteroid medications, and trauma.

1.12. Cancer

Some types of cancer, like oral cancer , can cause jaw pain. With oral cancer, there may be other symptoms such as: persistent pain in the mouth, mouth pain that does not heal, difficulty chewing or moving the jaw, swelling of the jaw, loose teeth, and swelling.

1.13. Some other conditions that can increase jaw and facial pain include

• Salivary gland disorders.
• Stress, fatigue and lack of sleep.
• Shortness of breath while sleeping.
• Fibromyalgia.
• Certain mental health conditions.

2. Symptoms associated with jaw pain

The specific and associated symptoms of jaw and facial pain will vary depending on the cause. They may include:

• Facial pain aggravated by jaw movement.
• Joint and muscle pain.
• Limited movement.
• Wrong bite.
• Clicking or crunching sound when opening or closing the jaw.
• Tinnitus in the ears.

When you have jaw pain, you may hear ringing in your ears

• Ear hurt.
• Headache with or without ear pain and pressure behind the eyes.
• Dizzy.
• Function lock.
• The pain ranges from a dull ache to a throbbing sensation.
• Dizzy.
• Toothache.
• Stress or other headaches.
• Nerve-type pain, such as a burning sensation.
• Fever.
• Face swelling.

Anyone concerned about jaw pain should see their doctor, dentist or oral surgeon.

3. When does jaw pain need treatment?

The above causes of jaw pain are not exhaustive. This is why it is so important to seek the correct diagnosis from your doctor or dentist.

Although the majority of jaw pain is not related to an emergency such as a heart attack, if your discomfort is severe and/or persistent; or if your pain is combined with symptoms such as: shortness of breath, chest pain, sweating or dizziness, be sure to see your doctor right away.

4. Examination and diagnosis of jaw pain

Exploiting medical history, medical history

To find out the cause of your jaw pain, your doctor will first ask some questions about your pain. Such as:

• When did the pain start?
• Severity.
• Is the pain constant or not?
• Have you had any recent jaw injury?
• Habits can cause jaw pain.
• Duration of jaw pain.

These answers will likely help your doctor diagnose your condition.

Clinical examination

After taking a thorough history, your doctor will begin an examination with a close look at: your mouth, teeth, TMJ, neck, and shoulders.

For a suspected TMJ disorder, the doctor may measure the range of motion of the jaw when opening and moving. While a normal cleft is 40 mm to 55 mm, people with TMJ often have an opening less than 30 mm. Patients with TMJ may also experience pain in the surrounding muscles, as well as a crackling sound (a clicking sound when the jaw opens and closes).

Finally, your doctor usually examines the cranial nerves to make sure: the pain you are experiencing is not related to an irritated or inhibited nerve (eg, trigeminal neuralgia).

Subclinical

Usually no blood tests are needed to treat jaw pain. Unless there's a concern about an autoimmune condition, or an infection.

In addition, if you are suspected of having cardiovascular disease, an electrocardiogram and blood test will be ordered.

X-ray film

Depending on findings from the history and physical examination, imaging studies may help provide additional details or confirm the diagnosis. For some causes of jaw pain, such as a TMJ disorder, an oral problem, a broken or misaligned jaw, a simple radiograph or a panoramic radiograph is usually sufficient.

X-ray

For more complex diagnoses, such as osteonecrosis of the jaw or diagnosis of a sinus infection, a computed tomography (CT) scan may be ordered. Magnetic resonance imaging (MRI) is often used to more thoroughly evaluate the TMJ in people with chronic or severe pain. MRI may also be used to evaluate the trigeminal nerve in trigeminal neuralgia.

5. Treatment of jaw pain

Treatment for jaw pain depends on its cause, but may include medications, self-care measures, or surgery.

5.1. Medicines and self-care measures

To relieve jaw pain, you can use the following methods:

• Apply moist heat or ice

Put ice in a plastic bag, wrap it in a thin cloth and place it on your face for 10 minutes. Then remove for 10 minutes before reapplying. Another way is to pour warm water on a towel, then apply it to the jaw area. The moist heat can relax overactive jaw muscles and relieve pain. You may have to re-wet the wipes several times to maintain the heat.

You can also buy hot or ice packs at your pharmacy or online. However, they should be covered with cloth at all times, or they may burn your skin. If it feels too hot or too cold, take it out.

>> Do you understand when to apply heat and when to apply ice? Find the answer in the article Hot and cold compress: Are you doing it the right way?

Cold compress helps relieve pain

• Massage the affected joint area

Using your index and middle fingers, press on the painful area of ​​your jaw, such as the area just in front of your ear where the jaw joint meets. Rub in a circular motion for 5 to 10 rounds, then open your mouth and repeat the exercise. Massaging the muscles on the side of the neck can also help relieve tension.

• Over-the-counter pain relievers

Medications such as ibuprofen and acetaminophen can help relieve discomfort.

• Specific medications prescribed for certain diagnoses 

For example, antibiotics will be prescribed for sinusitis or ear infections , while the anticonvulsants Tegretol (carbamazepine) or Trileptal (oxcarbazepine) are used to treat trigeminal neuralgia.

For TMJ disorders, a combination of medications (eg, nonsteroidal anti-inflammatory drugs and/or muscle relaxants) and self-care therapies (eg, trigger avoidance and sleep position changes) should be combined.

If teeth grinding is the cause of your pain, you can be treated with a mouthguard that protects your teeth. The mouth guard can be molded to fit your teeth.

5.2. Surgery

This is often one of the main treatments for oral cancer. Surgical repair may be needed for jaw fractures.

In addition, you may have some dental treatment, including:

• Root canal treatment.
• Tooth extraction.
• Heat or cold therapy.

6. Prevention of jaw pain

If you've had jaw pain in the past, follow these tips to help prevent a recurrence; at least during the recovery phase:

• Eat soft or liquid foods, such as soup or pasta.
• Avoid eating crunchy or chewy foods, such as chewing gum.

Should eat soft foods

• Eat small pieces.
• Take care of your teeth regularly.
• Reduce stress by practicing meditation, yoga, or other types of exercise.
• Massage the jaw area to relax the muscles and increase blood flow.
• Use a mouth guard to prevent teeth grinding.
• Adopt correct posture and do not carry heavy bags for too long on one shoulder.

Your doctor can advise you on the most appropriate preventive measures.

Jaw pain is a symptom of many different causes. Mainly due to temporomandibular joint disorders. But it is also a sign of many other conditions. It is best to visit the doctor early for timely diagnosis and treatment.

Doctor Truong My Linh