Causes of Jaw Pain and Treatment Options

Finding out what causes jaw pain can be difficult, mostly because there are numerous sources from where the pain can come from, such as muscles, joints, or bones in the jaw, or areas of the body you do not necessarily suspect, like your teeth, ears, sinuses, or even your heart.

Pain is your body's way of signaling that something is wrong—so getting to the bottom of your jaw pain is important, not only for your comfort but also to fix the underlying problem, which can be serious.

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

Temporomandibular Joint Disorder (TMJ Disorder)

The most common presenting signs and symptoms of the temporomandibular joint disorder include jaw tenderness that may feel like a toothache, headache, or an earache. The pain may get worse when chewing food and a person may hear and/or feel a clicking or popping noise when eating, as well as an overall decreased jaw range of motion. In addition, this condition may be associated with neck stiffness and pain, shoulder pain that radiates down the arm, and ringing in the ears (called tinnitus).

Teeth Grinding (Bruxism)

Teeth grinding can cause jaw pain, and, since many people grind their teeth while they are asleep, you may not be aware that you're doing it. Some research suggests that up to 8 percent of adults grind their teeth during sleep.

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

There are multiple dental problems associated with jaw pain. For example, a crack tooth may cause intermittent, dull or sharp jaw pain that is triggered by biting or eating. A cavity may cause constant pain that is worsened by hot or cold food. Other dental problems like tooth abscesses and dry sockets may also cause jaw pain.

Infection

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

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

Likewise, besides jaw pain, 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.

While jaw pain is classically linked to a TMJ problem, infection, or dental issue, there are other causes that a doctor needs to consider.

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 of 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 may be having a heart attack, go to the emergency room or call 911 immediately.

Autoimmune Conditions

Autoimmune conditions like rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus may also cause jaw pain, specifically symptoms that mimic that of TMJ disorder.

Trigeminal Neuralgia

Trigeminal neuralgia is a severely painful condition that affects the trigeminal nerve. This condition 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, the use of corticosteroid medications, and trauma.

Cancer

Certain types of cancer, like oral cancer, may cause jaw pain. With oral cancer, there may be other symptoms present, such as a 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, a lump or mass in the neck, and unexplained weight loss.

It may surprise you that the above list of "jaw pain causes" is not exhaustive. This is why it's important to see out a proper diagnosis from a doctor or dentist.

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

The diagnosis of jaw pain begins with a detailed medical history.

Medical History

In order to access the cause of your jaw pain, your doctor 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. He will also inquire about whether there has been any recent jaw trauma, as well as habits that may trigger jaw pain, such as frequent gum chewing. The timing of the jaw pain, like whether it occurs in the morning upon awakening, can also help a doctor figure out the diagnosis.

Physical Exam

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

Specifically, for suspected TMJ disorder, your doctor may measure the range of motion of your jaw opening. While a normal opening is 35 to 55 millimeters, people with TMJ often have a jaw opening that is less than 25 millimeters. Patients with TMJ may also have muscles 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 doctor to do a cranial nerve exam, in order to ensure that the pain a person is experiencing is not related to an irritated or compressed nerve (for example, trigeminal neuralgia).

Labs and Tests

Bloodwork is not often needed to access jaw pain unless there is a concern for an autoimmune condition, at which point pertinent antibodies and inflammatory markers may be drawn.

In addition, if you are being ruled out for a heart attack in the emergency room, an electrocardiogram and blood tests (for example, cardiac enzymes) will be ordered,

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 sufficient.

For more complex diagnoses, such as osteonecrosis of the jaw, or for the diagnosis of a sinus infection, a CT scan may be ordered. 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.

The treatment of jaw pain depends on its cause but may include therapies like taking a certain medication, self-care strategies, or undergoing 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 (for example, education on trigger avoidance and changing sleeping posture) is recommended.

If teeth grinding is the culprit behind your painful jaw, a mouth guard may be helpful. Mouth guards can either be purchased at a grocery store 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.

While getting to the bottom of your jaw pain may take a little patience and persistence on your end, especially if you find yourself going back and forth between your dentist and your primary care doctor, rest assured that once the source is found and a diagnosis is made, the vast majority of people can obtain relief.