Overview of Jaw Pain

Finding out what causes jaw pain can be difficult. The pain can originate in the teeth or in the muscles or bones of the jaw. Or, it may come from an unexpected area like the ears, sinuses, or even the heart.

Pain is your body's way of signaling that something is wrong—you're grinding your teeth, you have an infection, or you have a joint disorder, for example—so getting to the bottom of your jaw pain is important.

This article discusses the common and rare causes of jaw pain and typical diagnosis and treatment methods.

Common Causes

The most common causes of jaw pain are dental issues and disorders that affect the temporomandibular joint (TMJ), the joint that connects your lower jaw bone to your skull.

Temporomandibular Joint (TMJ) Disorder

The most common signs and symptoms of TMJ disorder include jaw tenderness that may feel like a toothache, as well as a headache or earache.

The pain may worsen when chewing food, and you may hear and/or feel a clicking or popping noise when eating. There may also be a decreased range of motion of the jaw. In addition, this condition may be associated with neck stiffness and pain and shoulder pain that radiates down the arm.

Teeth Grinding (Bruxism)

Teeth grinding, otherwise known as bruxism, can cause jaw pain. While grinding your teeth is often related to stress and anxiety, bruxism can also occur involuntarily during sleep.

In addition to stress and anxiety, research suggests that factors including sleep apnea and genetics may contribute to sleep bruxism.

Symptoms of bruxism include jaw, face, and neck pain; headaches; and dental problems, including fractured and worn-down teeth.

Besides teeth grinding, other muscle overuse conditions, like teeth clenching and excessive gum chewing, can also cause jaw pain.

Toothaches

Many dental problems may cause jaw pain. For example, a cracked tooth may cause intermittent, dull, or sharp jaw pain triggered by biting or eating.

A cavity may cause constant pain that's worsened by hot or cold food. Other dental problems like tooth abscesses (a build-up of pus inside the teeth) and gum disease may also cause jaw pain.

Infection

An infection within the head and neck area, specifically an ear or sinus infection (sinusitis), may cause jaw pain. Besides jaw pain, other symptoms of sinusitis may include:

• Fever
• Headache
• Toothache
• Cheek pain
• Nasal congestion

Other symptoms of an ear infection may include difficulty hearing, vertigo, nausea, and occasionally, ear drainage.

Trauma

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

Rare Causes

While jaw pain is commonly linked to a TMJ problem, infection, or dental issue, there are other rarer causes that a healthcare provider needs to consider.

Heart Attack

Jaw pain may signal a heart attack, a potentially life-threatening condition that warrants immediate medical attention.

Besides a crushing or heavy feeling in the center or left side of the chest that may move to the jaw, neck, or shoulder, other potential symptoms of a heart attack include difficulty breathing, sweating, dizziness, nausea and vomiting, and weakness.

If you or someone you're with appears to be having a heart attack, go to the emergency room or call 911 immediately.

Autoimmune Conditions

Autoimmune conditions occur when the immune system attacks healthy cells. Some conditions like rheumatoid arthritis, Sjögren's syndrome, and systemic lupus erythematosus may cause jaw pain with symptoms that mimic TMJ disorder.

Trigeminal Neuralgia

Trigeminal neuralgia is a severely painful condition that affects the trigeminal nerve, which helps you detect facial sensations and move your jaw. The condition commonly results from a blood vessel that presses on the trigeminal nerve, but it's possible for an injury or another medical condition to affect the nerve.

Trigeminal neuralgia causes one-sided attacks of sharp, electric-shock-like pain in the lips, eyes, nose, jaw, forehead, and scalp. The pain is generally triggered by eating, talking, or exposing your face to cold air.

Osteonecrosis of the Jaw

Osteonecrosis occurs when the blood supply to a bone is disrupted, and the bone begins to die. It can cause severe pain. Causes of osteonecrosis include excessive alcohol consumption, corticosteroid and bisphosphonate medications, radiation therapy to the head and neck, and trauma.

Cancer

Certain types of cancer, like oral cancer, may cause jaw pain. With oral cancer, there may be other symptoms, such as persistent pain in the mouth, a sore in the mouth that doesn't heal, trouble chewing or moving the jaw, swelling of the jaw, loosening of the teeth, and a lump or mass in the neck.

When to See a Healthcare Provider

The causes above may not be the only reasons for jaw pain. Other factors or underlining issues may have an influence. This is why it's important to seek a proper diagnosis from a healthcare provider, such as a physician or dentist.

While most causes of jaw pain are not related to medical emergencies like a heart attack, if your discomfort is severe and/or prolonged, or if your pain is associated with symptoms like trouble breathing, chest pain, sweating, or dizziness, be sure to seek immediate medical attention.

Diagnosis

In order to assess the cause of your jaw pain, a healthcare provider will first ask you several questions about your pain, like when it began, how severe it is, and whether the pain is intermittent or constant.

They will also ask about whether there has been any recent jaw trauma and if you have any habits that may trigger jaw pain. The timing of the jaw pain, like whether it occurs in the morning upon awakening, can also help a healthcare provider make a diagnosis.

Physical Exam

After a thorough history, your healthcare provider will begin the physical examination and look closely at your mouth, teeth, TM joint, neck, and shoulders.

If they suspect TMJ disorder, your healthcare provider may measure the range of motion of your jaw opening. While a normal opening is 40 to 55 millimeters, people with TMJ often have a jaw opening that's less than 30 millimeters.

Patients with TMJ may also have muscle tenderness around the TMJ, as well as joint crepitus (a crackling sensation) or a clicking sound when the jaw opens and closes.

Lastly, it's common for a healthcare provider to do a cranial nerve exam to ensure that the pain you are experiencing is not related to an irritated or compressed nerve (for example, trigeminal neuralgia).

Different parts of this neurological examination test different nerves of the head and face. To check the trigeminal nerve, the healthcare provider may gently touch your face .

Labs and Tests

Bloodwork is not often needed to assess jaw pain unless your healthcare provider suspects or wants to rule out an autoimmune condition. The C-reactive protein (CRP) test or the cyclic citrullinated peptide (CCP) antibody test can check for autoimmune conditions.

In addition, an electrocardiogram and cardiac biomarker test (formerly known as the cardiac enzyme test) may be ordered to rule out a heart attack.

Imaging

Depending on the findings from the history and physical examination, imaging tests may help provide additional insight or confirm a diagnosis. For certain causes of jaw pain, like TMJ disorder, a dental problem, or a fractured or dislocated jaw, a plain X-ray or panoramic X-ray is usually enough.

For more complex diagnoses, such as to check for osteonecrosis of the jaw or a sinus infection, a computed tomography (CT) scan may be ordered.

Magnetic resonance imaging scans (MRIs) are often used to more thoroughly evaluate the TMJ in people with chronic or severe pain. An MRI may also be used to evaluate the trigeminal nerve in trigeminal neuralgia.

Treatment

The treatment of jaw pain depends on its cause but may include therapies like medication, self-care strategies, or surgery.

Medications and Self-Care

Specific medications are prescribed for certain diagnoses. For instance, an antibiotic will be prescribed for a sinus or ear infection, while the anticonvulsant Tegretol (carbamazepine) or Trileptal (oxcarbazepine) is used to treat trigeminal neuralgia.

For TMJ disorder, a combination of medications (for example, a nonsteroidal anti-inflammatory and/or a muscle relaxant) and self-care therapies, such as trigger avoidance and changing sleeping posture, are recommended.

If teeth grinding is the culprit behind your painful jaw, a mouthguard may be helpful. Mouthguards can either be purchased at a drugstore and molded to fit your teeth, or you can have one custom-made at your dentist's office.

Surgery

Surgery is often one of the primary treatments for oral cancer, and surgical repair may be necessary for a jaw fracture.

Summary

There are many causes of jaw pain. Common ones include temporomandibular joint (TMJ) disorder, teeth grinding, and toothache, while rarer causes include trigeminal neuralgia and osteonecrosis.

To diagnose jaw pain, a healthcare provider typically does a physical exam and sometimes imaging and blood tests. Common treatments for jaw pain include medications, self-care therapies, and mouthguards. Surgery may be required for more severe conditions such as a jaw fracture.

A Word From Verywell

Getting to the bottom of your jaw pain may take a little patience and persistence, especially if you find yourself going back and forth between your dentist and your primary care healthcare provider. Rest assured that once the source is found and a diagnosis is made, most people can obtain relief.