What to do if your jaw hurts when you open your mouth and when you chew: probable causes of pain and ways to eliminate it. Causes of pain in the jaw when opening the mouth and chewing, what to do It is difficult to open the mouth on one side

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Pain can be caused by diseases of the jaws themselves, ENT organs (nose and paranasal sinuses, throat, ears), lymph nodes, tongue, gums, nervous system, chewing muscles, etc.

The main reasons leading to the occurrence of pain in the jaws include:

• trauma;
• inflammatory and infectious diseases;
• pathology of peripheral nerves and vessels;
• tumor processes.

Pain in the jaw while wearing orthoses

It is believed that for people with braces, pain in the jaw area and headaches are quite normal. At the same time, there is an increased fragility of the teeth. All these are signs that the braces are installed correctly, the teeth are shifting, and the correct bite is being formed. The orthodontist should definitely warn his patients about this.

Pain syndrome when wearing removable dentures worries due to the fact that the jaws are not yet accustomed to these structures. Thus, this symptom can be considered normal only at first. After some time, the aching pain in the jaw and discomfort should completely disappear. If this does not happen, you need to see a doctor.

Malocclusion

Jaw injury pain

Jaw injury

In case of an injury accompanied by a bruise of the face and pain in the jaw, it is worth visiting the emergency room and undergoing an x-ray to rule out more serious injuries.

jaw fracture

Fractures of the upper jaw are especially serious. If at the same time the pain is accompanied by hemorrhage around the orbits (the so-called "spectacle symptom"), then there is every reason to assume a fracture of the base of the skull. If droplets of blood or a clear liquid stand out from the ears, then the injury is very serious. You need to call an ambulance immediately.

In the trauma center, for the purpose of more accurate diagnosis, an X-ray examination is performed. After establishing the nature of the fracture, a special bandage is applied, or surgical treatment is resorted to. Fractures of the base of the skull are treated only in a hospital.

Dislocation

At the moment of dislocation, there is a rather strong sharp pain in the region of the lower jaw and temporomandibular joint. In parallel, there are other symptoms:

• the mouth is fixed in the open position, it is very difficult for the patient to close it;
• the lower jaw is not in the correct position: it is pushed forward, or beveled to one side;
• naturally, this leads to a speech disorder: if no one was nearby and did not see how this happened, it can be difficult for the patient to explain what happened to him;
• since it is impossible to swallow saliva normally, it is secreted in large quantities and flows out of the mouth.

Pain after jaw fracture

• damage to the necks, ligaments of teeth and gums with a wire, with which the doctor fixes the splint;
• repeated fracture or displacement of fragments, if at the same time a sharp pain in the jaw is again accompanied by the occurrence of edema and hemorrhage;
• massive trauma and nerve damage.

Jaw pain in purulent-inflammatory diseases

Osteomyelitis

With osteomyelitis, there is a fairly severe pain in the region of the upper or lower jaw. Other symptoms are clearly manifested:

• an increase in body temperature, sometimes very significant - up to 40 o C, and even more;
• swelling under the skin in the area of ​​the pathological focus;
• swelling can be so great that the face becomes distorted, asymmetrical;
• if the pain in the jaw is caused by an infection that has come from the tooth, then when examining the oral cavity, you can see this affected tooth - as a rule, there will be a large carious defect and pulpitis;
• at the same time, the submandibular lymph nodes become inflamed, resulting in pain under the jaw.

Phlegmon and abscesses

Pain in the jaws can also be caused by a paratonsillar abscess - an abscess, which is a complication of angina, and is located on the side of the tonsil, on the right or left.

Furuncle

With a boil, the cause of pain in the jaw is beyond doubt - the pathological formation is located on the skin, and manifests itself outwardly very brightly.

If the boil is on the face, then this condition is dangerous in terms of the possibility of infection spreading into the cranial cavity. Therefore, do not try to squeeze it out yourself - you need to see a doctor.

Pain in the jaw near the ear - pathology of the temporomandibular joint

arthrosis

• many patients note pain and crunch in the jaw at the same time - and sometimes various noises and crunches may be the only manifestation of the pathology;
• pain sensations intensify during strong opening of the mouth, closing of the jaws, chewing, which often causes patients to chew food on only one side;
• there is stiffness of movements in the joint in the morning.

Arthritis

• pain can be of varying degrees of intensity, from a slight feeling of discomfort to a very painful sensation;
• the sounds that are felt when the joint moves can be different: crunching, clicking, noise;
• often the disease begins with the fact that a person feels stiffness in the joint in the morning.

Temporomandibular joint dysfunction

• pain in the jaw area often radiates to other areas: temple, cheek, forehead;
• with strong and sharp openings of the mouth, the patient feels clicks;
• impaired jaw movements.

Chronic pain in the jaws with tumors

Benign jaw tumors

All benign jaw tumors that are asymptomatic or accompanied by pain are subject to surgical treatment.

Malignant tumors of the jaws

For the treatment of malignant tumors of the jaws, surgical methods, radiation therapy, chemotherapy, etc. are used.

Dental pathology

• Caries is a pathological process that is accompanied by tooth decay, the formation of a carious cavity in it, and irritation of nerve endings.
• Pulpitis is a lesion of the soft tissues of the tooth (pulp), this is a deeper process, which is a complication of caries.
• Periodontitis is an inflammatory process in the tissues surrounding the teeth.
• A periodontal abscess is an abscess that is located next to a tooth.
• Limited osteomyelitis of the jaw is the result of the spread of pathogens and inflammation from the tooth into the bone tissue. It may be the beginning of a more extensive purulent process in the bone.
• Injuries of the teeth: dislocation of the tooth from the hole, fracture of the neck of the tooth.
• Increased sensitivity of teeth to mechanical stimuli, high and low temperatures.
• Spontaneous toothaches - can occur briefly in some people for no apparent reason.

The diagnosis and treatment of pathologies that are the causes of odontogenic toothaches is carried out by a dentist (in the case of surgical pathology, a maxillofacial surgeon). In some cases, surgical intervention on the jaw is indicated (for example, with osteomyelitis).

Inflammation of the mucous membrane of the gums

There is also such a condition as alveolitis - inflammation of the alveoli after tooth extraction. In this case, pain also spreads to the jaw.

Pain in the jaw of neurogenic origin

2. Neuralgia of the superior laryngeal nerve. In this case, there is a fairly intense pain under the lower jaw, on the right or left. It can spread to the face, chest. Characterized by the occurrence of pain during yawning and chewing, blowing your nose. Often the patient is simultaneously concerned about coughing, salivation, hiccups.
3. Glossopharyngeal neuralgia. This is a fairly rare pathology. It is characterized by pain that occurs in the tongue, and then radiates to the lower jaw, pharynx and larynx, face, and chest. Provoking factors for the occurrence of pain are: tongue movements, conversation, eating. Usually the pain lasts no more than three minutes, and is accompanied by severe dry mouth. After an attack - on the contrary, increased salivation worries.

Treatment of pain in the jaws with nerve damage depends on the nature of the pathology. Usually, medications are prescribed first, and if they are ineffective, they resort to surgical intersection of the nerves.

Vascular diseases

Pain in the jaws is noted in the following vascular pathologies:
1. Arteritis of the facial artery accompanied by burning pains in the jaws. In this case, pain can occur in the lower jaw (along the lower edge, from the chin to the corner) or the upper jaw (in the region of the wings of the nose and upper lip). The most typical place of localization of pain is the middle of the lower edge of the lower jaw - where the facial artery bends through it. Pain is given to the inside of the eye.
2. Carotid artery injury , whose origin is not entirely clear, is today considered as a type of migraine. Pain occurs in the lower jaw and under it, in the neck, teeth, ear, sometimes corresponding to half of the face. Pain can be provoked by feeling the area of ​​the carotid artery.

For pain in the jaws caused by vascular pathologies, special medications are used.

Causes of pain under the lower jaw

First of all, it is worth considering the pathologies associated with the submandibular lymph nodes. They may develop an inflammatory process (lymphadenitis). In this case, the infection enters the lymph nodes with the flow of blood or lymph from diseased teeth, with injuries. In acute lymphadenitis, there is a sharp pain under the lower jaw, fever, general weakness and malaise. Without appropriate treatment, this disease can become chronic. In this case, an enlarged lymph node is well felt under the lower jaw. Periodically, the process is exacerbated, which is accompanied by the recurrence of acute pain. Submandibular lymphadenitis can lead to such purulent-inflammatory processes as submandibular phlegmon and abscess.

Tumors of the submandibular lymph nodes most often they are metastases that penetrate into them from the jaw itself or other organs. At the same time, there is an increase in lymph nodes for a long time, their cohesion with the skin and other neighboring tissues. There are chronic pains under the jaw of a different nature. Other symptoms: a slight increase in body temperature for a long time, weakness, malaise, weight loss. The doctor who conducts the diagnosis must ultimately answer two questions:
1. What takes place in this case: lymphadenitis or metastases in the lymph nodes?
2. If these are metastases, from which organ did they spread?

glossalgia- increased sensitivity of the tongue. There are pains that radiate to the lower jaw. Glossalgia attacks are provoked by a long conversation, chewing rough food, taking cold, hot, spicy, sour dishes, etc.

Glossitis is an inflammatory lesion of the tongue, in which there is also pain under the lower jaw. When examining the oral cavity, the tongue looks thickened, has a bright red color. With a long course, glossitis is able to transform into a submandibular phlegmon or abscess. In this case, there are pains that radiate to the lower jaw.

sialoliths- salivary stone disease. Accompanied by mild pain under the lower jaw and soreness with pressure on the site of the lesion. Salivary stone disease of the sublingual and submandibular salivary gland leads to pain in the lower jaw. Other characteristic symptoms of this disease:

• swelling under the lower jaw, usually only on the right or left;
• pus is released from the duct of the gland, which opens in the oral cavity, as a result of which the patient is worried about an unpleasant smell in the mouth;
• if the process escalates, then there are classic signs of inflammation: fever, malaise, weakness.

Sialadenitis is an inflammation of the salivary glands. With the development of the inflammatory process in the sublingual and submandibular gland, there is pain under the lower jaw, fever, and malaise. The process can transform into an abscess or phlegmon.

Benign and malignant salivary gland tumors manifested in the form of prolonged pain under the lower jaw of low intensity. With a malignant course and metastasis, there is an increase and soreness of nearby lymph nodes, exhaustion, weakness.

At pharyngitis(inflammation of the pharynx) patients in some cases are concerned about pain in the throat and lower jaw. There is a sore throat, cough.

Angina (tonsillitis) - inflammation of the tonsils, manifested in the form of severe pain in the throat when swallowing. In this case, the pain can be given to the jaw, to the ear. Body temperature rises, other signs of a respiratory infection may occur.

Tumors of the larynx. When the laryngeal nerve is irritated by a tumor, the pain spreads to the chest, lower jaw, and ear. Pain usually develops gradually over a long period of time. The patient is concerned about the "lump", the sensation of a foreign body in the throat, perspiration, cough, voice disturbance. And with large tumors, breathing becomes difficult.

Pain in the lower jaw on the left with myocardial infarction and angina pectoris

Such a course of angina pectoris, and especially myocardial infarction, is very dangerous. A heart attack always poses a threat in terms of the development of severe complications, up to death. The patient should be immediately placed in the intensive care unit. But he does not even think about visiting a cardiologist, but goes with his complaints to a dental clinic.

This can mislead even a dentist: the doctor is taken for the treatment of a non-existent dental disease.

Pathologies of the maxillary sinuses and parotid salivary glands

• persistent nasal congestion;
• successive acute respiratory infectionsthat do not go away;
• swelling in the upper jaw on the right or left, pain in this place when pressed;
• fever, malaise.

Mumps(mumps, viral infection of the salivary glands) - a disease that is most common in childhood. There is a general soreness of the gland (it is located anterior to the auricle), the spread of pain in the upper and lower jaws. The appearance of the patient is very characteristic: there is a pronounced swelling in the cheeks. The body temperature is elevated, the patient experiences general malaise. Parotitis passes without a trace, in the future a strong immunity is formed, which does not allow the re-development of the disease.

Sometimes there is such an unusual condition when the jaw does not open completely or does not open well. A person cannot fully eat, talk, and when trying to open his mouth a little wider, pain appears, sometimes of a sharp nature. Trying to sharply open his mouth, a person feels severe pain in the region of the mandibular joint, and it can also radiate to the temporal region. This condition, in which the jaw does not open completely, is called muscle contracture. Problems in the periarticular tissues of the temporomandibular joint can also be the cause of such complaints.

A sharply limited opening of the mouth is observed with ankylosis of the temporomandibular joint. With this disease, complete or partial fusion of the articular surfaces occurs. Normal eating becomes impossible, bite, breathing is disturbed. The face takes on a "bird" look. The treatment of this pathology is surgical. Additionally, massage, exercise therapy, drug therapy and a sparing diet are prescribed.

When a contracture of the jaw apparatus appears, it is recommended to consult a specialist. After additional diagnostic measures, he will be able to determine why the mouth does not fully open, why pain appears, and what to do in this case.

With contracture, there is a sudden difficulty in the mobility of the joint, which is responsible for the movements of the lower jaw, due to pathological processes in the muscle or ligamentous tissue. Often, such processes are provoked by injuries, diseases, reflex sharp muscle contraction.

There are certain reasons why it is impossible or difficult to open your mouth:

• contracture of the muscles of the jaw apparatus, which occurs due to injuries (for example, after a fall, impact), sprains of the muscular apparatus (with prolonged wide opening of the mouth at the dentist);
• myositis, which are obtained with the introduction of anesthesia (mandibular or torusal), which is used in the treatment or extraction of units on the lower dentition;
• inflammatory process in the muscular apparatus, which appeared as a result of hypothermia or infection;
• rheumatic diseases and, as a result, inflammation in the temporomandibular joint;
• injury to the joint or surrounding tissues;
• subluxation;
• periostitis of the alveolar process and inflammation, which has spread to all structures of the ligamentous apparatus of this area;
• processes of a purulent nature (phlegmon, abscesses) on the mandibular apparatus, which provoke an inflammatory process of the joint itself or the muscles that move the lower jaw.

All of these conditions can cause a condition in which the jaw cannot be fully opened, and the mouth opening range itself ranges up to one centimeter.

What to do

If the cause of contracture of the muscular apparatus was the introduction of anesthesia, overstretching of the muscle with prolonged opening of the jaw, such conditions usually resolve on their own within a few days and do not require special treatment. If the reasons lie elsewhere, a visit to a specialist is mandatory.

In the event that this pathology is caused by adhesions, scars, tissue fusion, it is advisable to use radical treatment, which involves surgery. Surgical treatment consists in excision of modified tissues, replacement of lost tissue areas. Typically, oral and maxillofacial surgeons perform such procedures.

If there is additional pain

If, in addition to muscle contracture, pain appears during opening of the mouth, there are probable causes of this condition:

1. Fracture. During it, there is soreness, difficulty with jaw movement, hematoma or bruising. In such a situation, you should immediately visit a specialist.
2. Osteomyelitis of the jaw. Treatment of the disease should be carried out immediately, since dangerous complications can occur.
3. Arteritis of the facial artery.
4. Dysfunctions in the jaw apparatus. They can be congenital (for example, malocclusion), acquired (inflammation of the joint).

Regardless of the cause and severity of symptoms, it is recommended to contact a qualified specialist in a timely manner, who can diagnose, determine the cause and prescribe the correct treatment regimen. If the use of conservative therapy options does not bring the desired result, it is advisable to undergo surgical treatment to restore the full function of the temporomandibular joint.

Bol in the jaw in the projection of the ear- a syndrome that can characterize the occurrence of various nosological units. Inflammatory and / or traumatic genesis, as a rule, is the cause of the pain syndrome.

Pain itself is an adaptation mechanism that is designed to ensure the constancy of homeostasis and prevent the continuation of the action of the inflammatory factor. A large number of inflammatory mediators are produced, which localize the process and prevent it from becoming systemic.

Reasons for the appearance

The appearance of pain in the jaw and ear has a number of reasons associated with organic tissue pathology or a traumatic factor.

Conditionally, it can be divided into several reasons:

• Acute inflammatory diseases.
• Chronic inflammatory diseases.
• Injuries.
• Neuritis and neuropathy.

Acute inflammatory diseases

Occur when a foreign infectious agent is introduced. Once in the body, it initiates the onset of a local inflammatory reaction. The main targets are the salivary glands, tonsils and lymph nodes.

immune cells- the host, determine the infection and contribute to the production of a large number of specific proteins - inflammatory mediators.

Under their action, blood migration occurs with the formation of areas of hyperemia. A liquid rich in proteins and plasma enzymes rushes to the focus of inflammation. It performs the function of eliminating foreign cells. The work of the cellular apparatus is rebuilt to create a capsular barrier in the cytoplasmic membrane.

With inflammation of the tonsils- pain in the ear and upper corner of the lower jaw, may indicate a complication of the process and the formation of a paratonsillar abscess.

Appears:

• General weakness.
• Sweating.
• An increase in temperature.
• Congestion in the ears.
• Pain when opening the mouth.
• Sharp pain when swallowing.

Accompanied by severe pain, which is located in the parotid space.

Symptoms:

• Swelling of the skin near the ear.
• Sharp pain on touch.
• Pain when opening the mouth and chewing.
• Increase in body temperature.
• Chills.
• General weakness.

Inflammation, is a concomitant disease with many other diseases and practically does not occur on its own. Symptoms are determined by the underlying disease.

Can be:

• Pain when opening the mouth.
• Pain on touch.
• Increase in body temperature.
• Edema of soft tissues.

If any of the symptoms occur, you should contact your doctor.

chronic inflammatory diseases

They are the result of not fully treated acute diseases and do not fundamentally differ from them.

The nature of the course of a chronic process is based on a number of features that are different from the acute course, such as:

• Persistent symptoms.
• The pain syndrome is poorly treatable.
• The nature of the pain changed from sharp to aching and dull.
• As the pathological process progresses, in the organs included in the work, organ failure increases with atrophy of their functions.

In order to prevent the chronicization of an acute process, it is necessary to strictly observe the treatment regimen and consult a doctor if the condition worsens. It is necessary to modify daily activities to alleviate the condition.

Injuries

Exposure to a mechanical, thermal or chemical factor can cause pain.

Mechanical factor

Mechanical trauma is one of the most common causes of jaw pain.

Main cases:

• Hit- short in time, force impact on soft tissues, with microruptures of blood vessels.
• Shake- a traumatic event that occurs during forceful inertial motion.
• stretching- excessive stretching of elastic structures, with their traumatization.
• Tearing of muscles and ligaments- separation of muscles and ligaments, against the background of increased mechanical action. The main place of detachment, the place of attachment of the aponeurosis to the head of the bone.

Chemical and thermal factor

When exposed to low or high temperatures, acids and alkalis, a burn of the skin occurs with damage to the neurons of the skin, followed by a violation of the passage of the pain impulse or excessive irritation of the neuron

Neuritis and neuropathy

Inflammation of the nerves that innervate the muscles and ligaments of the maxillofacial region can cause pain.

The most common lesions:

1. Neuritis of the facial nerve - basically begins, with the capture of the arch of the lower jaw.
2. Trigeminal neuritis - inflammation and impaired transmission of the nerve impulse, followed by the appearance of pain, occurs in the 2nd and 3rd branches of the trigeminal nerve.
3. Neuritis of the external nerve of the mandible - mainly manifests itself as numbness of the mandible, pain rarely occurs.

The doctor should deal with the establishment of the cause of the pain syndrome. Self-examination and further treatment is not recommended.

Pain in the jaw on the left and right side

As a rule, the causes of pain on the right or left are identical to each other. The anatomical structure is the same and it all depends on which side the inflammation occurs or the traumatic factor is applied.

But still, there are differences and relate to highly specific systems that are outside the cervicofacial region.

Pain on the left

These include:

• Inflammation of the lymph nodes of the neck and lower jaw
• Inflammation of the salivary glands.
• Injuries.
• Neuritis.
• Inflammatory process in the auditory canal.

The highly specific causes of pain on the left side of the jaw include:

1. Inflammation of the paranasal sinuses and upper jaw.
2. Heart disease (with myocardial infarction or an attack of angina pectoris, radiating pain occurs in the left arm, lower jaw on the left).
3. Diseases of the pancreas (irradiation of pain in the neck, lower jaw).
4. Obliterating atherosclerosis of brachycephalic arteries.

Pain on the right

The main types of disorder:

• Inflammatory process in the salivary glands.
• Lymphadenitis.
• carious teeth.
• Pulpitis.
• Diseases of the auditory canal.
• Neuritis and neuropathy of the cervicofacial nerves.

Highly specific reasons:

1. Acute or exacerbation of chronic cholecystitis (radiation of pain in the lower jaw on the right).
2. Liver diseases.
3. Diseases of the bronchopulmonary apparatus.

All these symptoms are equally valid for both sides and the doctor should deal with their analysis and differential diagnosis.

Oncological factor

With the appearance of pain in the jaw and ear, it is necessary to exclude a malignant neoplasm.

The main places of growth of sarcoma:

• Lymph nodes.
• Salivary glands and ducts.
• Bones.

The main clinical symptom consists of an alternating change of its two important components:

1. Numbness.
2. Pain.

• Numbness- Decreased sensitivity of the skin at the site of the oncological process.
  At the very beginning, the connective tissue grows, which compresses the receptors and nerves. As the tumor grows, the greatest violation of the passage of the nerve impulse occurs.
• Pain, occurs at the time of excessive growth of the tumor and the capture of surrounding spaces. As a rule, at this stage it is detected visually.

It is necessary to establish the type of cells of tumor growth, for this, the affected tissue is taken and examined by a morphologist.
Establishing the type of flow is one of the main tasks. Her decision will determine the tactics of patient management and raise the issue of starting chemotherapy courses.

Pain while chewing

The occurrence of this symptom may indicate a pathological process in the lower jaw, masticatory joint or in the structure of teeth and gums.

The most common causes of pain when chewing:

1. Tooth caries.
2. Insufficiency of the mandibular joint of the lower jaw.
3. Injury.

• Carious process, destroys the enameled surface of the tooth, exposing the nerve endings. When eating, they are irritated and the pain impulse passes through the lower branches of the trigeminal nerve, causing severe pain.
• Insufficiency of the mandibular joint of the lower jaw, is manifested in its insufficient mechanical activity. Its functionality is impaired.
• Injuries cause acute pathological process and pain syndrome.

Jaw pain when opening mouth

The most common causes of pain when opening the mouth include:

• Injuries of the lower and upper jaw (fractures, dislocations, ruptures of muscles and ligaments).
• Diseases of the teeth and gums (caries, periodontitis, pulpitis).
• Disorders in the metabolic and functional system of the upper maxillary joint of the lower and upper jaws.
• Oncological diseases (malignant and benign tumors).
• Inflammation of the facial nerves (neuritis of the facial and trigeminal nerve).
• Diseases of the hearing aid (otitis).

If you experience pain when opening your mouth, you should consult a doctor. In many diseases, the clinical picture is similar and the question arises of a deep differential diagnosis.

Treatment Methods

Treatment should be comprehensive and begin immediately after a preliminary diagnosis is made.

The following groups of drugs are mainly used:

1. NSAIDs- are designed to alleviate the painful period and act on the process of inflammation, in a pathogenetic way. They reduce the activity of mediators of inflammation and increase cellular metabolism.
2. Muscle relaxers- release pinched nerves, thereby improving the conduction of a nerve impulse along the nerve trunk.
3. Antiplatelet agents and metabolites- reduce platelet aggregation, improving blood flow in the vessels. Enhance metabolism, contributing to the reparative function of the body.
4. Antidepressants- increasing the release of serotonin and endorphins, reduce anxiety associated with pain.

• With injuries and ruptures of muscles and ligaments, the question arises of the advisability of surgical intervention.
• In case of fractures, skeletal traction and long-term fixation of bone fragments are performed.
• Broken connective structures are sewn together.

How to relieve pain at home?

If there is acute pain in the jaw and it is impossible to urgently get to the medical institution, it is necessary to perform the following manipulations:

• Stop speech activity, in order to prevent possible complications.
• Use dry ice, after wrapping it in a thin cloth. Apply to the site of pain.
• Take one tablet of available painkillers and write down the name of the drug on paper (do not use analgin, only in the absence of other painkillers for severe pain).
• Ask for help from the doctor on duty at the clinic or the emergency room of the hospital.
• In case of a fracture or dislocation, it is strictly forbidden to set bone fragments or a joint on your own.

If you experience pain in the jaw and ear, self-medication is strongly not recommended.

Sometimes a person is overtaken by a very unpleasant feeling - pain in the jaw. It hurts when you open your mouth, chew and talk. There is pain under the jaw or in the upper jaw, on the right side or on the left, sometimes only the joint hurts, and sometimes the whole mouth. To answer the question why the jaw hurts, a dentist, surgeon or neurologist will help you. But which one should you contact in your situation?

2 style="text-align: center;"> Causes of jaw pain

The fact is that pain in the jaw can have many different causes, it is on them that the choice of a doctor and, accordingly, treatment depends.

3 style="text-align: center;">Jaw injuries

If your jaw hurts, it means that you cannot speak, eat, sleep normally. The cause of this problem should be sought as soon as possible, as there is a possibility of dangerous complications.

4 style="text-align: center;">Bruised

When bruised, only the soft tissues of the jaw are damaged. There is pain, slight swelling, bruising, but these symptoms are not strong, it does not hurt to open the mouth, the patient fully recovers in 2-3 days. What to do in case of injury? It is most effective to use a cold compress and a special diet that will help keep the jaw at rest.

There can be many reasons for jaw pain. Get ready for examinations with doctors of various medical specialties.

4 style="text-align: center;">Dislocation

Dislocation of the lower jaw occurs when the mouth is opened abruptly. It can happen if a person opens a bottle or hard packaging with his teeth. In addition, dislocation threatens people with joint diseases.

When a dislocation occurs in a person, the mouth is fixed in an open position, the jaw is beveled on the right or left side, saliva flows out of the mouth (since there is no way to swallow it). The doctor of the emergency room sets the dislocation manually.

4 style="text-align: center;">Fracture

In the event of a mechanical injury (for example, as a result of an accident), a person may have a fracture of the upper or lower jaw. With a particularly strong impact on the human skull, a fracture of both jaws often occurs at once. The degree of complexity of the fracture depends on whether it is multiple or single, open or closed, and whether displacement is present.

A broken jaw is a terrible thing, and its treatment is an unpleasant business.

Fracture symptoms (other than pain): difficulty chewing, swelling, bruising. Of course, the treatment of a jaw fracture is carried out exclusively by a doctor. With early admission to the hospital, full recovery will take no more than one month. In addition to medical treatment, sufficient attention should be paid to caring for the sick: wash his mouth with warm water with an antiseptic and give grated food.

3 style="text-align: center;"> Osteomyelitis of the jaws

If the pain in the jaw has a pulsating character, a headache and a high temperature are added to it, then it is likely that you have osteomyelitis of the jaws. This is a special infectious disease of the jaw bones, which causes severe inflammation.

The main cause of this disease is an infected tooth, and the doctor makes a diagnosis based on this very tooth (it staggers, it hurts a lot, especially when tapped), an x-ray (it will show how many teeth are already infected) and a general blood test.

Alas, the removal of infected teeth in osteomyelitis is a necessity. In addition, treatment includes a course of antibiotics and general detoxification of the body.

Please note that osteomyelitis of the upper jaw is especially dangerous and can cause serious complications. That is why, with soreness in the upper jaw, you should consult a doctor immediately.

Trigeminal neuralgia - this nerve is responsible for the connection of our entire face with the central nervous system. When the trigeminal nerve is affected, pain radiates to the jaw. This pain can be characterized as boring or burning, moreover, it comes on in attacks and most often at night. As a rule, the jaw hurts only on one side and never hurts from the back.

The trigeminal nerve, the malfunction of which can cause pain in the jaw.

Neuralgia of the superior laryngeal nerve - in this case, quite severe pain occurs under the jaw (on the right or left side) when chewing, yawning, blowing your nose. Very often, the pain is accompanied by salivation, coughing, hiccups.

Neuralgia of the glossopharyngeal nerve is a very rare disease, it is characterized by pain in the tongue, which turns into soreness under the jaw, in the lower jaw in the larynx, chest. It is aggravated by movements of the tongue, chewing and talking, the attack of pain lasts about three minutes.

The treatment of all pain in the jaws caused by the pathology of the nerves is carried out by medication, and only if it is ineffective, the nerve is surgically suppressed.

One of the most common causes of jaw pain is cutting wisdom teeth. As a rule, such pain increases when opening the mouth. What to do in this situation? You have three options:

• go to the dentist, he will make a small incision and this will help the teeth grow easier, and if the wisdom tooth has grown, the doctor will remove it;
• take a strong pain reliever, for example, Dexalgin - often such drugs relieve not only pain, but also inflammation;
• use folk remedies, rinse your mouth with sage, it will not bring harm.

But not only wisdom teeth can cause jaw pain. Soreness under the jaw or in the jaw itself occurs when you have a tooth decay, flux or abscess. An abscess under a tooth can be enough reason for it to hurt you to open and close your mouth, eat and talk.

3 style="text-align: center;"> Arteritis of the facial artery

If you feel a burning pain under the jaw that reaches the upper lip, nose, or even the corners of the eyes, then there is a chance that you have arteritis of the facial artery. In fact, arteritis is an inflammation of the artery wall, respectively, the treatment of this disease is associated with the suppression of inflammation in the arteries.

3 style="text-align: center;"> Dysfunction of the temporomandibular joint

In this case, it can hurt not only in the joint itself, but also in the temple, cheek and even in the forehead. The pain intensifies when opening the mouth, and with each movement a click is heard.

A clear sign of a violation in the work of the temporomandibular joint is a click when the jaws open.

The fact is that there are many reasons for dysfunction of the temporomandibular joint (from malocclusion to osteoarthritis of the joint). Therefore, you cannot self-medicate, and if you are sure that the pain is associated with the joint, then go to the doctor: he will determine the cause and prescribe the appropriate treatment.

3 style="text-align: center;">Carotidynia

Carotidinia is a type of migraine. The pain occurs suddenly, is concentrated in the upper jaw (both on the right side and on the left side).

Various reasons can cause carotidynia. For example, it can be caused by a damaged tooth, inflammation in the sinuses, or the same lesion of the trigeminal nerve, which was discussed above. Treatment is prescribed by a doctor, but, as a rule, the most effective is the combination of indomethocin with antidepressants.

Why does my jaw hurt so much while wearing braces? Pain and slight looseness of the teeth in the first days after the installation of the bracket system is a sign that the brackets are installed correctly, the process of teeth displacement and bite formation occurs. In this case, you don't need to do anything.

But if the pain in the jaw and the inability to open the mouth normally are caused by malocclusion, then you should immediately contact the orthodontist.

According to the American Dental Association, about seventy-five million people in the United States suffer from some form of temporomandibular joint dysfunction. But often these patients do not receive proper diagnosis and suffer for years from chronic pain in the jaw, radiating ( giving) to the head, neck, ears and other areas. Various disorders of the function of the temporomandibular joint and joint pain are the cause of a wide range of painful symptoms, from moderate to permanent, causing severe discomfort to the patient. Sometimes such pains are accompanied by difficulty opening the mouth, dysfunction of the jaw, as well as painful clicking in the joint.

Anatomy of the temporomandibular joint, groups of perimaxillary lymph nodes

Upper and lower jaw

The upper jaw consists of:

• body;
• four surfaces ( anterior, posterior temporal, orbital, nasal);
• four shoots ( frontal, zygomatic, palatine, alveolar).

The facial region of the skull also includes the lower jaw, which is an unpaired and movable bone.

The lower jaw consists of:

• body;
• two branches ( between them is the angle of the jaw).

The alveolar part of the lower jaw has sixteen cells for the occurrence of teeth.

The lower jaw is involved in the formation of the temporomandibular joint.

Temporomandibular joint

The temporomandibular joint is located at the point of articulation of the lower jaw and the temporal bone of the skull. Every time a person chews, the temporomandibular joint moves, as does swallowing and talking. Thus, it is one of the most mobile and constantly used joints in the body.

The temporomandibular joint consists of:

• articular tubercle of the temporal bone;
• heads;
• disk;
• capsules;
• ligaments.

In the temporomandibular joint, movements are possible in the following directions:

• vertical ( lower jaw goes down and up);
• sagittal ( movement of the lower jaw forward and backward);
• frontal ( movement of the lower jaw to the side, right and left).

It should be noted that when the temporomandibular joint ceases to function normally, it affects all aspects of a person's daily life and becomes a source of constant pain and discomfort.

The lymph nodes

Lymph nodes are located in the path of lymph flow. The vessels through which the lymph goes to the node are called bringing, and through which it leaves - taking out.

Colloidal solutions of proteins, the remains of destroyed cells, bacteria, and lymphocytes enter the lymphatic vessels from the tissues. Through the afferent vessels, they reach the lymph nodes, foreign particles linger in them, and the purified lymph and lymphocytes exit through the efferent vessels.

There are up to eight hundred lymph nodes in the body of an adult. They are located in separate groups. Allocate groups of nodes of the head, neck, abdominal cavity, pelvic cavity, inguinal and others.

Lymph nodes have a different shape, oval, bean-shaped are more common, less often - segmental and ribbon-shaped.

Consider the groups of lymph nodes that are affected when the jaw and temporomandibular joint are disturbed ( for example, in the presence of an infectious-inflammatory process).

Why does pain occur when opening the mouth?

Pain in the temporomandibular joint can be:

• sharp ( suddenly appear and disappear);
• chronic ( regular pain for a long time).

Usually, to eliminate this kind of pain, the imposition of a cold compress and the creation of a gentle load on the temporomandibular joint for several days effectively help, that is, it is necessary to refuse chewing gum and dishes that require intensive chewing. You also need to carefully open and close your mouth ( e.g. coughing, yawning).

Chronic pain that occurs regularly and for no apparent reason may indicate the presence of a pathological process in the jaw joint, for example, with arthrosis of the joint that has developed as a result of the absence of supporting lateral teeth. If there are no molars in this place, then the chewing load is transferred not to the teeth, but to the bone. Chewing muscles, in turn, begin to squeeze the head of the temporomandibular joint into the articular cavity. This leads to the fact that the joint is too much stress and the person develops chronic pain.

Each person reacts differently to overload of the jaw joint. For most people in these situations, over the course of many years, the restructuring of the joint passes, and the joint gradually degenerates.

It should also be noted that the appearance of pain in the jaw joint can be caused by diseases of the middle ear and some diseases of the bones.

Most often, with pain in the jaw joint, atypical facial pain and trigeminal neuralgia are misdiagnosed.

Clinical, instrumental diagnostics, as well as a thorough questioning about the nature of the pain experienced, make it possible to make an accurate diagnosis of pain in the temporomandibular joint, separating it from other etiological factors that cause pain in the skull area.

Why does the temporomandibular joint click when opened?

Also, one of the causes of clicks of the temporomandibular joint in children is the growth of lymphoid tissue in the form of palatine tonsils or adenoids. Normally, a person breathes through the nose, and the excessive growth of this tissue reduces the volume of the airways and the person begins to breathe through the mouth. Over time, this leads to the fact that the lower jaw drops, and the tongue, following the jaw, leaves the arch of the palate and lies behind the lower teeth.

During normal nasal breathing, when the tongue occupies the vault of the palate, the pressure from the cheeks is balanced by the tongue. With oral breathing, nothing resists the pressure of the cheeks. As a result, there is an imbalance, which ultimately leads to deformation and narrowing of the upper jaw, which acquires a horseshoe or V-shape.

It also interferes with swallowing. When swallowed, the tongue rests on the lateral teeth, preventing their normal eruption ( lateral tongue laying). The constantly open mouth, in turn, leads to the protrusion of the lower incisors ( anterior teeth) up. As a result, there is a deformation of the lower dentition with shortened crowns of premolars ( small molars) and painters ( large molars), as well as advanced lower incisors and canines ( cone teeth). There is a distal step, that is, a decrease in the lower dentition behind the canines.

As a result of such deformation of the upper and lower dentition, contacts arise that displace the lower jaw from the physiological trajectory distally ( way down). The narrowed upper jaw displaces the lower jaw posteriorly, while the articular head also moves distally, and the articular disc, in turn, moves forward. When the mouth is opened, the disc can move to the articular head, restoring its normal position, and when closed, it can return to the front position again, resulting in a reciprocal click.

It should be noted that a distally displaced mandible and tongue cause an even greater narrowing of the airways. In order to open the airways, the neck begins to move forward, and the head tilts back. This increases the load on the spine and muscles, which subsequently leads to the development of pain in the neck, back and shoulders.

Clicks when opening the mouth can also be observed with the wrong position of the jaws. Violation of the correct position of the jaw can cause parafunctional muscle activity, in the form of teeth grinding, that is, bruxism. Over time, bruxism can lead to excessive tooth wear ( pathological abrasion). As a result, the teeth become even shorter, the lower jaw moves even more distally, and the bite height decreases. In the future, there is a deformation in the joint area, damage or overstretching of the ligamentous apparatus. As a result, the articular disc can become stuck in front of the articular head and cause a click to form when it returns to its original position.

Causes of inflammation of the temporomandibular joint

• bruised jaw;
• dislocation of the lower jaw;
• dysfunction of the temporomandibular joint;
• arthritis of the temporomandibular joint;
• furuncle and carbuncle;
• dental diseases;
• temporal arteritis;
• neuralgia;
• erythrootalgia ( red ear syndrome);
• alveolitis;
• jaw swelling.

Jaw contusion

Causes of a bruised jaw can be:

• blow to the face;
• fall on the face.

• pain in the jaw area;
• bruise;
• dysfunction of the jaw speech disorder, difficulty chewing food).

Dislocation of the lower jaw

Dislocation of the mandible can be unilateral ( dislocation of one joint) and two-sided ( dislocation of two joints).

The causes of dislocation of the lower jaw can be:

• blow to the jaw area;
• wide opening of the mouth, for example, when trying to bite a large product, yawning, laughing, coughing, vomiting.

Symptoms of a dislocation of the temporomandibular joint are:

• severe pain in the area of ​​the affected joint ( may radiate to the ear, temporal or occipital region);
• the mouth is open, when you try to close it, severe pain occurs;
• salivation;
• speech disorder;
• the lower jaw is somewhat pushed forward, skewed.

jaw fracture

There are the following types of jaw fracture:

• complete fracture with displacement of fragments of the jaw;
• incomplete fracture without displacement ( e.g. a crack in a bone).

Symptoms of a jaw fracture are:

• severe pain in the fracture area;
• inability to open mouth especially in fractures of the mandible);
• tissue swelling;
• bruising ( with a fracture of the upper jaw, bruising under the eyes).

Temporomandibular joint dysfunction

The most common causes of temporomandibular joint dysfunction are as follows:

• malocclusion ( can lead to jaw pain);
• lack of teeth;
• improperly performed dental or orthodontic treatment ( e.g. poor quality dental prosthetics);
• improper swallowing inherited from childhood, in which the lower jaw unnaturally moves back;
• habits such as mouth breathing, bruxism ( teeth grinding);
• neurotic clenching of the teeth, leading to an overload of the muscles surrounding the jaw;
• abnormal development of the jaw, in which the upper or lower jaw is underdeveloped;
• head, neck and spine injuries;
• some degenerative diseases such as osteoarthritis.

• crunch in the joint area;
• pain in the joint, head, neck and back;
• irradiation of painful sensations in the teeth, ears and eyes;
• movement disorders in the joint for example, a person cannot open their mouth wide, difficulty chewing food);
• grinding of teeth;
• sleep apnea ( cessation of breathing during sleep).

Arthritis of the temporomandibular joint

Arthritis of the temporomandibular joint causes symptoms such as:

• pain in the area of ​​the affected joint;
• increase in local and general temperature;
• swelling of the soft tissues of the face;
• hyperemia ( redness- skin in the area of ​​the affected joint;
• chewing dysfunction;
• speech disorder;
• hearing loss.

Osteomyelitis

The reason for the development of osteomyelitis is the ingress of pathogenic microorganisms into the bone tissue of the jaw.

The penetration of infection into the bone can occur in the following ways:

• odontogenic - through the teeth ( for example, with advanced caries, pulpitis, alveolitis);
• hematogenous - through the blood ( e.g., furuncle or carbuncle of the maxillofacial region, acute otitis media);
• mechanical - due to direct trauma to the jaw.

According to the prevalence of the process, osteomyelitis can be:

• limited ( defeat of one or more teeth, in the zone of the alveolar process);
• diffuse ( damage to one or two sections of the jaw).

• increase in body temperature;
• sleep disturbance;
• pain in the affected area may radiate to the temporal region, ear or eyes);
• swelling of the gums and skin in the area of ​​the affected teeth;
• between the affected tooth and the gum, there is a release of purulent contents;
• dysfunction of the jaw speech change, difficulty swallowing);
• decreased sensitivity of the lower lip and skin of the chin ( with osteomyelitis of the mandible);
• enlargement and soreness of regional lymph nodes.

Furuncle and carbuncle

Carbuncle is a purulent-necrotic inflammation of several hair follicles located nearby.

Most often, furuncle and carbuncle are formed in the face and neck, since the skin in these areas is most susceptible to contamination and microtrauma.

The reasons for the formation of a boil or carbuncle are:

• violation of the integrity of the skin ( e.g. cuts, scratches, scratching of the skin due to itching);
• violation of hygiene;
• frequent colds;
• infectious and inflammatory processes in the ear, nose, maxillary paranasal sinuses ( e.g. otitis media, sinusitis, chronic rhinitis).

• soreness ( depending on the location on the face, the pain radiates to the upper or lower jaw);
• redness of the affected area of ​​the skin;
• infiltration ( accumulation of cellular elements, blood and lymph in the tissue) and edema;
• purulent plugs are visible, from which a purulent bloody liquid is released;
• e.g. weakness, loss of appetite, malaise).

Dental diseases

• caries ( pathological process in which the destruction of enamel and hard tooth tissue is observed);
• pulpitis ( dental pulp injury);
• periodontitis ( damage to the periodontium - the tissue located between the tooth and the alveolar process);
• periodontal abscess ( purulent-inflammatory lesion of the periodontium);
• tooth cyst ( damage to bone tissue with the formation of a sac covered on the outside with connective tissue and filled with pus inside);
• limited osteomyelitis of the jaw;
• dental trauma ( bruised, dislocated or fractured tooth).

Temporal arteritis

The existing inflammation in the vessel leads to thinning of its wall. In some cases, this may contribute to the formation of pathological expansion of the vessel. Over time, an aneurysm formed ( extension) can burst and lead to the development of cerebral hemorrhage.

Symptoms of temporal arteritis are:

• severe pain in the temporal region of a pulsating nature ( can give to the jaw, neck, tongue and shoulder);
• increase in body temperature;
• weakness and malaise;
• pain in the temporomandibular joint when chewing or talking;
• pain when touching the scalp;
• hyperemia ( redness) and swelling of the temporal region;
• with damage to the ophthalmic artery, visual impairment, pain and double vision, as well as drooping of the eyelid are observed.

neuralgia

Pain in the jaw develops with neuralgia of the following nerves:

• Trigeminal neuralgia. Nerve that innervates the face and mouth. It divides into three branches, the upper is the ophthalmic nerve, the middle is the maxillary, and the lower is the mandibular. When the middle and lower branches of the nerve are affected, a person experiences severe pain in the region of the upper or lower jaw. Painful sensations occur, as a rule, at night and are of a burning nature. An attack of pain can also occur even with a minor irritant, such as a draft, hot or cold food. Before the onset of a painful attack, a person may experience itching of the skin or a feeling of crawling on the skin.
• Neuralgia of the ear. A disease characterized by damage to the ear vegetative ganglion. Its development is usually associated with the presence of infectious and inflammatory processes in the area of ​​the ear node ( e.g., suppurative otitis media, mumps, sinusitis, periodontitis). When the ganglion is affected, a person develops pains of a burning or pulsating nature. Painful sensations can be given to the region of the lower jaw, neck, neck, and shoulders.
• Glossopharyngeal neuralgia. This nerve is mixed. It innervates the muscle that lifts the pharynx and parotid gland, and also provides sensitivity to the posterior third of the tongue ( taste sensitivity). For some diseases ( e.g. brain tumor, inflammatory diseases, carotid aneurysm) the work of the glossopharyngeal nerve may be disturbed. In this case, a person will experience pain in the throat, lower jaw and ear.
• Neuralgia of the superior laryngeal nerve. With the defeat of this nerve, the patient has severe pain of a pulsating nature. Painful sensations are localized in the region of the larynx and lower jaw ( pain is given to the ear, eyes, temporal region). Often, during a painful attack, a person has a cough and dry mouth, and after it ends, on the contrary, there is profuse salivation.

Erythrootalgia ( red ear syndrome)

The causes of the development of this syndrome can be cervical spondylosis, neuralgia of the glossopharyngeal nerve, dysfunction of the temporomandibular joint.

Alveolitis

Symptoms of alveolitis are:

• increasing pain at the site of tooth extraction a few days after the procedure;
• severe pain radiating ( bestowing) in the jaw and face;
• putrid odor from the mouth;
• redness and swelling in the affected area;
• increased separation of saliva;
• increase in local and general temperature;
• enlargement of regional lymph nodes;

Glossitis

The reason for the development of glossitis is the ingress of pathological microorganisms ( bacteria, viruses) in the tissue of the tongue, which subsequently leads to the development of the inflammatory process.

The following factors can contribute to the entry of pathological agents into the tissues of the tongue:

• violation of the integrity of the tissue of the tongue;
• the use of spicy, as well as very hot food and drinks;
• violation of oral hygiene;
• decrease in body resistance;
• oral dysbiosis.

• burning and pain in tongue may radiate to the lower jaw);
• redness and swelling of the tongue;
• softening of the tongue;
• violation of speech, swallowing and chewing;
• increase in general and local temperature;
• salivation;
• the appearance of bubbles on the tongue, after opening, which form erosion ( if glossitis is caused by a virus).

Sinusitis

The cause of the development of sinusitis is the entry of infectious agents into the maxillary sinus.

The infection can enter the sinus in the following ways:

• hematogenous ( through the blood);
• nasal ( due to infection in the nose);
• odontogenic ( in the presence of an inflammatory process in the teeth of the upper jaw).

• severe pain in the affected sinus, radiating to the upper jaw, eyes and bridge of the nose;
• nasal breathing disorder;
• observed mucous or purulent discharge from the nose;
• headache;
• increase in body temperature;
• signs of intoxication of the body ( weakness, malaise, sleep disturbance, loss of appetite).

Tumor of the jaw

Tumors of the jaw are divided into:

• odontogenic - formed from dental tissue ( for example, ameloblastoma, cementoma, odontogenic fibroma, or sarcoma);
• nonodontogenic - are formed from bone, cartilage, connective tissue ( e.g. osteoma, osteoblastoclastoma, chondroma, hemangioma).

With a tumor of the jaw, a person may experience the following symptoms:

• pain in the affected area, as well as in the temporomandibular joint;
• disruption of the temporomandibular joint;
• asymmetric facial change ( due to bone deformity);
• tooth shifting and increased tooth mobility.

Diagnosis of the causes of inflammation of the temporomandibular joint

Diagnosis of jaw pain in trauma

• Collection of anamnesis. When collecting an anamnesis, the doctor receives the necessary information about the patient by questioning. If you suspect an injury to the upper or lower jaw, it is paramount to find out what the patient was doing at the time of the injury, how exactly it happened ( for example, a person has fallen or been hit). You should also find out what complaints you have, clarify the severity of clinical manifestations. After collecting the necessary information, the doctor proceeds to examine the patient.
• Medical checkup. On examination, the doctor should pay attention to the state of bite in the patient. On palpation of the jaw, you should find out if there is pain, what kind it is and what intensity it is. It is necessary to examine the skin, to identify the presence of bruising and swelling, whether there is a violation of the integrity of the skin. You should also examine the oral cavity, whether there is a deformation of the teeth and mucous layer, profuse salivation, an admixture of blood in saliva. If there is a fracture of the jaw on palpation in the affected area, bone crepitus will be observed ( characteristic crunch).
• X-ray of the jaw. This diagnostic method allows you to determine the nature of the injury ( bruise, dislocation or fracture). When bruising the upper or lower jaw, the integrity of the bone is not violated. With a dislocation, a jaw displacement will be observed on the x-ray. In case of a jaw fracture, an x-ray helps to identify its localization, whether it is single or multiple, the condition of the roots of the teeth and alveolar processes, as well as the presence of displacement of bone fragments.

Diagnosis of pain in the jaw in infectious and inflammatory diseases

• Collection of anamnesis. When interviewing a patient, the doctor should clarify whether he has any chronic diseases ( e.g. chronic sinusitis, pulpitis), and has recently had an acute infection ( e.g. furuncle). It is necessary to find out when the patient last visited the dentist, as improper orthodontic treatment increases the risk of developing infectious complications ( for example, improper tooth extraction can lead to the development of alveolitis).
• Medical checkup. In infectious and inflammatory diseases, the skin in the affected area will be hyperemic ( redness), edematous. There will be an increase in both local ( skin is hot to the touch) and overall temperature. On palpation of the affected area, severe pain will be noted, and pain will also be observed when the regional lymph nodes are felt. The patient will have a violation of the function of speech, swallowing and chewing. In the presence of an infectious process in the oral cavity, defects, vesicles, sores, serous or purulent discharges can be observed on the mucous membranes. For diseases of the ear or nose, an ENT doctor ( otolaryngologist) can perform otoscopy ( ear examination), as well as anterior or posterior rhinoscopy ( examination of the nasal cavity).
• Laboratory tests. In order to diagnose the presence of an infectious-inflammatory process in the body, it will be necessary to pass a general blood test. It is given in the morning on an empty stomach from the cubital vein or ring finger. The test results may show leukocytosis ( with a bacterial or viral process, trauma, neoplasms), lymphocytosis ( in a viral process), as well as an accelerated erythrocyte sedimentation rate ( indicates the presence of a pathological process in the body). In the presence of an infectious process in the ear ( e.g. acute otitis media), as well as the upper respiratory tract ( e.g. sinusitis, tonsillitis) the patient may be assigned a bacteriological examination of the discharge. This analysis allows you to identify the type of bacterial agent that caused the infectious process, as well as determine the sensitivity to the antibiotic for subsequent treatment.
• Instrumental diagnostics. In some cases, X-ray examination or computed tomography is used to detect inflammatory lesions of the bone or soft tissues of the jaw ( e.g. sinusitis, osteomyelitis, pulpitis, periodontitis). These studies help to identify the localization and extent of the pathological process, the anatomical features of the teeth, the state of the periodontal and periodontal. Also, their conduct allows to evaluate the effectiveness of the treatment for various diseases.

Diagnosis of pain in the jaw with dysfunction of the temporomandibular joint

When visiting a doctor, the patient should first of all tell about his complaints. The doctor will collect an anamnesis of life and illness, clarify whether there were inflammatory diseases or injuries of the face and jaw, visually determine the presence of facial asymmetry, the degree of lower jaw mobility, the presence of hyperemia and edema in the area of ​​the affected joint, auscultate hear clicking or crunching of the joint during movement.

On palpation of the temporomandibular joint, the doctor can feel its displacement, swelling of the surrounding tissues, and also identify the presence of pain.

Then the doctor proceeds to the procedure of palpation of various muscle groups:

• temporalis muscles ( usually one side is more sensitive);
• lateral pterygoid muscles ( control the position of the jaw, and therefore soreness is usually felt on both sides);
• chewing muscles ( these points are especially painful in people suffering from bruxism);
• sternocleidomastoid muscle ( usually more sensitive on the right);
• the trapezius and posterior occipital muscles are also examined.

• X-ray of the temporomandibular joint. Allows you to evaluate the ratio of the articular head to the articular cavity, as well as to study the structure of bone tissue, which is involved in the formation of the jaw joint.
• Computed tomography of the joint. It is a high-precision X-ray diagnostic method, in which a layer-by-layer examination of the jaw is performed in various planes. This research method allows you to identify even minor changes in the joint in the early stages of the disease.
• Orthopantomography. This is an X-ray examination method that allows you to take a panoramic picture of the teeth, as well as the tissues of the upper and lower jaws. With the help of this study, it is possible to diagnose pathological processes in the jaw bones, determine the condition of the teeth, and also identify dysfunction of the temporomandibular joint ( e.g. arthrosis and arthritis of the joint, anomalies in the development of the jaw).
• Phonoarthrography. This diagnostic method using a special device allows you to listen to articular noises and visually track them on the graph. Normally, when listening to a person, soft, uniform and sliding sounds are determined. With dysfunction of the temporomandibular joint ( for example, with displacement of the articular heads, arthrosis) pronounced noises are observed, as well as crepitus and clicking sounds of varying intensity.
• Electromyography of facial muscles. A diagnostic method that allows using special electrodes to study the electrical activity of the facial muscles and nerves that innervate these muscles.
• Arthroscopy of the jaw joint. Using a special device - an arthroscope, the temporomandibular joint is examined. A small incision is made in the joint area, a device is inserted on which there is a camera that transmits the image to the monitor. This study helps not only to diagnose the disease, but also to treat ( for example, flush a joint, remove cartilage or scar tissue, administer a drug).

Self-diagnosis
Before starting the study, it is paramount to prepare a pen and a sheet of paper.

Self-diagnosis involves testing the sensitivity of six points of the face and neck.

You can do it yourself like this:

• Place the tips of your index and middle fingers in the temple area on both sides just behind the eye socket area. Press lightly and compare the sensations on the right and left sides, whether the sensitivity of the sides is the same or not. The result should be noted on a piece of paper.
• Place the fingers of both hands in the pits below the neck behind the corner of the lower jaw, again compare the sensations, whether there is increased sensitivity on one side or the other in this area, write down your sensations.
• Place the tips of all four fingers ( except for the big) on both cheeks in the area between the upper and lower jaws. Again compare your sensations on the right and on the left side and again write down the result.
• You need to go down to the neck. Using all your fingers, carefully feel the muscle that runs from the ears to the shoulders. Compare the pain sensations on each side. Make a note on the sheet.
• With your right hand, feel the trapezius muscle on your left shoulder, then with your left hand, feel the same muscle on your right shoulder. If pain is felt on at least one side, this should be noted.
• At the end, place the tips of the little fingers in the ear canals, opening and closing the mouth, try to feel if pain is felt in the temporomandibular joint, and if it is felt, write it down on a sheet.

Diagnosis of jaw pain in neoplasms

At the consultation with the doctor, the patient is first questioned, examined and palpated.

On examination, you may find:

• facial asymmetry;
• swelling and hyperemia of the affected area;
• swelling of the bone;
• deformation of the affected tissues ( e.g. ulcers, fistulas);
• impaired mobility of the lower jaw;
• nasal obstruction, purulent or bloody discharge ( when a tumor of the upper jaw grows into the nasal cavity).

• changes in affected tissues softening, compaction, infiltration);
• looseness of the teeth and their soreness;
• decreased sensitivity of the skin of the chin and lips;
• cohesion of the neoplasm with soft tissues;
• enlargement and tenderness of regional lymph nodes ( e.g. cervical, submandibular, parotid).

• X-ray and computed tomography of the jaw. Computed tomography is a more informative diagnostic method, since a layer-by-layer examination of the jaw is performed. Four to five topographic sections are made with a distance between them of one centimeter. These studies allow you to identify the localization of cancer, the prevalence of the process, as well as determine the degree of destruction of bone tissue.
• X-ray and computed tomography of the paranasal sinuses. The paranasal sinuses are hollow, air-filled structures that communicate with the nasal cavity. This diagnostic method is performed in order to study the bone structures of the sinuses, to identify the presence of growths and calcifications ( deposition of calcium salts) in their cavities.
• Anterior and posterior rhinoscopy. With neoplasms of the upper jaw, a study of the nasal cavity is performed. For anterior rhinoscopy done with a rhinoscope) it is possible to identify a neoplasm in the nasal cavity, as well as to take a piece of tissue for histological examination or puncture the tumor for cytological examination. Posterior rhinoscopy ( made with a spatula and a mirror), in turn, allows you to determine the germination of the tumor in the nasopharynx.

• cytological examination of the neoplasm punctate and lymph node ( study of the structure of cells under a microscope);
• tumor and lymph node biopsy for histological examination ( study of the cellular composition of tissues under a microscope).

• ophthalmologist;
• surgeon;
• neurologist;
• otolaryngologist ( ENT doctor).

Treatment of pathology of the temporomandibular joint

Treatment of jaw pain in trauma

Treatment of jaw pain in infectious and inflammatory diseases

• Antibacterial treatment. In infectious diseases ( e.g. furuncle, facial carbuncle, osteomyelitis, periodontitis) antibiotic therapy is primarily prescribed to inhibit the vital activity of the bacteria that caused the pathological process. The type of drug, method of administration and duration of treatment are prescribed individually depending on the disease, its severity and the general condition of the patient. Also, to establish an effective antibacterial treatment, a bacterial study is initially performed before its appointment ( sowing pus on a special medium) to identify a pathological agent and determine its sensitivity to a particular drug. As a rule, in infectious and inflammatory diseases, broad-spectrum antibiotics from the Penicillin group are prescribed ( e.g. Ampicillin), Quinolones ( e.g. ciprofloxacin) and other pharmacological groups.
• Mouth rinse. The patient may be prescribed a mouth rinse, such as a weak solution of potassium permanganate ( potassium permanganate), furacilin ( 3% ) or saline solution.
• Compresses. The application of compresses with ointments, for example, Levomekol ( has an antibacterial effect), Solcoseryl ( improves metabolism and tissue regeneration).
• Surgery. If necessary, surgical intervention is performed, in which an opening of the infectious-inflammatory focus is made, its washing ( e.g. hydrogen peroxide) and creating the necessary conditions ( drainage) for unhindered outflow of purulent contents.

In severe infectious diseases, the patient may be shown detoxification therapy ( introduction of glucose solution 5%, sodium chloride 0.9%).

Treatment of jaw pain in temporomandibular joint dysfunction

• bite correction;
• dental prosthetics;
• wearing an articular splint;
• the use of the Myotronics apparatus;
• adherence to the regime of the day and diet;
• use of medicines.

• braces;
• kapp.

Braces are a type of permanent wear that is used to straighten the teeth and correct malocclusion. Braces are metal, ceramic, sapphire, plastic, depending on the material from which they are made. The duration of wearing braces is individual and depends on the complexity of the clinical situation.

Mouthguards are removable devices made of transparent plastic.

There are the following types of caps:

• individual mouthguards, which are made after taking an impression of the teeth;
• thermoplastic mouthguards, which are standard.

Partial dentures are performed:

• in the absence of the crown part of the tooth ( for example, with significant tooth decay by caries);
• in the complete absence of a tooth.

Total prosthetics helps:

• exclude the constant wearing of mouthguards;
• achieve normalization of the position of the lower jaw;
• restore aesthetic function ( beautiful smile, straight teeth);
• eliminate dysfunction of the temporomandibular joint.

The articular splint has the following therapeutic effects:

• effectively and quickly eliminates pain in the jaw;
• relaxes the muscles of the jaw and neck;
• relieves pressure in the temporomandibular joint;
• limits bruxism;
• relieves chronic pain in the neck.

As a rule, immediately after the installation of the splint, there is an immediate relaxation of the muscles due to their lengthening, which leads to a significant decrease in the tension of the muscles of the jaw and neck.

For the first few days, the splint should be worn for at least an hour a day to get used to it.

The reduction in soreness is usually felt within the first days of use, but in some cases it takes several weeks to significantly reduce it. This is individual for each patient. After a few days, you should supplement the daytime wearing mode with a night one. This may be uncomfortable at first for those who have a habit of breathing through their mouths or snoring in their sleep, but it can help to correct the problems that have arisen and subsequently eliminate them.

Treatment of dysfunctions of the temporomandibular joint should be carried out under the supervision of a physician. If the use of the tire is not enough, an individual program is assigned to eliminate the causes of the pathology.

Application of the device Myotronics
Myotronics devices are devices with the help of which muscle stimulation is carried out. Due to myorelaxation of the muscles, the position of the lower jaw is normalized.

During treatment, the following therapeutic effects are observed:

• muscle relaxation occurs;
• eliminates pain associated with dysfunction of the temporomandibular joint;
• the movement of the lower jaw is restored;
• normalization of occlusion occurs ( clenching of teeth).

The patient must comply with the following recommendations:

• provide voice peace ( avoid emotional conversations, raising your voice);
• avoid wide mouth opening e.g. laughing, yawning, eating);
• during sleep, try to sleep on the healthy side;
• when talking on the phone, make sure that the phone does not put pressure on the affected joint;
• avoid eating hard foods that require prolonged chewing ( e.g. raw hard fruits and vegetables, crackers, bagels);
• consume food in grated and liquid form ( e.g. puree soup, cereals, mashed potatoes or peas, cottage cheese);
• avoid chewing gum.

With dysfunction of the temporomandibular joint, the following drugs can be prescribed to eliminate pain:

• Paracetamol ( take one to two tablets three times a day);
• Ibuprofen ( take one to two tablets three to four times a day);
• Diclofenac ( take 25 mg three to four times a day);
• Ketoprofen ( take 100 - 300 mg two - three times a day).

Treatment of pain in the jaw with neoplasms

• Radiation therapy. It is an important aspect in the treatment of benign and malignant tumors. This method of treatment is characterized by the fact that the neoplasm is affected by ionizing radioactive radiation. Under their influence, the development of DNA mutations of cancer cells occurs, as a result of which they die.
• Chemotherapy. Treatment of the oncological process is carried out through medicines ( e.g. methotrexate, cisplatin). The action of these drugs is aimed at destroying the tumor cell, slowing down the growth of the malignant process and reducing symptoms. Chemotherapy drugs are usually given in combination. The combination of drugs is prescribed individually depending on the type of tumor present, the stage of the process, and the general condition of the patient. It should be noted that chemotherapy can be used in addition to surgical treatment of the tumor or radiation therapy.
• Surgery. It consists in the surgical removal of a tumor of the upper or lower jaw. Before surgery, orthopedic structures must first be prepared, which will subsequently help keep the jaw in the correct position ( for example, bus Vankevich). Proper orthopedic actions increase the healing rate of the postoperative wound, and also play a big role in the aesthetic aspect.

Physiotherapy

Why do the lymph nodes under the jaw hurt?

In its movement, lymph passes through the lymph nodes. These nodes contain many cells that filter the lymph in order to remove the pathogens present in it. The purified lymph through the subclavian vein returns to the circulatory system. Thus, the lymphatic system drains and clears about three liters of lymph per day.

The human body contains from four hundred to one thousand lymph nodes. Depending on the location, they are all divided into groups. Thus, the lymph nodes that are located in the submandibular region form a group of submandibular lymph nodes. Normally, lymph nodes are painless.

Pain in the lymph nodes under the jaw is most often a sign of an inflammatory process, which usually develops as a result of an infectious disease of a nearby organ. Pain with lymphadenitis inflammation of the lymph node) occurs due to stretching of the connective tissue capsule covering the surface of the lymph node.

Pain in the submandibular lymph nodes can provoke diseases such as:

• tonsillitis ( tonsillitis);
• glossitis ( inflammation of the tongue);
• osteomyelitis ( bone inflammation) jaws;
• boil ( acute purulent inflammation of the hair follicle) on the face;
• carbuncle ( acute purulent inflammation of several hair follicles) on the face;
• pulpitis ( inflammation of the neurovascular bundle of the tooth);
• periodontitis (
• irritability;
• an increase in body temperature.

Why does the upper jaw hurt?

• upper jaw injury
• osteomyelitis of the upper jaw;
• trigeminal neuralgia;
• arteritis of the facial artery;
• pulpitis;
• periodontal abscess;
• osteogenic sarcoma of the jaw;
• sinusitis.

Why does my jaw and temples hurt?

The temporomandibular joint is a paired joint. It is formed by the mandibular fossa of the temporal bone and the head of the mandibular bone. In humans, these are the only joints that do their work at the same time. Thanks to the coordinated actions of the temporomandibular joints, movements of the lower jaw are carried out ( side to side as well as forward and backward).

There are a large number of nerve receptors in the joint capsule, which is why a slight violation of its function negatively affects the general well-being of a person. In this case, a frequent symptom is pain in the jaw and temples.

Temporomandibular joint dysfunction is a disease in which the joint suffers directly due to underdevelopment of the upper or lower jaw and malocclusion. According to studies, about eighty percent of patients suffer from this disease.

During the formation of malocclusion, an incorrect position of the lower jaw occurs, which, in turn, causes pathology in the joint. In this case, the disease can occur with severe symptoms or asymptomatically.

Symptoms of temporomandibular joint dysfunction are:

• unusual sound ( crunch) in the area of ​​the joint during opening or closing of the mouth;
• limitation of the amplitude of mouth opening;
• difficulty swallowing;
• headache;
• pain, noise and ringing in the ears;
• pain and pressure in the eye area;
• neck and back pain;
• pain in the temporal region when chewing, during yawning, with wide opening of the mouth;
• change in bite;
• grinding of teeth;

Pain in the jaw and temples that appear regularly and for no apparent reason may indicate pathological changes in the temporomandibular joint, for example, with arthrosis, which has developed as a result of the absence of supporting lateral teeth. In this case, the entire chewing load is transferred to the head of the mandibular joint, which, under the influence of the masticatory muscles, is displaced into the articular cavity. Excessive stress placed on the joint eventually leads to its degeneration.

Also, pain in the temporomandibular joint can be caused by the following diseases and pathological processes:

• inflammatory diseases of the ear e.g. otitis media);
• trauma of the maxillofacial bones;
• osteomyelitis of the upper jaw;
• trigeminal neuralgia;
• arteritis of the facial artery.