Jaw or Orofacial Pain - What is it?
Jaw or Orofacial Pain is a common condition in modern society, impacting on patients' quality of life. It can be defined as pain or discomfort located in the orofacial region (mouth, teeth, tongue, mucous membranes, lips, gums, chewing muscles, temporomandibular joints, ear, etc.) and/or craniocervical region (neck, spine, skull, etc.). Initially, it is essential for a dentist to distinguish the origin of the pain, differentiating it between pain of dental or non-dental origin (more often temporomandibular dysfunction).
Excluding dental origin, the most common orofacial pain is Temporomandibular Dysfunction, affecting the temporomandibular joint, the muscles of mastication and adjacent structures. However, there are other pathologies that can affect the head and neck region, such as sinusitis, viral infections, vascular and neurological alterations, pathology of the cervical spine, etc.
The characteristics of the pain vary: it can be low intensity or severe, acute or chronic, permanent or intermittent, unilateral or bilateral, grinding, pulsating, shock-like, etc. It may or may not worsen with jaw function and stimulation of the affected area. These characteristics sometimes make differential diagnosis difficult, and the role of one or more specialised health professionals is essential. Only a correct diagnosis will lead to treatment and/or symptom relief.
Possible Symptoms
The symptoms associated with Orofacial pain can vary depending on the underlying cause. Some of the most common symptoms include:
Sensitivity or Pain in the Jaw
Discomfort or pain when chewing, speaking, swallowing or opening the mouth. There may also be episodes of pain at rest and without stimulation or use of the TMJ.
Difficulty opening or closing the mouth
Feeling that the jaw is locked or stiff, making normal mouth movements difficult.
Headache
Headaches of various kinds that can be associated with Temporomandibular Dysfunction, migraines, etc.
Ear pain
or tinnitus
Discomfort in the ear area or a sensation of tinnitus, often related to Temporomandibular Dysfunction.
Clicking or crackling when moving the jaw
Popping, clicking or squeaking sounds when opening or closing the mouth, indicating a possible temporomandibular disorder.
Swelling of the face
face
Oedema or swelling in the jaw area or around the TMJ.
Tooth wear
Exaggerated tooth wear associated or not with dental pain and pain in the TMJ area and chewing muscles.
Available Treatments
The treatment of orofacial pain always depends on the underlying cause and the severity of the symptoms. Therefore, diagnosis is key. Here are some commonly recommended treatment options:
Dental intervention
If the orofacial pain is of dental origin, the dentist will be the first-line professional for treating and resolving the symptoms. The underlying pathology could be dental caries (with or without pulp involvement), periodontal disease, loss of tooth structure and consequent tooth sensitivity due to wear, trauma, gum recession or acid erosion, etc.
Use of oral devices
If the orofacial pain is Temporomandibular Dysfunction, myorelaxing drops can be used to reduce tooth wear, promote muscle relaxation and reduce tension/pressure within the joint. These devices are personalised for each patient and are a valuable aid during sleep.
Pharmacological treatment
Aimed at relieving pain and/or inflammation, analgesics and NSAIDs may be first-line drugs. Depending on the diagnosis, muscle relaxants, anxiolytics, antidepressants and other drugs that act on the central nervous system may also be used.
Antibiotics may be prescribed to treat dental or bone infections that could be causing the pain.
Surgery
In severe cases of TMJ dysfunction, where conservative treatments are not effective, surgical options can be considered, ranging from minimally invasive procedures to more complex surgical interventions.
Behavioural therapy
Stress management techniques, such as biofeedback or cognitive-behavioural therapy, can be useful for patients whose Orofacial pain is related to stress or anxiety. Learning to manage stress can reduce muscle tension and, consequently, pain in the jaw and face.
Complementary therapies
Physiotherapy should be considered in the treatment and management of pain in a significant number of cases. Whenever muscle and joint structures are involved, both in the TMJ and the cervical spine, physiotherapy proves to be an important tool in resolving the patient's condition.
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FAQ's
1. What causes orofacial pain?
Orofacial pain can be caused by dental and/or gum diseases/infections, TMJ dysfunctions, bruxism, rheumatic diseases, trauma, viral infections, changes in the Central Nervous System, among other factors. A correct diagnosis is essential in order to treat the underlying cause.
2. How can I relieve jaw pain at home?
If the source of the pain is a temporomandibular disorder, applying hot or cold compresses to the affected area, avoiding hard foods, practising relaxation exercises and using over-the-counter painkillers can help relieve the pain temporarily. However, it is important to seek professional help for proper treatment.
3. When should I see a dentist for jaw pain?
If the pain in your jaw is persistent, severe or accompanied by other symptoms such as difficulty opening your mouth, ear pain, or clicking in your TMJ, it's important to see a dentist who specialises in orofacial pain.
4. Can bruxism cause jaw pain?
Yes, bruxism, which is the act of grinding or clenching the teeth, can cause tension in the chewing muscles and pain in the TMJ. The use of oral devices, such as myorelaxing drops, can help prevent bruxism and relieve pain.
5. Can jaw pain be related to stress?
Yes, stress can lead to increased muscle tension and bruxism, both of which are related to jaw pain. Stress management techniques can be useful for relieving symptoms.
6. What are the treatments for TMJ dysfunction?
Treatments include medication, physiotherapy, oral devices, behavioural therapies and, in severe cases, surgery. The appropriate treatment depends on the severity of the condition and the patient's symptoms.
7. Can children have jaw pain?
Yes, children can also experience jaw pain due to dental problems, trauma or habits such as bruxism. It's important to monitor symptoms and seek professional help if necessary.
8. What can I do to prevent Orofacial pain?
Maintaining good oral hygiene, avoiding habits such as chewing gum frequently, managing stress and using oral devices recommended by your dentist to prevent bruxism can help prevent pain in this area of the jaw and face. Regular visits to the dentist are also essential to detect and treat problems early.
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