Understand your severe jaw pain symptoms, including 7 causes & common questions.
8 most common cause(s)
Severe jaw pain symptoms
The jaw is a system of bones, hinges, and muscles that function to move the mouth. The upper jaw (also known as the maxilla) is fixed and immovable. The mandible is the lower, movable part of the jaw. The muscles of the jaw help to facilitate chewing and other movements of the mouth.
Jaw pain can affect your ability to eat and speak greatly inhibiting everyday activities. When severe, jaw pain can be an extremely debilitating condition and can signal causes that vary in severity.
Common characteristics of severe jaw pain
Severe jaw pain often results in symptoms such as:
- Pain that radiates to or from the ear
- Pain with chewing
- Locking sensation: Difficulty opening the mouth to eat, drink, or take medication
- Shooting pains or spasms
- Tenderness around the nose and eyes
- Congestion
- Persistent facial pain
If you experience such symptoms on a consistent basis, make an appointment with your physician as soon as possible to get appropriate care and follow-up.
Causes of severe jaw pain
Conditions that affect the jaw itself can result in severe pain. However, conditions that affect different parts of the face the sinuses, ears, and teeth can also cause severe jaw pain. This makes it difficult to assess if jaw pain is because of a jaw issue or other condition. As a result, it is very important to make an appointment with your physician in order to discuss the possible causes of your pain.
Musculoskeletal
Dysfunction in the different components of the jaw itself is called temporomandibular joint (TMJ) disorder. TMJ Disorder can result from injury or trauma to the jaw, excess stimulation of the jaw, or mechanical issues with the discs that help support jaw movements. Furthermore, diseases or syndromes that affect the bones themselves for example, Paget's disease of the bone can also result in severe pain.
Neurologic
Neurologic causes of jaw pain may include the following.
- Neuropathic: The word neuropathic refers to a disruption in nerve functioning. Severe jaw pain can be caused by a malfunction of the trigeminal nerve the nerve that provides sensation to the scalp and face. Often the jaw pain is triggered by everyday actions such as brushing your teeth, shaving, speaking, and even a gentle breeze.
- Central: Central neurologic causes such as headaches and migraines can also be associated with severe jaw pain. Often the pain will be associated with eye pain that radiates to the jaw.
Inflammatory
Causes related to inflammation of the jaw may include the following.
- Infection: Infection of different components of the face can cause pressure and jaw pain. For example, sinusitis is an infection of the air-filled cavities (sinuses) in the face. When the sinuses become infected, drainage of mucus and fluids is obstructed. The excess mucus can put extreme pressure on the face and radiate to the jaw. Similarly, the bones of the jaw themselves can become infected. This condition is known as osteomyelitis.
- Vasculitis: Vasculitis is the umbrella term for inflammation of the blood vessels. Some autoimmune diseases can cause inflammation of the blood vessels in your head leading to facial pain that can radiate to the jaw. One such condition is called Giant Cell Arteritis or Temporal Arteritis.
- Arthritis: Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Though less common, arthritic processes can affect the parts of the jaw resulting in difficulties in movement and pain.
Dental
Since the teeth are in such close proximity to the jaw, conditions that directly affect the teeth can result in severe jaw pain. For example, an infection that specifically affects the teeth can result in abscesses (collections of pus due to infection) that can radiate to the jaw. Mechanical habits such as teeth grinding and jaw clenching can also cause severe jaw pain over a period of time.
This list does not constitute medical advice and may not accurately represent what you have.
Tooth abscess (infection)
A tooth abscess is a collection of infected material (pus) in the center of a tooth. It is due to a bacterial infection.
You should seek dental care within 24 hours. The diagnosis is made based on your history, an exam, and an x-ray of the mouth. If the abscess is affecting your breathing, it's considered a medical emergency and you should seek emergency care. Treatment involves incision and drainage of the abscess in addition to antibiotics.
Rarity: Uncommon
Top Symptoms: severe jaw or tooth pain, swollen jaw, jaw stiffness, tooth pain that gets worse with hot, cold, or sweet beverages, warm and red jaw swelling
Symptoms that always occur with tooth abscess (infection): severe jaw or tooth pain
Urgency: Primary care doctor
Tension headache (first onset)
Tension headache is described as feeling like there is a band around the head that gets tighter and tighter. The headaches may occur in episodes – a few times a week – or chronically, where they almost never entirely go away.
This is a common type of headache but the cause remains unclear. It may be a combination of stress and an overactive sensitivity to pain.
Symptoms include dull, aching pain and tightness in the forehead, sides, and back of the head, and sometimes pain in the neck and shoulder muscles. Unlike migraines, there is usually no nausea, vomiting, or sensitivity to light.
Tension headaches are not dangerous in themselves, but can interfere with work and with quality of life.
Diagnosis is made through patient history and sometimes physical examination. CT scan or MRI may be done to rule out a more serious cause of the headaches.
Over-the-counter and other pain relievers are sometimes prescribed. Lifestyle changes to reduce stress, improve diet, and increase exercise are often helpful, as is massage and biofeedback.
Rarity: Common
Top Symptoms: new headache, nausea or vomiting, moderate headache, loss of appetite, mild headache
Symptoms that always occur with tension headache (first onset): new headache
Symptoms that never occur with tension headache (first onset): photo and phonophobia, throbbing headache, headache resulting from a head injury
Urgency: Self-treatment
Temporomandibular joint (TMJ) dysfunction disorder
Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.
The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.
TMJ disorder has three types:
- Pain or discomfort in the muscles controlling the TMJ.
- Dislocation or injury to the jawbone.
- Arthritis of the TMJ.
Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.
Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.
Rarity: Common
Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck
Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw
Urgency: Primary care doctor
Myofascial pain syndrome
Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.
The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.
This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.
Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.
Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.
Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.
Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.
Rarity: Common
Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness
Symptoms that always occur with myofascial pain syndrome: tender muscle knot
Urgency: Primary care doctor
Infected wisdom tooth (pericoronitis)
Pericoronitis of the 3rd molar is an infection of the gums surrounding the 3rd molar (wisdom tooth). It almost never happens to normal teeth because wisdom teeth take a long time to break the gums (erupt). It's believed that once the wisdom tooth breaks the surface of the gums, the bacteria in the mouth get into the gums at that spot and cause an infection. This is also worsened by food particles that build up in the area.
You should go immediately to your dentist, or, if they are not available, go to the nearest urgent care center. There, the dentist/doctor will clean the area, drain any pus, and write for an antibiotic mouth rinse. Penicillin is reserved for severe cases. A follow-up with a dentist is required to see if you need to get the tooth pulled.
Rarity: Rare
Top Symptoms: possible wisdom tooth pain, moderate tooth pain, tooth pain that makes chewing difficult, severe tooth pain, mild tooth pain
Symptoms that always occur with infected wisdom tooth (pericoronitis): possible wisdom tooth pain
Urgency: In-person visit
Fibromyalgia
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Dislocation of the jaw
A jaw dislocation is when the bones of the mandible (lower jaw) come unhinged from the bones of the side of the head.
You should go to the ER, where the jaw can be put back into place and the possibility of fractures of the bones can be ruled out.
Rarity: Rare
Top Symptoms: jaw pain from an injury, locking or dislocating jaw
Symptoms that always occur with dislocation of the jaw: jaw pain from an injury
Urgency: Hospital emergency room
Acute salivary duct stone (sialolithiasis)
A salivary duct stone is the most common disorder of the salivary glands (where you make spit). They can range in size from tiny particles to stones that are several centimeters in length.
You can try treating this at home and going to the doctor if things don't work. You can stay well hydrated, apply warm compresses, and massage or "milk" the duct with the stone in it. Another tip would be to suck on lemon drops or other hard tart candy (called sialogogues, which promote salivary secretions) throughout the day. Pain is treated with NSAIDs like Ibuprofen. If things do not get better or you cannot find the stone, it's best to go to your doctor.
Rarity: Uncommon
Top Symptoms: swelling on one side of the face, swollen jaw, painful face swelling, spontaneous jaw pain, painful jaw swelling
Urgency: Phone call or in-person visit
Severe jaw pain treatments and relief
The recommended at-home treatment described below applying ice or heat is only a temporary solution. You should seek professional treatment for severe jaw pain sooner rather than later.
At-home treatments
If you experience an episode of severe jaw pain at home, applying ice or heat can provide immediate relief. Put an ice pack on your face wrapped in a towel every 15 minutes in order to reduce pain. Applying heat can help relax muscles and relieve pain as well.
Medical treatments
It is necessary to make an appointment with your physician in order to get treatment such as:
- Pain medication: Your physician may recommend non-steroidal anti-inflammatory drugs (NSAIDs) to fight pain as well as inflammation that may be contributing to your severe jaw pain.
- Anticonvulsants: Several anticonvulsant medications are used to combat nerve pain and your physician may prescribe medications such as gabapentin (Neurontin) or carbamazepine.
- Antibiotics: If your severe jaw pain is due to infectious causes due to bacteria affecting your sinuses, your physician will prescribe the appropriate antibiotic medication to combat your symptoms. Viral causes will not resolve with antibiotics, and your physician will most likely suggest supportive remedies if that is the case.
- Surgery: There are surgical procedures that can destroy nerve fibers in the face to reduce pain symptoms, especially for the neurological causes of severe jaw pain. Non-invasive and invasive surgeries can also be used to relieve pain caused by TMJ disorders.
Seek immediate treatment for the following
The following could be signs of Temporal Arteritis which must be treated quickly as this disease can severely damage vision:
- Sudden-onset scalp pain
- Fever
- Visual symptoms
Severe jaw pain treatment quiz
Take a quiz to find out how to treat your symptoms.
Questions your doctor may ask about severe jaw pain
- Have you been experiencing dizziness?
- Do you hear a ringing or whistling sound no one else hears?
- Are you experiencing a headache?
- Do you feel a painful, tight knot or band in your muscle anywhere on the body?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Gauer RL, Semidey MJ. Diagnosis and Treatment of Temporomandibular Disorders. American Family Physician. 2015;91(6):378-386. AAFP Link
- Acute Sinusitis. Harvard Medical School: Harvard Health Publishing. Published May 2015. Harvard Health Publishing Link
- Pincus DJ, Armstrong MB, Thaller SR. Osteomyelitis of the Craniofacial Skeleton. Seminars in Plastic Surgery. 2009;23(2):73-79. NCBI Link
- Robertson DP, Keys W, Rautemaa-Richardson R, Burns R, Smith AJ. Management of Severe Acute Dental Infections. BMJ. 2015;350. BMJ Link
- Giant Cell Arteritis. U.S. National Library of Medicine: MedlinePlus. Updated August 10, 2018. MedlinePlus Link