Where can jaw pain be caused from

More than one in twelve people suffer from pain and discomfort in the jaw, which affects their ability to eat and speak.

In most cases, the pain is caused by a disorder or injury to the joint that connects the lower jaw to the rest of the face. This joint is called the temporomandibular joint, located in front of the ears, and is one of the most complex in the human body, as it is structured in such a way that we can chew, swallow, and speak comfortably.

When this joint is damaged, the patient may develop what is known as temporomandibular joint syndrome. “This term refers to a group of dysfunctions involving the joint, its supporting structures (muscles, ligaments, tendons), and nerves, on one or both sides of the head, causing pain in the jaw, face, head, and/or neck,” explains Dr. Katerina Douma-Michelaki, DDS, PhD, Specialist Orthodontist for Children & Adults. “The pain and other discomforts can be severe, intermittent, or continuous, and may be temporary or last for many years. Additionally, symptoms may flare up during periods of life with intense stress (positive or negative).”

Damages to the temporomandibular joint may have many possible causes, such as an injury that does not necessarily manifest in the jaw or the temporomandibular joint. In fact, even injuries to the teeth, neck, and/or the muscles of the head, neck, or face (e.g., from a blow to the head or face) can lead to the syndrome.

Other possible causes include:

* Teeth grinding and clenching (bruxism) at night during sleep, which exerts high pressure on the jaw.

* Poor bite alignment, which can lead to long-term, asymmetric pressure on the jaw muscles.

* Wear of the articular cartilage (the soft tissue that coats the bone surfaces forming the temporomandibular joint, to prevent friction between them).

* Displacement of the articular disc (a disc that lies between the surfaces of the temporomandibular joint and protects them).

* Stress, which makes many people unconsciously tighten the muscles of the face and jaw or clench their teeth.

* Bad habits, such as using the teeth as bottle openers or talking with the head tilted to support the phone on the shoulder.

* Various disorders and conditions, such as arthritis, inflammatory diseases, and local factors from dental problems.

The temporomandibular joint syndrome mainly affects young people (ages 20 to 40), who are otherwise healthy, but it can also be observed in older age, especially after the age of 50.

It is estimated that one in three men and women have experienced at least one symptom indicating a temporomandibular joint disorder in their lifetime, while 7% of the general population experiences severe symptoms for which they seek medical advice.

For reasons that are not yet fully understood, women develop temporomandibular joint syndrome at twice the rate of men.

The symptoms

Common symptoms of temporomandibular joint syndrome include:

* Pain or tenderness in the face, temporomandibular joint, neck, shoulders, and around or inside the ear when the sufferer chews, speaks, or opens their mouth wide.

* Difficulty opening the mouth.

* “Locking” of the jaw in one position, due to pain preventing the patient from moving their mouth.

* Clicking or popping sounds from the joint when the sufferer opens or closes their mouth or chews. The sounds are not always accompanied by pain.

* Feeling of fatigue in the face.

* Difficulty chewing or sudden sensation that the upper teeth do not align well with the lower teeth.

* Swelling on the sides of the face.

The sufferer may also have toothache, headache, neck pain, dizziness, pain or/and ringing (tinnitus) in the ears, hearing problems, or/and pain in the upper shoulder.

Diagnosis and treatment

“The symptoms of temporomandibular joint syndrome are non-specific and likely multifactorial,” emphasizes Dr. Douma-Michelaki. “To determine their cause, we must take a detailed medical history from the patient and carefully examine the face and oral cavity, looking for signs of tenderness and sounds during the movement of the lower jaw.”

In many cases, an X-ray of the face is also necessary to visualize the jawbones, temporomandibular joints on the sides of the face, and teeth, and to rule out other possible causes of the patient’s symptoms. “Depending on the case, additional tests may be needed, such as the new methods of computed tomography or magnetic resonance imaging, which will show in detail all the structures of the joint,” says Dr. Douma-Michelaki.

The treatment will be determined based on the findings of the examination and is usually conservative, involving the use of a special oral splint, orthodontic work to correct any bite problems, medication, and, in rare cases, when the patient does not improve with conservative measures, surgical intervention may be needed, concludes Dr. Douma-Michelaki.