Definition and Overview

Jaw pain is considered as a painful sensation or tenderness that is felt in or around the jaw. The pain sometimes extends to the ears and neck, affects almost the entire face, and causes headaches. The feeling may worsen when the person chews or bites, but may also occur even when the jaw is at rest. The pain is usually centered on the jaw joint, which is known in medical terms as the TMJ or temporomandibular joint, and may be sudden, temporary, or chronic, depending on the underlying cause.

The temporomandibular joint is made up of the jawbone (or the bone located right below the mouth), as well as the maxilla (or the bone located in the upper part of the mouth). The jaw joint plays a major role and is responsible for controlling the opening and closing movement of the mouth. Out of all the joints in the body, it is considered as one of the most frequently used. Since joints are made up of muscles and tendons surrounding the bones, any of the soft tissues may fall prey to wear and tear or injury due to long-term use.

Cause of Condition

There are many possible causes of jaw pain, ranging from joint problems to dental and gum problems. Pain caused by a problem involving the TMJ may be due to any of the known temporomandibular disorders. TMJ disorders, in turn, are caused by:

• Frequent tooth grinding or clenching
• Injury to the jaw
• Dislocation of the joint
• Rheumatoid arthritis
• Osteoarthritis
• Stress

The tooth-related causes of jaw pain include:

• Toothache
• Periodontal disease

Other possible medical causes of jaw pain include:

• Infection
• Sinus condition

Key Symptoms

Jaw pain is usually diagnosed based on the group of symptoms that the patient experiences. TMJ disorders have some very specific symptoms that help doctors differentiate them from other causes of jaw pain.

Pain that is associated with a TMJ syndrome typically meet the following characteristics:

• Pain or tenderness in the jaw, face, neck, shoulders, and around the ears
• Pain when chewing or speaking
• Inability to open the mouth wide (or painful when doing so)
• Locked jaw, or when the jaw gets locked in a particular position
• A popping sensation
• A clicking sound when the joint is moved
• Difficulty biting or chewing
• An uneven bite, or when the upper and lower teeth do not fit properly together
• Facial swelling
• Dizziness
• Hearing issues
• Tinnitus, or a ringing in the ears

Some of these symptoms may also be felt even when the jaw pain is caused by factors other than a TMJ disorder. Thus, doctors usually do a thorough checkup before diagnosing jaw pain.

Who to See and Types of Treatments Available

People experiencing jaw pain may see either a general practitioner or dentist for a diagnosis. They will then make referrals to specialists, such as physiotherapists, if it is necessary.

Temporomandibular joint disorders are not generally considered to be serious conditions with any threat to life, but they can negatively affect a person’s overall quality of life due to the pain and certain limitations imposed on their normal activities, such as speaking or eating. Thus, it is important that these disorders receive prompt treatment.

TMJ disorders are initially treated by some home remedies and lifestyle adjustments. Making some changes to a person’s lifestyle, either temporarily until the pain disappears or permanently to make sure the problem does not occur again, can greatly help improve the condition of the patient. These self-help remedies include:

• Shifting to a soft foods diet with yogurt, mashed potatoes, soup, fish, cooked fruits and vegetables, grains, oats, and beans
• Avoiding chewing gum
• Placing a warm or cold compress on the jaw several times a day for about 10 to 20 minutes each time
• Doing some mild exercises to stretch the jaw gradually
• Refraining from opening the jaw wide until the pain subsides
• Massaging the joint muscles
• Relaxing or resting to relieve the stress that usually causes a person to clench his jaw by instinct
• Refraining from resting the chin on the hand
• Refraining from clenching the teeth

If these don’t help, doctors can also use laser treatment to relieve pain and inflammation. This treatment involves applying low-level or low-intensity laser energy to the main source of the problem, i.e. the joint or soft tissues surrounding it. The effectiveness of laser therapy for jaw pain depends heavily on the proper laser dosage and on applying it to the correct spot on the jaw. Since jaw pain is often accompanied by referred pain in several other locations, it is important for the therapist to determine the exact source of the pain.

Other forms of therapy used to relieve temporomandibular joint disorders include:

• Radio wave therapy
• Trigger point injections
• Ultrasound
• Transcutaneous electrical nerve stimulation

For tooth-related problems, dentists usually prescribe:

• The use of mouth guards, for temporary conditions such as an injury or dislocation
• Root canal therapy
• Tooth extraction
• Orthodontics, if there is an existing bite problem
• Tooth replacement, to resolve an uneven bite due to missing teeth
• Periodontal or gum disease treatment, for gum-related issues

If the pain is severe, doctors may prescribe some pain medications, such as paracetamol or ibuprofen. If these fail to help, stronger pain relievers or even antidepressants and muscle relaxants may be used. For pain associated with arthritis, the patient may also be given steroid injections to relieve both the pain and inflammation affecting the soft tissues of the joint. In many cases, pain may begin to subside within 24 hours, and the condition continues to improve over a period of weeks or months. In some cases, steroid injections may completely resolve arthritis-related pain.

Some conditions causing joint pain may also be too severe to require surgery. The available surgical treatments include:

• Arthrocentesis or joint wash-out
• Open joint surgery
• Total joint replacement, which is only reserved for patients experiencing chronic pain that has lasted for several years with no marked improvement using other treatment options, and when the impairment of jaw function is too severe that it has begun affecting the person’s overall health.

Surgery is often only used as a last resort if all known treatments fail to help. It is also more commonly used when the joints or bones are affected, instead of just the soft tissues.

References:

• Herrmann HJ. Wilderness dentistry and management of facial injuries. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa.: Elsevier Mosby; 2007:chap 26.

• Kellman RM. Maxillofacial trauma. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa.: Elsevier Mosby; 2010:chap 23.