Jaw Pain

Your jaw joints, or temporomandibular joints (TMJs), are found on either side of your head. A wide range of factors can affect the health of your jaw and cause jaw pain. While some types of jaw pain go away on their own, other types of pain need treatment to avoid more severe problems.

Your jaw joints are located in front of each ear. TMJs operate like hinges that allow your lower jaw to perform three-dimensional movements. This allows your jaw to move up and down, forward and back, and side to side. Jaw pain can make it hard for you to chew, swallow, speak, make facial expressions, and breathe.

A healthcare provider or dentist can help you find the cause of your jaw pain. Treatment can range from home care to surgery. In some cases, jaw pain resolves without treatment.

This article discusses the symptoms and potential causes of jaw pain. It also covers risk factors and when to consult with your healthcare provider for treatment.

Symptoms of Jaw Pain

Symptoms of jaw pain can affect one or both sides of your jaw. These symptoms can vary and may include other problems, based on the cause of your jaw pain. Symptoms of jaw pain include the following:

• Pain or tenderness in your jaw joint and/or muscles that comes and goes
• Pain in your jaw joint and/or muscles that occurs when you chew
• Jaw muscle stiffness
• Pain or stiffness that spreads to your face, neck, or shoulders
• Limited jaw movement or a feeling of a locked jaw
• Painful jaw clicking, grating, or popping of the jaw joint when you open or close your mouth
• Ringing in your ears and/or hearing loss
• Ear pain, ear pressure, or clogged feeling in your ears
• Fever
• Tooth sensitivity or pain
• Clenching or grinding of your teeth
• Swelling of the jaw or face
• Dizziness
• Chronic headaches
• A feeling that your upper and lower teeth don't fit together normally
• Numbness or tingling in your fingers

Causes of Jaw Pain

The causes of jaw pain can include a wide range of acute or chronic conditions that range from sinusitis to cluster headaches. These problems cause pain when they affect your jaw joints, jaw muscles, and/or areas of your mouth.

While there is a wide range of factors, the most common causes of jaw pain include the following:

• Temporomandibular joint (TMJ) disorders
• Dental problems
• Trigeminal neuralgia

Temporomandibular Joint (TMJ) Disorders

Temporomandibular joint disorders are a group of more than 30 conditions that affect the joints that connect the temporal bones of your skull to your mandible (lower jaw bone).

TMJ disorders are complex conditions that can be related to acute and chronic conditions in other parts of the body. They can also occur as a result of factors related to genetics, hormones, and the environment.

TMJ disorders can be related to the following conditions:

• Autoimmune diseases (diseases that occur when your immune system attacks your body's own cells)
• Connective tissue disorders (autoimmune diseases that affect collagen and elastin fibers)
• Infections
• Trauma to the jaw area
• Dental procedures or other types of prolonged periods of mouth opening
• Arthritis
• Having a breathing tube during surgery
• Parafunctional activities (repetitive behaviors) such as bruxism (teeth grinding, gnashing, or clenching)

Dental Problems

Jaw pain can occur as a result of many types of dental problems. Your teeth are held in place by dental alveoli, small sockets in your upper and lower jawbones, so dental problems can easily affect your jaws. Some common oral health problems that cause jaw pain include:

• Bruxism: Bruxism often occurs during periods of intense concentration, anxiety, or sleep. It can result in myofascial pain syndrome.
• Abscessed tooth: An abscessed tooth is an infection of the dental pulp or nerve inside your tooth that causes pain and inflammation.
• Periodontal disease: Periodontal disease, or gum disease, can spread to the jawbone and cause inflammation.
• Toothache: Toothaches occur when the nerves in or around a tooth are irritated or inflamed, often related to tooth decay.
• Impacted wisdom teeth: When wisdom teeth get stuck, or impacted, below the gum line, they can disrupt the normal alignment of other teeth, resulting in pressure on nerves that spread back to your jaw.
• Fractured or misaligned jaw: Trauma or other types of injuries can cause a fracture or other injury to the jaw joint, causing pain.
  

Trigeminal Neuralgia

Some types of neuralgia (irritated nerves) can also cause jaw pain. Trigeminal neuralgia affects up to 150,000 people annually. This condition, also known as tic douloureux, causes extreme jaw pain in the jaw and lower face, sometimes including the areas above the eye and around the nose. It irritates the trigeminal nerve, the nerve responsible for sending sensations to your face.

Trigeminal neuralgia causes severe, jabbing, or shooting pain in your jaw. It is so intense that it is described as being similar to an electric shock. Simple actions like touching your face, brushing your teeth, or feeling a breeze, can trigger these spontaneous attacks.

What Medications Can Cause Jaw Pain?

Jaw pain can sometimes occur as a side effect of certain medications. The following medications are linked to certain types of jaw pain:

Antidepressants

Certain serotonergic antidepressants have been linked with bruxism, a common cause of jaw pain, most often within three to four weeks of starting a medication. These drugs are used to treat conditions including anxiety, depression, and psychosis.

The following drugs have been linked to bruxism,

Serotonin reuptake inhibitors (SSRIs):

• Celexa (citalopram)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Luvox (fluvoxamine)
• Brisdelle (paroxetine)
• Zoloft (sertraline)

Serotonin-norepinephrine reuptake inhibitors (SNRIs):

• Strattera (atomoxetine)
• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)

Norepinephrine-dopamine reuptake inhibitors (NDRIs): Wellbutrin XL (bupropion)

Bisphosphonates

Bisphosphonates are a group of drugs used to treat bone diseases like osteopenia or osteoporosis, which cause fragile or thin bones that put you at a higher risk of fracture.

These drugs improve bone density and help reduce the risk of fracture in people with low bone density. They are also used to treat bone pain and hypercalcemia (abnormally high blood calcium) that occur in some types of cancers.

Bisphosphonates have been linked to osteonecrosis of the jaw, a condition in which the jaw bone is exposed and begins to deteriorate from a lack of blood. "Osteonecrosis" means "bone death." Early symptoms include jaw pain. The following medications are included in this class of drugs:

• Binosto, Fosamax (alendronate)
• Boniva (ibandronate)
• Actonel (risedronate) 
• Reclast, Zometa (zoledronic acid)
  

How to Treat Jaw Pain

Treatment of jaw pain varies based on its cause. Some types of jaw pain resolve without treatment. Your healthcare provider can advise how to treat your jaw pain. If home care or a wait-and-see approach is advised, they can monitor your condition so you don't risk serious consequences.

Common treatments for different types of jaw pain include the following:

Jaw Pain From TMJ Disorders:

• Soft diet to allow jaw muscles to rest
• Ice and hot packs to relieve pain
  
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve jaw pain and/or headaches
• Stress-relieving exercises to reduce teeth grinding caused by stress
• Orthodontic appliance or mouth guard to reduce teeth grinding
• Strategies to stop habits like gum chewing, nail biting, or jaw clenching
• Muscle relaxants to loosen tight facial muscles
• Botox (botulinum toxin) injection to reduce muscle activity in facial muscles
• Corticosteroid injection for an inflamed TMJ
• Acupuncture (specific points of your body are stimulated by inserting thin needles through your skin)

Jaw Pain From Oral Problems:

• Prescribed antibiotics to eradicate an infection or a tooth abscess
• Root canal, periodontal treatment, or other dental procedures to correct tooth decay, infected tooth roots, or diseased gums causing jaw pain
• Removal of impacted wisdom teeth
• Heat for myofascial pain if it is caused by severe muscle tightness

Jaw Pain From Sinusitis:

• Allergy medication or decongestants to relieve sinus pressure
• Prescribed antibiotics to treat a sinus infection

Jaw Pain From Medication:

• A reduction in dosage after consultation with your healthcare provider.
• A change in medication or treatment after consultation with your healthcare provider.

Jaw Pain From a Traumatic Injury:

• Surgery to repair a fracture or other injury
• TMJ implants (artificial devices used to replace part of your jaw joint or your entire joint)

Complications and Risk Factors Associated With Jaw Pain

Certain conditions and characteristics can increase your risk of jaw pain. These factors include the following:

• Misaligned teeth or bite
• Deformities of the jaw or face
• Joint conditions, including osteoarthritis and rheumatoid arthritis
• Past facial or jaw injuries
• Stress or other psychological problems
• Persistent jaw clenching or teeth grinding
• Habits that strain your jaw, like biting your lips, biting your fingernails, and chewing gum or hard candy
• Medications linked to jaw pain

Accurate diagnosis can identify the underlying causes of jaw pain. Prompt and appropriate treatment can help prevent the condition and its underlying cause, such as infection, from worsening and causing permanent jaw damage.

Chronic jaw pain can interfere with your ability to speak, eat, and chew normally. Any type of chronic pain can interfere with your quality of life and increase your risk of depression and anxiety.

Are There Tests to Diagnose the Cause of Jaw Pain?

No single standard test is used to diagnose the cause of jaw pain. A typical examination by a healthcare provider or dentist for jaw pain will likely include the following strategies for a diagnosis:

• Detailed medical history
• Questions about the location, frequency, and other characteristics of your jaw pain
• Physical examination of your head, face, neck, and jaw for tenderness, range of movement, and jaw sounds
• Non-invasive cranial nerve neurological exam to test for nerve-related pain as in trigeminal neuralgia
• Blood tests to identify suspected infection or other health problems
• C-reactive protein (CRP) test or cyclic citrullinated peptide (CCP) antibody test to check for autoimmune conditions
• Electrocardiogram and cardiac biomarker test (formerly known as the cardiac enzyme test) to rule out a heart attack
• X-ray or panoramic X-ray (a two-dimensional dental X-ray that captures your entire mouth and jaws in a single image) to look for fractures in bones and teeth
• Magnetic resonance imaging scans (MRIs) or computed tomography (CT) scan to view the health of your internal structures, joint space, bone, and ligaments
  

When to See a Healthcare Provider

If you have jaw pain that interferes with your ability to speak, eat, chew, or breathe normally, you should see a healthcare provider for a physical evaluation and diagnosis of the cause of your pain.

While some types of jaw pain can resolve without treatment, delaying the diagnosis and treatment of a serious condition can increase your risk of more serious consequences.

Note that not all dentists are trained to treat jaw pain. You may need to find or be referred to an orofacial pain dentist or TMD specialist. They may be found at many university dental clinics.

Jaw pain is a common symptom of a heart attack. If you have pressure in your chest with jaw pain, seek immediate emergency care.

Summary

Jaw pain can occur as a result of minor to severe factors. The causes of jaw pain can involve problems that include diseases, oral health, or stress. Some problems require treatment, while others resolve on their own.

Your jaw joints operate like hinges that allow your lower jaw to move up and down, forward and back, and side to side. When jaw pain changes the way your jaw moves, it can hinder your daily life. Jaw pain can affect the way you talk, chew, and breathe.

With so many causes of joint pain, finding the source of your pain can be a challenge. Your healthcare provider or dentist can diagnose your pain and advise the right treatment. Without care, jaw pain can worsen and pose a threat to your jaw health and your overall well-being.