Jaw Pain

“Jaw pain” refers to discomfort in the jaw area, without specifying whether it is in the upper or lower jaw or which specific region is affected. Common sources of jaw pain include the teeth, temporo-mandibular joints, and chewing muscles.

There are multiple potential causes of jaw pain. Below, we discuss the most common regions, possible causes, and the development of pain patterns. However, since a text can never replace a personal examination, we are here to provide individual advice and assistance with your specific concerns at our practice.

If you’re feeling pain in your upper jaw, it’s important to consider the various structures located there. The discomfort could stem from a tooth-related issue, or be linked to sinus problems.

Tooth-Related Causes:

The root tips of teeth of the upper jaw extend toward the maxillary sinus. As a result, dental inflammations can frequently lead to an inflammation of the sinus membrane (Schneiderian membrane). This can cause pressure sensitivity, especially when bending forward, but also spontaneously while sitting or standing.

Sinus-Related Causes:

Due to the proximity of these structures, such conditions can cause tooth and jaw pain.

Additionally, if you suffer from headaches or migraines, these can also radiate to the jaw area.

The lower jaw, extending from the area near the ear down to the chin, is a complex structure that has numerous muscles attached to it. Tension in the masticatory system often manifests here, a condition known as craniomandibular dysfunction (CMD). Stress and grinding of the teeth can further aggravate lower jaw pain.

Cavities, jaw infections, gum inflammations, and periodontitis are also common causes of pain of the lower jaw. Additionally, the salivary glands, located on the sides of the cheeks and under the tongue, should not be overlooked. Issues such as salivary stones (sialolithiasis), blockages of the ducts, or salivary gland cancer can be very painful and require immediate treatment.

Neck pain can also radiate into the jaw, contributing to lower jaw pain.

Jaw pain can also be caused by issues with the temporomandibular joints, which are located just in front of your ear canals. You can feel these joints from the outside when you open and close your mouth. For more detailed information on this topic, please refer to the article “Jaw Joint Pain“.

This section and the following three need to be kept somewhat general, as unilateral pain of the jaw, bilateral pain, jaw pain when opening, and pain when chewing can have multiple complex causes. We would like to list the possible issues here and go into further detail in the other texts of this website. Possible causes of unilateral jaw pain include cavities, deep dental fillings, prior root canal treatments, cysts located under a tooth, CMD, wisdom tooth issues, periodontitis, and gum inflammations.

Bilateral pain of the jaw can originate from various causes, including cavities in multiple teeth, deep fillings located on both sides of the jaw, new dental prosthetics involving several teeth, and often, conditions like CMD (Craniomandibular Dysfunction).

Experiencing jaw pain while chewing may indicate that either the pressure on the teeth is causing discomfort or that the masticatory muscles and temporo-mandibular joints are affected. If the teeth are the source of the pain, potential causes include cavities, conditions following a deep filling, fractures of a tooth, root tip inflammations, or worn-down teeth due to grinding. If the chewing muscles and jaw joints are the culprits, CMD is often the most common reason.

Jaw pain specifically during the opening phase of the mouth points to a disorder of the temporo-mandibular joints, as they move forwards during this action. Overloaded cartilage structures, friction, and grinding in the joint can all contribute to this pain. Seeking relief is essential, and a CMD splint treatment can serve as an initial aid to alleviate the joint and allow it to regenerate. For effective regeneration of the joints and treatment of the disturbed chewing system, the splint should be specially designed for the individual patient and adjusted every two weeks. More detailed information can be found in the CMD article.

In this section, we will explore the causes of jaw pain. A thorough diagnosis and clear understanding of the causes are crucial for effective treatment.

Jaw pain caused by a wisdom tooth is often due to a lack of space or pressure on the neighboring teeth. This pressure can radiate, leading to headaches or affecting the positioning of nearby teeth, which can also cause discomfort.

When the rear jaw area is too small for the wisdom tooth and cleaning becomes difficult, an inflammation can occur. Bacteria can penetrate deep under the gums, evade dental care, multiply, and affect the jawbone. This results in a chronic inflammation around the wisdom teeth. This condition typically arises during adolescence but can also develop later in adulthood.

Symptoms often fluctuate, reappearing after a few weeks, while never completely disappearing, depending on the immune system’s activity. It becomes a constant battle between the bacteria and the body’s defenses. Without treatment, this situation will not improve in the long term. It is essential to have an X-ray (at least an OPG/OPT panoramic X-ray, preferably a CBCT scan) taken by the dentist. This allows for an assessment of the space, the extension of the inflammation, the urgency of action, and the optimal timing for removal.

Gum inflammations can vary in severity and may cause jaw pain. Often, it begins as mildly as gingivitis and can progress to periodontitis. Over time, as the bone around the teeth deteriorates due to periodontal pathogens, the teeth can become loose. These processes are often chronic and may not be felt by the patient. However, acute, increasing inflammation may cause noticeable pain. In severe cases, a periodontal abscess can develop, leading to significant tissue damage and severe discomfort. Timely diagnosis and regular therapy, including thorough subgingival dental hygiene (cleaning under the gumline) and ozone disinfection, can help alleviate gum inflammation, halt its progression, and even regenerate lost tissues depending on individual health conditions. Chronic inflammation often occurs when the body is in a state of increased inflammation, so comprehensive medical support can also help strengthen the body and have a positive influence on the health of the gums and bone.

Jaw pain is often reported after a root canal treatment. Pressure in the jawbone can occur, especially when biting down onto the tooth, and may radiate. During a root canal treatment, the nerve is removed, the walls of the nerve canal are cleaned with small scraping needles, and the canals are flushed with disinfecting solutions. As nerves from the other side of the tooth extend into the bone, they can continue to cause issues later. Biting down can cause the typical pain, and an x-ray often reveals a cyst at the root tip. Another possibility is the irritation of tissues and bone caused by the rinsing / disinfecting solutions used during the procedure. These solutions aim to kill bacteria, but can also be very irritating and painful to the bone if overused. Root filling materials (such as gutta-percha and sealers) can also irritate the tissue if they extend from the tooth into the bone. This can easily happen when striving for a dense, stable root filling and pressing the filling material firmly into the tooth. Please schedule an appointment with your dentist if you experience pain after a root canal treatment or filling.

Cavities occur when bacterial acids demineralize a tooth. In the early stages, you might not feel any discomfort, but as the decay progresses deeper, it can cause more frequent pain, especially as it approaches the dental nerves. Initially, you might experience toothaches, but over time, strong pressure can build up in the tooth, and the infection can spread into the jawbone, potentially causing pain.

Jaw pain can also occur after getting a dental filling. This can happen if the filling is too high, causing excessive pressure on the dental support structures and nerves, or if the filling is near the dental nerve. The depth of the filling depends on the depth of the cavity. If the cavity is close to the nerve and is thoroughly cleaned, the nerve might become irritated. Additionally, the tooth must be dried by blowing air across it and the surface roughened for a clean filling, which can also cause irritation. If you suspect your jaw pain is caused by a cavity or a recent filling, please schedule an appointment with your dentist.

After a dental or oral surgery, it is common to experience swelling and increased blood flow to the area. This increased blood supply tansports oxygen and nutrients to the operated areas, promoting healing. It is normal to experience wound pain and swelling in the first few days after surgery. Ensuring that the operation is performed gently, carefully, minimally invasive, and with minimal trauma can significantly increase comfort.

In very complex wisdom tooth surgeries (depending on the location of the tooth) or the removal of severely inflamed teeth, jaw pain may be more pronounced. If there are no medical contraindications or allergies, typical pain medications such as ibuprofen, paracetamol, or mefenamic acid, as well as natural pain relievers, can help cover the challenging first days. Cooling the cheeks, gentle lymphatic drainage (light stroking over the cheeks towards the neck), and various integrative medical treatments such as neural therapy can help minimize pain after a surgery.

CMD, or craniomandibular dysfunction, refers to issues with the masticatory system that can lead to various health problems and symptoms.

Experiencing head and jaw pain due to CMD can be quite challenging for those affected.

It’s important to seek treatment by experienced, specialized dentists to avoid further imbalances in the system.

The therapy step is to relax the entire masticatory system and help the temporomandibular joints return to a healthy, centered position. Once this foundation is established, the teeth and bite situation can be properly addressed.

Trigeminal neuralgia is often described as very rapid, spontaneous, extremely painful, stabbing, and shooting sensations reminiscent of an electrical impulse. This condition is more common in women than in men, has various causes, and requires a complex treatment. The trigeminal nerve, which is divided into three branches, transmits facial sensations to the brain. Disruptions in this transmission, such as pressure of blood vessels onto the nerve, can trigger typical pain. Sometimes, facial trigger points can also stimulate its occurrence.

In some cases, especially when the pain radiates into the lower or upper jaw, it is necessary to check for neuralgia-inducing cavitations (NICOs). These chronic inflammation regions, located deep in the jaw can trigger neuralgic symptoms. Dental-related inflammations, apical osteolyses, and cysts can also be involved, so thorough dental evaluation alongside the neurological treatment is essential.

We have successfully treated patients in the past who were previously diagnosed with “trigeminal neuralgia.” Ensuring a healthy oral cavity is crucial, which may involve removing inflamed teeth, chronic infections, any metals, and possibly wisdom teeth depending on their location.

Jaw pain is commonly associated with a cold due to the close proximity of the sinuses to the jaw. Especially in the upper jaw, the dental roots reach up close to the sinuses. A cold, flu, or COVID-19 infection can cause swelling of the mucous membranes, increased blood flow, and thus an increase in pressure and pain. It is also possible for the virus to infect the oral mucosa itself (the nasal mucosa and the mucosa of the throat seamlessly transition into the oral mucosa), requiring the body’s immune system to fight the infection.

Many people suffer from uncomfortable jaw pain and the issues related to it. In the next section, we’re here to answer some of the most common questions about pain of the jaw regions.

Here, you can find additional information on the topic to gain a deeper insight.