Jaw pain, as a rule, brings very strong discomfort and anxiety. By nature, they can be sharp, sudden, pulsating, or vice versa – aching, having a chronic, protracted nature. Often these feelings are so intense that they can even cause a depressed emotional state and depressive disorders.
In many respects, the nature of the pain in the face area, as well as the accompanying symptoms (joint mobility, clicks in it, the presence of edema, etc.) depends on why the patient has a jaw pain. During the examination, doctors pay attention to the localization of sensations – they are one- or two-sided. It is often difficult to determine exactly whether the pain in this area is associated with an injury or pathology of the bones, joint, or caused by some other reason.
Causes of jaw pain
The face has a complex anatomical structure. In this area:
- complex articulation of the jawbone with the skull (temporomandibular joint);
- rich innervation – the trigeminal nerve passes on both sides of the face;
- oral cavity lined with mucous membrane;
- teeth, gums, richly innervated tongue;
- the proximity of reflexogenic zones (areas where many receptors are located).
Violations and pathologies in any part can cause pain in the jaw, which often spreads (radiates) to the entire area of the face.
And yet, the most common cause of discomfort is pathology or disorders of the dentoalveolar system. That is why, if a patient has a jaw pain, he is advised to contact the dentist first.
Dental tissue damage is one of the most common reasons why the lower or upper jaw hurts. At the same time, such sensations are often radiating, that is, they can manifest themselves as pain in the jaw, temple and even ear. Probable reasons:
- caries at various stages, pulpitis;
- damage to the crown or implant.
Another reason for the discomfort in the facial area associated with dental problems is the increased sensitivity of the teeth. In this case, acute short-term pain occurs when touching the teeth, inhaling cold air, taking hot, cold, spicy, salty, sweet or sour drinks and food. Sharp pain in the teeth while eating or drinking, when brushing your teeth, or even after a while can spread to the jaw area.
Other symptoms of tooth damage:
- increased constant discomfort when pressing on the surface of the teeth;
- throbbing pain radiating to the cheeks, temples, ear.
Recent dental procedures
This group includes cases when discomfort is associated with previous dental procedures. These include:
- ultrasonic or mechanical cleaning of teeth;
- teeth whitening;
- treatment of deep carious cavities, pulpitis;
- removal of a tooth;
- implantation, etc.
Inflammatory diseases such as gingivitis and periodontitis can cause severe damage to the gums. Gingivitis is accompanied by a feeling of discomfort, swelling and bleeding of the gums, and periodontitis can lead to loosening and even loss of teeth. Inflammation of the periodontal tissues is accompanied by severe pain in the affected area, including the jaw.
Sharp, severe, sometimes throbbing pain in the jaw can be a sign of inflammation of the periosteum, or periostitis.
Temporomandibular joint dysfunction
This disorder is one of the most common causes of facial pain (5–12%) not associated with dental problems. The fact is that the temporomandibular joint (TMJ) has a very complex structure. It is formed by the head of the lower jaw and the articular surface of the temporal bone. In this case, the left and right joints perform their functions synchronously.
The joint is strengthened by the joint capsule, ligaments and muscles. Any violation in the mobility of the system of muscles, ligaments, cartilage and bones leads to dysfunction of the TMJ (disruption of normal functioning) and possible pain in the jaw, both on one and both sides. A characteristic sign of a malfunction of the TMJ is that when you open your mouth, a click is heard and the jaw hurts.
The main symptoms:
- pain in the jaw joint;
- discomfort in the ears, face;
- persistent headaches;
- vision problems.
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Bruxism is an unconscious or involuntary contraction of the jaw muscles, causing strong compression and friction of the teeth to a characteristic grinding.
This phenomenon is not a disease in the literal sense. Bruxism is a symptom of a fairly large group of disorders ranging from partial missing teeth or malocclusion to stress and psychological stress.
This phenomenon occurs at any age, but in about 50% of cases it occurs in children. According to various estimates, about 5-20% of people suffer from it. There are nocturnal and daytime bruxism.
“With physiological chewing, the teeth of the upper and lower jaw are in contact for 25-30 minutes in 12 hours. With nocturnal bruxism, the teeth can be in contact for 40 minutes per hour”
“Mechanisms of formation and pathogenetic principles of treatment of bruxism”, Ph.D. Gaidarova T.A.
The main symptoms are:
- discomfort in the facial muscles in the morning;
- pain in the lower jaw due to overexertion or damage to muscles and ligaments;
- during sleep – sounds of grinding, rubbing of teeth;
- cracks and chips of enamel
Trigeminal neuralgia refers to cases where the jaw hurts due to causes other than dental disorders or bone abnormalities. It is a chronic disease that affects the trigeminal nerve and can cause discomfort of varying degrees of intensity in the innervation area (face, teeth, eyes, tongue, upper and lower jaw, etc.).
The main symptoms are attacks of sharp, cutting, burning pain in certain areas of the face:
- in the area of the forehead, eyebrows, temple – with the defeat of the I branch of the nerve;
- in the area of the upper lip, nose, cheekbones, upper jaw – with the defeat of the II branch of the nerve;
- in the area of the lower lip, chin, lower teeth, tongue, lower jaw – with damage to the third branch of the nerve.
Discomfort can be greatly increased by talking, touching the face or teeth, chewing food, contact of the teeth with food or a toothbrush
Contusions of the soft tissues of the face, damage to the bones of the facial skull or temporomandibular joint (dislocations, fractures) cause discomfort, including pain in the lower and upper jaws, as well as discomfort of varying intensity. Such damage is accompanied by redness, bruising, swelling.
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With a number of general somatic disorders and diseases, such as rheumatoid arthritis, mumps, heart attack and others, patients complain that their jaw hurts on the right or on the left.
For example, one of the symptoms of a heart attack and other acute conditions of the cardiovascular system may be reflected in pain in the jaw on the left side. With swelling of the salivary glands accompanying mumps (the so-called “mumps”), the jaw often aches in the area of inflammation. In rheumatoid arthritis, joints, including the temporomandibular joint, can swell, which causes pain in the jaw and discomfort when opening and closing the mouth.
To diagnose the causes of pain in the jaw and prescribe treatment, the doctor collects an anamnesis. The patient is asked questions about existing complaints, the severity of clinical manifestations, possible bruises and past injuries, current diseases. Having received the information, the specialist palpates the jaw. This is necessary to identify pain, its location, nature and intensity. Also, the skin is examined to confirm or exclude the presence of edema, abrasions, bruises. The condition of the oral cavity is checked. In this case, the doctor is interested in deformation of the teeth or mucous membranes, blood impurities or purulent discharge in saliva.
If an infectious disease is suspected, an otoscopy or rhinoscopy is performed. The patient is sent for a general blood test. With otitis media and sinusitis, a bacteriological examination of the discharge will be required.
Instrumental diagnostics is not excluded, be it ECG, computed and magnetic resonance imaging, orthopantomography, phono arthrography, electromyography of facial muscles, arthroscopy of the jaw joint.
Which doctor should I go to?
If there is no specific information about the causes of pain, then you need to contact a therapist. After an initial examination and identification of the cause, he will refer the patient to a dentist, surgeon, ENT or neurologist. If the discomfort is caused by a tumor, then an oncologist’s consultation will be needed.
To prevent the onset of pain in the jaw, you need to regularly visit the dentist, avoid eating solid foods, and do not bite your nails or foreign objects (pencils, pens). You also need to monitor your posture, including massage in your lifestyle. You cannot carry bags on one shoulder, it is not recommended to sleep on your stomach. During meals, you need to eat in small pieces, it is advisable to give up caffeine. On the recommendation of doctors, calcium or magnesium should be taken.