What are Some of the Causes of Jaw Pain?
There are many causes of jaw pain. Jaw pain may be the result of decay in close proximity of the nerve or the pulp within the tooth, or it may be the result of an abscessed tooth, bone cancer (malignant), temporomandibular joint syndrome (TMJ), impacted wisdom tooth, trauma, earache, traumatic occlusion, jaw surgery, jaw muscles, non-malignant lesions such as a growing cyst creating pressure on a nerve, periodontally involved (loose) teeth, poorly fitting dentures, a failing root canal or implant, cracked or split tooth, or many other causes, even sinus infection. You can easily determine that there are many different causes or etiologies, as we say. Determining the cause of sudden jaw pain, as well as chronic jaw pain (which may even have a slower onset) requires very careful, extensive and thorough, examination and diagnosis.
When we discuss jaw pain, we are referring to either the maxillary arch (upper jaw), the mandibular arch (lower jaw), or both. In either case, the patient may experience sudden jaw pain. But the causative factor may be long-standing other than trauma resulting in a fracture to one of the arches, or sudden pain brought on by a cracked or split tooth.
One of the many causes of jaw pain is decay spreading until it reaches close approximation to the pulp or nerve of the tooth. If the tooth is beginning to abscess, bacteria invade the pulp and create gas. This then builds up the pressure and then travels out the root tip resulting in significant jaw pain. If the tooth is abscessed, it will need treatment by either a root canal or extraction. If one suffers through the pain and receives no treatment, infection from the root tip will eventually erode through the bone, create a gum boil, and then drain (fistula). A root canal may still treat the tooth in order to heal up the fistulous track.
Jaw pain may also result from bone cancer expanding into the surrounding areas resulting in increased pressure. The pressure is what creates discomfort. Careful diagnosis via CT “Cat” scan x-rays, the patient’s history, palpation of the area, visual examination, and other diagnostic methods are required for diagnosis. The patient is strongly advised to see the oral surgeon. The exact same thing can be said about soft tissue cancer. Periodic check-ups by your general dentist and referral to the oral surgeon specialist is a must. A biopsy may be deemed necessary to determine exactly the specificity of the lesion.
Temporomandibular Syndrome (TMJ) may well be the etiology of non-specific jaw pain. The pain begins in the temporomandibular joint and results in jaw pain, joint pain, and usually causes fairly severe headaches. TMJ Syndrome is treated in many fashions…a bite splint, occlusal equilibration, orthodontic treatment, or maxillofacial surgery.
The symptoms of TMJ are often headaches, earaches with no evidence of infection, pain in the surrounding muscles of the head, neck, and shoulders, jaw pain, and soreness of the teeth. Often clicking or popping of the jaw is present. The pain is usually elicited when the ball of the mandibular bone is not functioning properly with the socket of the temporalis bone of the skull for a variety of reasons. This often results in damage to the meniscus or cartilage pad between the two, and improper tension on the muscles, tendons, and ligaments of the jaw. Arthritis, which is inflammation of the joint, may also be involved. All this leads to pressure on the facial nerves which in turn cause the patient discomfort, such as ear pain or jaw pain.
Wisdom teeth, if you speak in evolutionary terms, are on the way out. They are useless in most cases and approximately 82% need to be removed for one reason or the other. An impacted wisdom tooth can cause:
- muscle tightness,
- pain in the ear or joint,
- an undue pressure in the area,
- orthodontic complications,
- jaw pain in general.
- iatrogenic dentistry
Iatrogenic dentistry (a condition caused by the dentist) such as a “high” crown or a “high” filling that comes into contact with the opposing tooth first, every time you chew or swallow, and can very quickly cause jaw pain. The treatment, in this case, most of the times is simple and quick. Simply make an adjustment in the height of the crown or the filling and the discomforting jaw pain goes away.
Improper occlusion caused by poorly aligned teeth or jaws easily may cause jaw pain. If the teeth and jaws do not fit together properly and the condition is severe, then orthognathic surgery and/or orthodontic treatment may become mandatory.
Cracked or Split Tooth
A cracked or split tooth usually results in jaw pain and the unrepairable tooth must be removed and either replaced by an implant and crown or by a fixed bridge.
Multiple myeloma, a type of blood cancer, may certainly cause jaw pain. One of the types of blood cells usually proliferates and becomes abnormal in numbers. This creates a tumor within the soft internal part of the bone. This prohibits the bone from producing blood cells in the correct ratios or quantities. If this occurs in the jaw, the resultant situation is chronic jaw pain. The patient should be referred to an oncologist (cancer specialist). This is because this condition usually causes a reduction in the cell count of oxygen absorbing platelets. The patient than not only develops jaw pain but also becomes anemic.
There is such a variety of causes for jaw pain. An astute person should definitely visit their dentist at least twice a year as many of these situations can be avoided. Should jaw pain develop for any reason, see your general dentist. He will refer you to an oral surgeon, orthodontist, endodontist, or periodontist if necessary. Should the jaw pain be from trauma such as a car wreck or a fall, or the like, place ice over the area to prevent swelling and see the oral surgeon.
Life member of the American Dental Association, Emeritus Fellow of the Academy of General Dentistry, American Association of Implant Dentists