jaw pain

introduction

The jaw is anatomically counted to the facial skull ( Viszerokranium ) and consists of two parts, the upper jaw ( maxilla ) and the lower jaw ( Mandibula ).

Both the maxilla and the mandible serve as a support structure for the embedded teeth.

Jaw pain can originate both from the jawbone and from the surrounding soft tissue (eg the musculature) - the causes are very diverse. The pain is extremely stressful for those affected and may severely limit the quality of life.

Everyday things like drinking, eating and talking are difficult and unpleasant for people with jaw pain.
However, as it is not always easy to differentiate the exact cause of this jaw pain, it takes time to help the patient in the long term.

Initially, the affected patient can help themselves with the use of painkillers, but these can not be taken indefinitely.
The long-term use or the excessive dosage of painkillers can have a negative effect on the organism and cause serious organ damage.

For long-lasting jaw pain, it is advisable to visit a dentist and to describe the problem as accurately as possible.

Also, the visit of an orthodontist can be advisable in many cases.

Overview of the causes of jaw pain

The causes of jaw pain are very diverse. It turns out, however, that the temporomandibular joint is a frequent trigger for this pain. The temporomandibular joint is a very complex joint that is subjected to great stress every day. Like any other joint in the human body, this too can wear out over time if used too much.

The temporomandibular joint arthrosis

Arthritis in the temporomandibular joint is not uncommon. The word " osteoarthritis " is the medical term for overuse of the joint, which exceeds the usual age of joint wear. Our jaw is actually constantly on the move - talking, chopping food, swallowing, and even at night, often unconsciously. The older you get, the higher the risk that the temporomandibular joint will not cope with the ongoing strain and wear will begin.

Wrong strain on the temporomandibular joint

Another important cause, which is also related to the one mentioned above, is an incorrect loading of the jaw. Such an incorrect loading can also have effects on the temporomandibular joint and thus cause the pain or even lead to it.
The incorrect loading is usually caused by missing teeth (often in the posterior region), an outdated crown or a new, which was not correctly ground and used, no longer well-fitting prostheses or tooth filling.

Inflammations in the jaw

Of course, one should not ignore inflammation or damage caused by bacteria that cause tooth decay and are often the cause of oral diseases.
These bacteria can not only attack the tooth or its root, but systematically work its way through the tissue and into the bone, where they cause a jaw inflammation. The diseases of the periodontium, also called gingivitis or periodontitis, may be precursors that can also cause pain in the bone.

Injuries of the temporomandibular joint

Jaw pain can also occur as a result of injury, possibly triggered by a fall or a blow. And also the phenomenon of the jaw lock is accompanied by pain, since the muscles can cramp when trying to open the mouth.

gnashing of teeth

Another cause that affects many people is "bruxism." Bruxism is understood to mean teeth grinding and a strong clenching of the teeth, which usually happens unconsciously during sleep. Triggers can be the following: a malposition in the TMJ, an incorrect occlusion (contact between upper and lower jaw teeth) and above all stress and mental suffering.

A cold can also radiate to the jaw due to the nerve courses. Jaw pain, although a very atypical symptom, may also indicate a myocardial infarction, which then confines itself to the lower jaw and radiates into the left arm. Many people also suffer from postural deformity, which leads to a bad load on the back and neck and must therefore be considered as a cause of jaw pain.

Jaw pain depending on localization

It makes sense to divide the jaw pain according to its location - up / down / left / right or combinations - and then to be able to rule out possible causes. When visiting the dentist, you should describe the present pain as precisely as possible - this includes the respective painful area, the quality of the pain, any trigger factors or what else has noticed unusual symptoms.

Maxillary pain

The upper jaw is supplied by the maxillary nerve (2nd branch of the trigeminal nerve ). Pain in this area can be due to infection in the jawbone due to periodontal disease (common saying: periodontal disease), due to antritis, or from a single dying nerve of a tooth.

But also fractures, z. B. in the anterior teeth in a fall or tumors can trigger pain in the upper jawbone.

The maxillary nerve is also irritated by ongoing pressure, so it may be responsible for pain in permanent crunching or night crunching.

Jaw pain

The mandibular nerve, which sensitively supplies the mandible on both sides, is responsible for pain in the lower jaw. Cause may, as in the upper jaw, a fracture, a tumor or other space requirements, inflammatory foci of teeth due to dying teeth or at the end of the ascending mandibular branch, a pain from the temporomandibular joint.

In a fall, especially the chin is endangered, so it comes here again and again to fractures. In this context, ie with impact on the chin, but it must always be checked whether there is pain in the temporomandibular joint, which could be caused by a fracture of the jaw joint head. A "no longer matching the rows of teeth" is here an indirect sign, which can be detected by an X-ray image. The mandibular nerve is also irritated by ongoing pressure. One should pay attention to whether one often grits with the teeth or presses them together.

left or right side jaw pain

In many cases, jaw pain is caused by signs of wear in the area of ​​the temporomandibular joint.
Mismatched restorations, dentures, crowns or bridges, as well as inherited jaw anomalies, can trigger these signs of wear. In addition, patients with enormous malocclusions often suffer from severe jaw pain.
The symptoms of pain are particularly pronounced in movements of the temporomandibular joints, which are executed from the central axis to the right or left. For this reason, joint-related jaw pain occurs especially when chewing, talking and biting. So in those movements in which the temporomandibular joints slide to the left or right.

In addition, an over-mobility of the jaw can lead to jaw pain. This increased mobility can be triggered by weakness of the ligaments and lead by the sliding of the joint axis to the right or left to jaw pain.

In addition, many patients have hyper-mouth opening, which in worse cases can lead to dislocation. In extreme cases, the temporomandibular joint can no longer be independently fixed from such a wide opening.

One-sided localized pain in the jaw is usually associated with a dysfunction of the gnathological system ( gnathology deals with the question of how the rows of teeth and jaws to each other). Before, dead or dying teeth, tumors or fractures should be excluded. The discomfort can radiate, beginning at the lower jaw angle edge at the beginning of the Musculus Masseter (a Kaumuskel) of the lower jaw over its entire length high up to the temporomandibular joint and in addition into the temporal muscles ( Musculus Temporalis ). Even the neck, neck and shoulder muscles can be affected. The cause can be many. An unoccupied gap in the tooth, where a tooth from the opposing jaw "grows" into the gap and thereby forms an obstacle in the normal chewing process, a wisdom tooth that lacks the antagonist (counter tooth) or chipped filling materials. Even dented prosthetic teeth, whose missing cusp design allows a deep immersion of the jaw joint head into the socket, can lead to a compression in the temporomandibular joint.

Bilateral jaw pain

Bilateral simultaneous pain symptoms are often the result of overuse of the masticatory muscles with resulting dysfunctions. The mouth can then no longer be properly opened, the jaw joints crack when opening and / or closing the mouth and the patient gets the feeling that the teeth no longer fit together correctly.

It happens that physiotherapy must be done before a splint is made so that the patient can first open his mouth properly. Only then can an impression for a rail be made.

Situation-related jaw pain

Jaw pain often manifests itself in colds when under stress or, for example, after drinking alcohol. Sometimes they only express themselves when chewing or falling when teeth grind. Even dental procedures can cause subsequent pain, such as after a syringe, wisdom tooth surgery or root canal treatment.

Jaw pain with colds

In a cold, the maxillary sinuses are often affected, ie the mucous membranes located there are inflamed, so infected with bacteria. Pain in the area of ​​the jaw due to a cold in the upper jaw is often associated with the close proximity of the maxillary sinus floor to the root tips of the teeth in the posterior region. If there is an infection (sinusitis), the path of the bacteria is very short and the upper jaw supplying nerve ( maxillary nerve ) is temporarily irritated. With the onset of the cold, the complaints usually go back. Therefore, it is possible that you can also have pain in the jaw in a cold.

Jaw pain during chewing movements

If one feels a pain in the jaw during normal chewing, then there are several possibilities of the cause. The simplest cause is a hard particle, such as. B. a cherry stone on which one bites. In this case, the affected teeth, which are not completely rigid with the jaw bone are grown, but on fibers ( Sharpey-sche fibers ) are suspended, down to the bottom of the alveolus (bone compartment of the tooth) pressed, causing a compression (squeezing) of the There comes in the tooth entering nerve. By reflex, the mouth is forced to an opening. Similarly, the situation after a visit to a dentist, where a tooth has received, for example, a new filling, partial crown or crown. If the height conditions are not exact, the tooth can hurt so badly during biting that you can feel the pain even in the jaw.

Often fillings are placed under a local anesthetic (syringe), so that the numb feeling does not allow correct feedback regarding the correct filling height. Although the dentist has the opportunity to check by means of a color so-called occlusion foil height, but often falsified the long lying and mouth-open-hold the normal position of the rows of teeth to each other.

Another way to feel pain while chewing may be in the temporomandibular joint. Between the parts of the upper and lower jaw, which form the temporomandibular joint, there is a cartilage disc, which under normal function supports the movement process. However, if the distance between the upper and lower jaws is too small, compression will occur here as well, resulting in permanent deformation (compression and permanent deformation), causing the movement to cause pain. For example, undershoots, spilled prosthetic teeth, or crunched teeth may be the cause of insufficient clearance.

Jaw pain from teeth grinding

Pain in the jaw area caused by teeth grinding can be felt on the teeth as well as in the jawbone or temporomandibular joint. The pain on the teeth can be due to the overloading and rotational movement (torsion), which arise when grinding on the teeth. This results in microcracks both in the outer shell of the tooth (tooth enamel) and at the transition between enamel and root cementum (layer on the surface of the root). Tiny small portions of the enamel prisms involved in the outer tooth structure are almost "blown out" by the improper loading. These, in turn, cause tooth components associated with nerve fibers to respond to this condition. Longer teeth grinding may also have led to a loss of height and thus to a lowering of the bite position and as a result to a pain in the temporomandibular joint.

Jaw pain due to stress

Pains in the jaw are often simply stress-related. In fact, most patients do not even realize that they are constantly gritting their teeth or pressing the rows of teeth tightly, even when they're doing it during the day. This behavior is called bruxism. Even a tense posture, in which the muscles no longer find their way back to a relaxed posture, can be an expression of stress. During exercise, one literally bites his teeth, which happens unconsciously.

Jaw pain due to tension

Tension of the jaw muscles come about mainly due to malpositions of the jaw to each other. Cause may be unilateral or bilateral Fehlbelastungen by missing teeth (ie by tooth gaps) and elongated, ie elongated teeth (unhindered growth), damage in the temporomandibular joint, poor working posture (eg bent sitting on the computer) or accidental damage, the scarring of the musculature no Allowing the muscles to release more.

In addition to physiotherapy, physiotherapy (including osteopathy) or muscle relaxants (drug for chemical muscle loosening), relaxation techniques such as progressive muscle relaxation, meditation, yoga or Pilates can lead to relaxation and end the jaw pain or not even arise.

Jaw pain after alcohol consumption

Pain in the jaw area after drinking alcohol is usually reported to the teeth, which are already damaged and show an incipient or occurred inflammatory reaction. By drinking alcohol, the blood vessels in the interior of the Zahnpulpa (nerve) widen and you can literally feel your own pulse. Alcohol consumption after surgical procedures has proven to be extremely bad. The mechanism of dilation of the blood vessels again plays the decisive role. The already closed blood vessels do not withstand the pressure and open again, resulting in a rebleeding with appropriate pain. This can lead to the Umstechung (surgical method for vascular occlusion) of the vessel when a pressure bandage is no longer sufficient.

Jaw pain after root canal treatment

Carious defects, which are not treated for a long time, cause after a while strong stinging and / or throbbing pain. These jaw pain are a warning sign. The affected patient should urgently visit a dentist and initiate appropriate treatment in a timely manner.
Deep carious defects, which have already penetrated the hard tooth substance and opened the medullary cavity, can damage the nerve fibers and cause the death of the tooth. In these cases, the occurring jaw pain can usually be alleviated only by a so-called root canal treatment. In the course of this therapeutic measure, the dental pulp, together with the nerve fibers stored therein, is completely removed and the root cavity subsequently closed by an artificial filling material.

But even after a root canal treatment, jaw pain can recur. There can be various causes for this phenomenon. Patients who suffer from jaw pain with the same localization after completing root canal treatment should consult a dentist in a timely manner. An X-ray examination of the affected tooth can quickly provide information about which measures must be taken and whether the tooth can still be preserved. In everyday clinical practice shows that pain after root canal treatment usually do not represent a good starting point for the tooth preservation.
On the one hand, the recurrence of the jaw pain after root canal treatment could be due to the fact that in the first treatment trial no complete clearing of the root canal took place and thus there are still bacteria in the root canal system. Especially in patients who have very narrow or crooked root canals, the implementation of a root canal treatment is very complicated. On the other hand, jaw pain after root canal treatment can be an indication of the emergence of a cyst near the root tip.

Jaw pain after a wisdom tooth operation

Even before an operation, breaking wisdom teeth cause great problems for the patient. The wisdom teeth are an ancient rudiment when man had to chew food even more by chewing. These days they are no longer needed.
But with every second human there is not enough room for the 8's, so that there is pain in the jaw when it breaks through. The teeth remain in the jaw, they usually cause no problems, only the breaking brings the suffering with it. If they only partially break through, they are an easy target for bacteria, which can also migrate into the jaw and cause pain.

Jaw pain following wisdom tooth surgery is not uncommon and is part of the normal healing process, such as a thick cheek, bruising, and difficulty swallowing. They are the result of surgery that takes place under anesthesia. The wisdom teeth are usually very deep and wedged in the bone, so that the bone is affected during the procedure and must withstand high loads. As a concomitant symptom, jaw pain also occurs after surgery, but should improve over time.

Nerve ends are exposed and also the tissue fluid needed for healing can cause the pain. However, if these do not improve, a re-visit of the attending physician is strongly advised as it may have caused an alveolitis sicca, which causes the other jaw pain. In alveolitis sicca, the empty tooth compartment becomes inflamed by bacteria because the protective blood glaucoma decays or does not develop.

Jaw pain after a syringe

A syringe can be used in dental procedures to relieve the patient of the pain and make the procedure as bearable as possible. Most of these jaw pain occurs with a restricted mouth opening. This is also called a jaw clamp.

This is because when injected with the needle, a blood vessel may have been injured or it may bleed into the tissue. Vascular injury can cause bruising. This type of jaw pain disappears after a certain time, but again by itself.

Concomitant symptoms in addition to jaw pain

Often, jaw pain is accompanied by ear or headache. Even a cracking temporomandibular joint can occur and unsettle the person concerned. Some jaw pain may in rare cases also indicate a heart attack.

Pain in the jaw and ear

Diseases of the teeth, periodontium or temporomandibular joints do not exclusively produce symptoms that are limited to the oral cavity.
In many cases, jaw pain, in combination with painful sensations, occurs in the ear. Especially during chewing, biting or talking, many patients experience jaw pain that extends to the ear. This phenomenon is usually caused by over or under loading of the temporomandibular joint.
Furthermore, strong tensions of the masticatory muscles can also lead to jaw pain that radiates up to the ear and puts a lot of strain on the affected patients. In these cases, a targeted massage of tense muscles is often perceived as soothing. But long-term healing is rarely possible in this way.
Both stress and tension associated jaw pain involving the ear should be evaluated by a dentist. In many cases, the symptoms can be dealt with quickly by simple means such as crunchy splints or physiotherapy.

Head and jaw pain

Headaches usually go hand in hand with jaw pain and are especially noticeable if the problem persists for a long time. Thus, the above-mentioned wear and tear on the temporomandibular joint can not only cause jaw pain, pain when chewing, speaking or yawning but also headaches.

Also the permanent misloading by crunching and pressing in the night or problems causing dentures can bring headaches as a further concomitant. The individual parts of the body can not be judged separately, but working together are also to be considered as an entire system. A cold can also cause headaches, such as permanent sneezing.
Wisdom teeth can also cause headaches in addition to the jaw pain. Frequently, however, the concomitant symptoms of headaches lead to misdiagnosis, as the causes are widely scattered. The fact that jaw pain is often limited to the jaw area because of its development is also shown by the association that jaw joint problems cause ear pain very quickly.

Cracking TMJ

TMJ sounds (cracking) are generally harmless in the majority of cases and need not necessarily be treated. However, patients who frequently experience TMJ cracking should consult a dentist to rule out a serious underlying condition.

Especially if jaw pain and / or movement limitations are observed in addition to the cracking, a comprehensive diagnosis makes sense.
For noises caused by the temporomandibular joint, a distinction must be made between so-called rubbing noises and real cracking.

Rubbing sounds are in many cases not in need of treatment, but may also be a first indication of a change in the shape of the joint head (for example, by Osteoarthrose). In addition, such rubbing noises can also be caused by the smallest cracks in the area of ​​the cartilage disk (discus) of the temporomandibular joint.
Cracking in the temporomandibular joint, on the other hand, usually indicates a shift in the position of the cartilage disc.

Jaw pain as an indication of a heart attack

Pain that radiates into the lower jaw can actually also be an indication of a heart attack. The typical signs of a heart attack are sudden and persistent chest pain that is common in the left arm. They can also reach into the abdomen or between the shoulder blades. Add to that a pale complexion, cold, damp hands, cold sweats on the face, severe breathlessness, which can increase to the point of death. If these symptoms appear in addition to the jaw pain, an ambulance should urgently be alerted.

forecast

The prognosis for all possible pain occurring in the jaw area is basically good if timely medical or dental treatment has taken place and the patient shows a high level of cooperation.

A possible exception are the defects in tumor events. Here, the primary tumor and the course of the disease as well as the timely treatment prevail. In second place are temporomandibular damage, since there are few possibilities of complete recovery, an arthrosis may arise that is no longer curable. All other causes such as pure muscle pain or inflamed teeth are usually cured after a few days.

Duration of jaw pain

The duration of pain in the jaw is always related to the triggering cause. A fracture will not hurt anymore if it has been properly treated, eg bolted to metal plates. A muscle pain no longer hurts when a muscle has learned to relax again in addition to the tension or was helped to relax it by external action (physiotherapy). Temporomandibular joint pain often subsides with the onset of a crunching splint, and teeth in the jaw no longer hurt when the centers of inflammation have been eliminated or when pain medications have been taken. All causes together are based on the assumption that the patient fulfills his share of the healing and can be guided.

Treatment options of jaw pain

Since many patients suffering from jaw pain are due to purely mechanical causes, the treatment can be relatively simple.
If the jaw pain is caused by too high crowns, bridges and / or dental fillings, it is advisable to have them exchanged or abraded by a dentist. Many patients already feel very relieved after this simple procedure and notice a decrease in jaw pain.

In patients who crunch heavily at night with their teeth or bite the jaws too hard on each other, a so-called functional splint can serve as a therapeutic approach. The rail serves as a buffer between the teeth of the maxilla and the mandible and reduces the forces acting on the temporomandibular joints. In everyday life, these patients can easily help themselves out.

If the tongue is consciously applied to the palate, behind the incisors, it automatically leads to a relaxation of the masticatory muscles and thus to a relief of the joints.

If dental and / or maxillofacial misalignment is the reason for the development of jaw pain, an orthodontist should urgently be consulted. He can accurately assess how improvement can be achieved and what orthodontic measures are needed to help the patient and reduce jaw pain.

Home remedies for jaw pain

Home remedies for pain in the jaw area can only be used meaningfully if the cause of the symptom pain is known. This would mean, for example, that the heat that is felt to be beneficial and relaxing in tense masticatory muscles has a counterproductive effect on the inflamed tooth. Heat would even increase the pain here, as the added heat can increase the inflammation.

However, a painkiller like ibuprofen can "take the lead" of pain until you have the opportunity to visit the dentist for an appointment.

Homeopathy for the treatment of jaw pain

In case of jaw pain caused by overuse of the jaw by crunching and pressing (bruxing), natural remedies such as homeopathy can also help. A variety of preparations aims to lessen the triggers such as nervousness, mental stress, pressure to perform or sleep disorders with the help of globules (lat. In general, consist of a proportion of sugar and diluted active ingredients such. B. Cina D 6, Cuprum D 12, Phytolacca D 6 or magnesium phos. D12. Which of these active substances can now specifically counteract nervousness, fatigue or stress remains a decision of the attending physician or advisory pharmacist.

diagnosis

For severe pain in the jaw area you should make an appointment as soon as possible with a dentist. This is the first point of contact and the doctor refers to an orthodontist after assessment and necessity.

The attending dentist examines the site in the mouth and will then usually initiate an x-ray on which one can accurately see and assess the bone structure and perhaps a possible inflammation. Subsequent treatments or referrals to another specialist are then initiated to treat the cause of the jaw pain.

Which doctor is the right contact person?

In addition to the in-house dentist with special knowledge of functional diagnostics and analysis, the oral and maxillofacial surgeon is also a suitable contact for pain in the jaw area. Because the complaints can emanate both from the jawbone and from the surrounding muscles.

An ENT specialist can also be consulted for jaw pain that might have been caused by a cold or something similar, but usually the cause is in the temporomandibular joint area or caries.


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