Types of jaw pain – causes, symptoms and treatments

Jaw pain is a common but often overlooked problem that can significantly affect quality of life. From difficulties with chewing and speaking to headaches or discomfort radiating to the neck and ears, this pain can have many causes.

Understanding the symptoms and triggers is essential for correctly identifying the source of the pain and intervening in time to prevent complications. In this article, we will examine the causes of jaw pain, as well as methods of diagnosis, treatment and prevention.

Jaw pain can have numerous causes, ranging from temporomandibular joint (TMJ) disorders to bruxism, which is often caused by stress and puts excessive strain on the jaw muscles and joint.  

“Dental problems, such as deep cavities, abscesses or the eruption of wisdom teeth, can cause pain that radiates to the jaw, as can muscle tension caused by stress or poor posture. Infections and inflammation, such as sinusitis or ear infections, can also cause discomfort in this area. Jaw pain can also have neurological causes, such as trigeminal neuralgia, or rheumatic conditions such as arthritis, which affect the joint structures of the jaw,” explains Dr. Diana Hîrjanu, a resident in Dental Prosthetics. 

Dental problems (tooth decay, infections, extractions)

Jaw pain is frequently caused by dental conditions, as the teeth and their nerve structures are deeply interconnected with the jaw. Thus, a deep cavity can cause radiating pain, especially when the inflammation reaches the dental nerve. A dental abscess causes intense pain, swelling and sometimes fever, with the sensation being perceived as deep and throbbing.  

Periodontal disease can also cause discomfort in the jaw by affecting the bone and tooth roots.  

Impacted or inflamed wisdom teeth exert pressure on the jaw, causing severe pain and limiting mouth opening.  

Furthermore, malocclusion places uneven strain on the teeth and muscles, causing pain that can be mistaken for joint pain, whilst dental fissures and severe sensitivity can radiate to the jaw.  

In many cases, an apparent joint or muscle problem originates from a dental condition, which is why a comprehensive dental examination is essential for an accurate diagnosis and appropriate treatment.

Bruxism and its impact on the jaw

Bruxism, i.e. the involuntary grinding or clenching of the teeth, is a condition that causes jaw pain through several mechanisms that overwork both the muscles and the temporomandibular joint (TMJ).  

During episodes of bruxism, particularly during sleep, the muscles involved in chewing contract strongly and repeatedly, leading to muscle fatigue, inflammation and pain felt in the jaw, temples or neck.  

Teeth grinding can exert 3–4 times more pressure than normal chewing, placing excessive strain on the TMJ and causing pain. If left untreated with anti-bruxism mouthguards, there is a risk of microtrauma, which would lead to inflammation and persistent pain. At the same time, bruxism can wear down the enamel and alter the contact points between the teeth, affecting the bite balance and overloading certain areas of the jaw.  

“I frequently see patients with bruxism, most often caused by stress and anxiety. I recall two recent cases that shared precisely this emotional factor. The first was a 65-year-old patient who hadn’t been to the dentist for four decades; his teeth were severely worn and loose, which meant some had to be extracted, even though they showed no signs of decay. The second case was a 27-year-old man, who was anxious and prone to panic attacks, whose teeth showed advanced wear for his age. “In his case, we managed to stabilise the progression of the problems with the help of a night guard, designed to protect the teeth and relax the muscles,” explains Dr Diana Hîrjanu, a resident in Dental Prosthetics.  

Maxillary neuralgia

Maxillary neuralgia is a form of nerve pain that affects one of the most important nerves in the face – the trigeminal nerve.

This pain is often intense, sudden and sharp, and is described as “an electric shock” or a deep burning sensation. Unlike common jaw pain, which is triggered by muscles, the temporomandibular joint (TMJ) or dental problems, maxillary neuralgia has a neurological origin and is triggered by the slightest stimuli: speaking, chewing, brushing your teeth or even exposure to the cold.

Temporomandibular joint (TMJ) problems

Temporomandibular joint (TMJ) disorders are a common cause of jaw pain, as they can affect both the joint and the muscles that control the movement of the jaw.  

The TMJ connects the jawbone to the temporal bone and is essential for speaking and chewing, so any dysfunction can cause pain, clicking or even locking. Dysfunctions can be muscular, caused by tension, bruxism or stress, or joint-related, when the articular disc is displaced or the joint is inflamed.  

The pain is usually felt in front of the ear and may radiate to the temples, teeth or neck, worsening with movement of the jaw. Contributing factors include stress, trauma, bruxism, malocclusion, arthritis and harmful habits such as nail-biting or resting the chin in the palm of the hand.

ENT infections (sinusitis, otitis – ear and jaw pain)

ENT infections, such as sinusitis and otitis, can cause pain felt not only in the ear or sinus area, but also in the jaw, as all these structures are closely interconnected via nerves and shared anatomical areas.

Sinusitis, particularly maxillary sinusitis, occurs when the sinuses beneath the cheeks become inflamed or infected. The pressure built up in the sinuses irritates the nerves in the cheek and upper jaw area, which can create a dull, throbbing pain, felt as a deep tension in the jaw, teeth and cheekbones. Sometimes, patients believe they have a ‘toothache’ when, in fact, sinusitis is the cause.

Otitis, or an ear infection, causes pain that also affects the jaw due to the anatomical proximity between the ear and the temporomandibular joint. Inflammation or pressure in the ear irritates the nerves in the area, and the pain occurs not only in the ear but also in the jaw, temples or neck. This is why some ear infections can mimic TMJ pain or toothache.

In both cases, jaw pain is usually secondary, i.e. the result of inflammation in neighbouring structures. It usually occurs alongside other symptoms: a feeling of a blocked ear, facial pressure, nasal discharge, congestion, difficulty chewing or sensitivity to touch.  

Jaw pain can take various forms, and recognising the type of pain and associated symptoms is essential for identifying the actual cause.  

Left and right jaw pain

Muscle pain is common in bruxism and during periods of stress, manifesting as a dull, aching pain on either the left or right side of the face. This type of pain is often accompanied by fatigue and radiates towards the temples or neck.

Joint pain, specific to TMJ disorders, is located in front of the ear and worsens when speaking, chewing or yawning, often accompanied by clicking sounds or limited mouth opening.  

Pain of neurological origin, as in trigeminal neuralgia, occurs in the form of short, very intense episodes, described as ‘electric shocks’, triggered by trivial touches or movements.  

Jaw and ear pain

ENT infections, such as sinusitis and otitis, can cause pain radiating into the jaw. Associated symptoms include:

• facial pressure
• congestion
• nasal discharge

In the case of jaw trauma, the pain is acute and severe, accompanied by swelling, bruising and difficulty opening the mouth.

Jaw and sinus pain

Dental problems, such as deep cavities or abscesses, can cause intense, throbbing pain that is felt deep within the jaw, as well as in the sinuses. This type of pain may be accompanied by sensitivity to cold and heat. 

Jaw pain is treated depending on its cause, but there are both general solutions and specific treatments for each type of problem. Here are the most effective treatment methods:

Ear and jaw pain – recommended treatment  

Treatment for ENT infections that cause earache and jaw pain focuses on clearing the infection and reducing inflammation in the affected areas, such as the sinuses or the ear. For bacterial infections, an ENT specialist may recommend antibiotics.

For the treatment of sinusitis, decongestants, nasal sprays or saline rinses are recommended, as these help to reduce pressure in the sinuses and clear the nasal passages. Ear infections, on the other hand, require specific treatments, such as anti-inflammatories, ear drops or ENT procedures tailored to the severity of the infection. With the correct management of these conditions, ear and jaw pain is significantly reduced. 

Treatment for maxillary neuralgia

If the jaw pain is of neurological origin, the neurologist will recommend specific medication for neuralgia or certain muscle relaxants, which help to alleviate the pain. If medication is not sufficient to reduce the pain, there are also options for interventions, which involve the injection of an anaesthetic to temporarily block pain transmission, or minimally invasive treatments targeting the nerve fibres responsible for the pain.  

Solutions for bruxism and jaw tension

When discussing jaw pain caused by bruxism or jaw tension, treatment options focus on relaxing and protecting overworked jaw muscles. Applying warm compresses is recommended to relax the muscles, whilst gentle massage reduces accumulated tension and alleviates discomfort.

As bruxism can cause tooth wear, it is recommended to use a protective mouthguard at night. In addition, jaw relaxation exercises and stress management techniques help to reduce episodes of teeth grinding, providing lasting pain relief.

Treatment of pain caused by the temporomandibular joint (TMJ)

Treatment for temporomandibular joint (TMJ) disorders aims to reduce pain and improve jaw mobility. Physiotherapy and specific TMJ exercises help to relax the muscles and reduce joint tension. Anti-inflammatory medication may also be used to control inflammation and pain.  

If the jaw pain is actually caused by an incorrect bite, occlusal correction or orthodontic treatment can restore balance.