My jaw hurts and it seems that’s it. Why does the jaw near the ear hurt when opening your mouth and when chewing? What are the accompanying symptoms and what to do? When chewing and closing teeth
Acute pain in the temporomandibular joint (TMJ) usually appears when it is inflamed ( arthritis). Pain may be unilateral or bilateral, acute or chronic ( long-term). Quite often, this disease is accompanied by increased pain when opening the mouth, difficulty eating and other symptoms. In the case of chronic pain, such disorders can cause serious harm to both the physical and emotional state of a person, so delaying treatment for this disease is not recommended.
More often this disease is observed in children and elderly people. In the first case, this is explained by the constant processes of growth of bones and teeth in the child’s body, as well as the increased risk of injury to the joint during games. Elderly people are more likely to experience various infectious and systemic inflammatory diseases. Men and women get sick with the same frequency.
Interesting facts
- The temporomandibular joint moves whenever a person chews, swallows or speaks ( that is, on average every 30 - 40 seconds).
- Every second person has experienced pain or discomfort in the jaw joint at least once during their life.
- Movements in the mandibular joint can be carried out in three planes, which is due to the peculiarities of its structure.
Anatomy of the temporomandibular joint
The temporomandibular joint is a pair and is located at the point of connection of the lower jaw with the temporal bone of the skull. It also refers to combined joints, that is, movements in the left and right joints are always simultaneous and synchronous. Its main function is to ensure mobility of the lower jaw. The structural elements of the temporomandibular joint are:
- Articular surfaces. The joint itself is formed by the articular surfaces of the lower jaw ( articular head) and mandibular ( articular) fossa of the temporal bone.
- Joint capsule. The TMJ capsule is composed of dense connective tissue. It surrounds the joint from the outside and limits the articular cavity.
- Synovial fluid. The inner layer of the joint capsule is lined with endothelial cells, which produce the so-called synovial fluid. It fills the joint cavity, ensuring the sliding of the articular surfaces relative to each other, as well as providing protective ( antibacterial) function. The amount of synovial fluid in the joint cavity directly depends on the functional activity of the joint - with increasing loads, the rate of its formation increases, while with prolonged inactivity of the joint ( for example, when immobilized after a jaw fracture) its quantity decreases.
- Intra-articular disc ( cartilage). An important structural feature of the temporomandibular joint is the presence of special fibrous cartilage between the articular surfaces. With its edges, this cartilage fuses with the articular capsule, dividing the joint cavity into 2 sections ( top and bottom).
- Ligamentous apparatus. In the area of the temporomandibular joint there are three ligaments - 1 large ( collateral ligament) and two small ones. Their main function is to limit the movements of the articular head - the collateral ligament prevents its excessive posterior displacement, while the minor ligaments support the lower jaw. This joint is also connected by two ligaments to the malleus of the middle ear ( bone formation involved in the perception of sounds).
There are 3 types of movements possible in the temporomandibular joint:
- Opening and closing the mouth. These movements are carried out due to the displacement of the articular head of the lower jaw, while the articular disc remains in place. This occurs during speech and when chewing food.
- Moving the lower jaw forward. In this case, the head of the lower jaw is displaced along with the articular cartilage, that is, the movement occurs in the upper part of the articular cavity.
- Lateral displacement of the jaw. During this movement, the head of the lower jaw from the side of rotation ( that is, in the joint towards which the jaw moves) rotates around its axis, while in the opposite joint the articular head is displaced downward and sideways. This movement is especially important when chewing hard, rough foods.
Arterial blood enters the joint through branches of the external carotid artery ( along the superficial temporal and other smaller arteries). Venous blood flows into the venous network of the lower jaw and further into the jugular vein of the neck. Lymphatic drainage occurs in the cervical lymph nodes, which is important for the spread of infection during purulent inflammation of the joint.
Causes of inflammation of the temporomandibular joint
Pain in the joint area can result from many reasons. Depending on the cause, both pathological processes and approaches to diagnosing and treating the disease differ. The cause of inflammation of the temporomandibular joint can be:
- mechanical injury;
- infection;
- systemic inflammatory diseases.
Mechanical injury
An impact or fall can cause damage to any component of the joint, leading to characteristic clinical manifestations.Joint injury can cause:
- rupture of the joint capsule;
- rupture of periarticular ligaments;
- crack/fracture of the articular surfaces of bones;
- hemorrhage into the joint cavity.
Infection
When pathogenic microorganisms enter the joint cavity, an inflammatory process can also develop.Infection can enter the joint cavity in three ways:
- straight;
- contact;
- hematogenous ( through blood).
In this case, infection occurs when the joint is injured, accompanied by a violation of the integrity of the joint capsule ( with a fracture of the lower jaw, with blows, knife and gunshot wounds). Microorganisms penetrating into the joint cavity can cause specific ( tuberculous, syphilitic) or nonspecific ( staphylococcal, streptococcal)inflammation.
Contact route of infection
Contact infection of the temporomandibular joint involves the spread of bacterial agents from infected nearby tissues ( muscles, bones, ligaments and so on).
The cause of hematogenous infection of the TMJ can be:
- tuberculosis of the lungs or intestines;
- purulent foci of any location;
- sepsis ( penetration and spread of pyogenic microorganisms in the blood).
Systemic inflammatory diseases
This group includes a number of rheumatic diseases characterized by the development of generalized ( systemic) inflammatory process in various organs and tissues. Under normal conditions, the human immune system is designed to protect the body from foreign infectious agents. However, in some diseases, its work malfunctions, as a result of which immunocompetent cells begin to interact with the tissues of their own body, leading to their damage.TMJ inflammation can be caused by:
Rheumatoid arthritis
This disease is characterized by damage to connective tissue throughout the body. The most obvious clinical sign is damage to various joints. Damage to the temporomandibular joint in rheumatoid arthritis occurs in approximately 15% of patients.
The exact causes of the disease have not been established. Genetic predisposition and viral infections play a certain role in its occurrence ( herpes virus, hepatitis B virus and others). The essence of this disease is that activation of immune system cells occurs in the joint cavities ( T and B lymphocytes), which accumulate in the tissues of the articular cavity. A chronic inflammatory process develops, the outcome of which is damage and destruction of intra-articular components ( cartilage, articular surfaces of bones and other).
Systemic lupus erythematosus
Joint damage in systemic lupus erythematosus occurs in more than 90% of patients. The essence of this disease is also a disruption of the immune system, but in this case B lymphocytes produce autoantibodies ( that is, immune complexes that attack the intracellular structures of the body’s own cells), which leads to damage to various tissues. A distinctive feature is the fact that deformation of the components of the articular cavity does not occur, and clinical manifestations can completely disappear after the underlying disease is cured.
Reactive arthritis
This disease is characterized by non-purulent inflammation of the joints that occurs soon after an intestinal or genitourinary infection ( after infection with mycoplasmas, chlamydia and other microorganisms). The reason for joint damage is that the structural components of some microorganisms and their toxins are similar to some tissues of the human body.
Once entering the body, infectious agents come into contact with the immune system, as a result of which a number of defensive reactions are launched aimed at identifying and destroying “foreign” agents ( antigens). However, since “foreign” antigens are similar to “our own”, cells of the immune system also damage the tissues of their own body, including various components of the joints ( cartilage, ligaments, articular surfaces).
Gout
This disease is characterized by a metabolic disorder, as a result of which uric acid crystals begin to be deposited in the tissues of the body. There are many causes of the disease, but their essence boils down to either increased formation of uric acid ( when consuming large amounts of meat, during antitumor treatment), or to a violation of its excretion by the kidneys. As a result of an increase in the concentration of uric acid in the blood, its salts ( urates) accumulate in various tissues, including joints, causing the development of an acute inflammatory process.
Symptoms of inflammation of the temporomandibular joint
Regardless of the cause, inflammation of the TMJ always manifests itself with similar symptoms. However, when assessing symptoms, clinical manifestations in other organs should also be assessed ( damage to other joints, signs of infection, etc.) and the entire body as a whole, in order to promptly recognize and begin treatment of systemic and infectious diseases. As mentioned earlier, the inflammatory process in the joint can be acute or chronic.
Symptoms of acute inflammation
An acute inflammatory process is characterized by pronounced tissue swelling and increased sensitivity of nerve endings ( which causes severe pain). In addition, exudate often accumulates in the joint cavity ( inflammatory fluid formed as a result of increased permeability of the walls of blood vessels), which further aggravates the course of the disease.Acute inflammation of the temporomandibular joint can manifest itself:
- Pain. When a joint is inflamed, the pain is always sharp, sharp, stabbing or cutting. Pain always increases with movement ( during speech, when chewing food, etc.), which can significantly affect a person’s quality of life ( usually patients cannot open their mouth more than 1 - 1.5 cm). The pain may also radiate ( spread, "give") into nearby organs and tissues of the face and head. The irradiation of pain is due to the fact that different parts of the soft tissues of the face are innervated by the same nerve ( trigeminal nerve). As a result, pain impulses emanating from the temporomandibular joint area may be perceived by the patient as pain in other areas.
- Swelling and redness of the soft tissues in the joint area. This symptom is characteristic of purulent arthritis, accompanied by the proliferation of pathogenic microorganisms in the joint cavity. At the site of inflammation, a large number of inflammatory mediators are released. They cause the dilation of blood vessels, the flow of blood into the affected area increases, resulting in its redness. At the same time, there is an increase in the permeability of the vascular walls, as a result of which blood plasma leaves the vascular bed and permeates the surrounding tissues, causing the development of edema.
- Local increase in temperature. Increase in temperature by 1 - 2 degrees compared to surrounding tissues ( or with a symmetrical area of another joint, if only one of them is inflamed) is also due to the expansion of blood vessels and the influx of a larger amount of warmer blood to the site of inflammation.
- Feeling of fullness in the joint area. This sensation can be caused by both tissue swelling and the accumulation of a large amount of exudate in the joint cavity.
- Hearing impairment. As a result of the spread of the inflammatory process to the tissue of the external auditory canal, its narrowing may occur, as a result of which the patient may experience ear congestion and decreased hearing on the side of the injury. If the inflammation is infectious, the infection can spread to the structures of the middle and inner ear, which can lead to more serious hearing impairment, including complete deafness.
- Fever. Symptoms such as an increase in body temperature above 38ºC, pain and aching muscles, headaches, general weakness and increased fatigue may indicate the presence of a systemic infection in the body, as well as purulent inflammation of the TMJ.
Symptoms of chronic inflammation
As the inflammatory process subsides, the amount of exudate in the joint cavity gradually decreases, but proliferative processes may develop ( that is, at the site of inflammation, active cell proliferation and the formation of new tissues begin). The resulting tissue can compress intra-articular structures, causing dysfunction of the joint.Chronic inflammation of the temporomandibular joint can manifest itself:
- Pain. The pain in this case is less pronounced and is described by patients as “aching”, “pulling”. The pain may be constant or appear only when the joint is loaded ( while talking or eating). The function of the joint is also limited ( the patient can open his mouth no more than 2–3 cm).
- Stiffness of movements in the joint. Stiffness is especially pronounced in the morning or after a long period of time ( several hours) inactivity of the joint. The development of this symptom is due to compression of the articular components by proliferating cells. After several active movements, the joint “warms up”, as a result of which the feeling of stiffness may disappear.
- Crunching when moving the joint. The occurrence of a crunch or “click” when moving in a joint is caused by a narrowing of the joint space and the bringing together of the articular surfaces of the bones. Quite often, the crunching may be accompanied by increased pain.
- Moderate systemic manifestations of inflammation. Body temperature may be normal or slightly elevated ( up to 37 – 37.5ºС). The patient may complain of a feeling of weakness and increased fatigue.
- Hearing impairment. When an acute process becomes chronic, damage to the components of the ear may disappear on its own, but quite often various types of hearing impairment remain.
Diagnosis of the causes of inflammation of the temporomandibular joint
As mentioned earlier, inflammation of the TMJ can be caused by various diseases and pathological conditions. A specific cause can be suspected based on a patient interview and clinical assessment of symptoms, but a series of additional laboratory and instrumental studies are sometimes required to finally confirm the diagnosis. Which doctor should you consult if you have inflammation of the jaw joint?
Depending on the root cause, treatment of inflammation of the temporomandibular joint is carried out by specialists from various fields of medicine. If the symptoms of inflammation interfere with a person’s normal daily life, but do not pose an immediate threat to health and life ( that is, if the inflammation is not caused by trauma or injury to the joint), it is recommended to make an appointment with your family doctor.After a thorough interview and clinical examination, the doctor may suspect one or another cause of inflammation and, based on this, refer the patient to the appropriate specialist.
Depending on the causes of arthritis, the process of diagnosis and treatment may involve:
- Orthopedist and traumatologist – in case of damage to the bone, cartilaginous or ligamentous components of the joint.
- Dentist - for diseases of the teeth and oral cavity.
- Otorhinolaryngologist ( ENT doctor) – for diseases of the ear, throat, nose, and paranasal sinuses.
- Infectious disease specialist – when identifying infectious and inflammatory processes in the body.
- Rheumatologist – if the cause of arthritis is systemic inflammatory ( rheumatic) disease.
- Dermatovenerologist – if there are foci of infection in the head, neck, face or other parts of the body.
- Phthisiatrician – if you suspect a tuberculosis infection.
- Neurologist – if there is suspected damage/disease of the trigeminal nerve.
To identify the cause of inflammation of the temporomandibular joint, the following is used:
- assessment of clinical data;
- general blood test ( UAC);
- determination of proteins of the acute phase of inflammation;
- determination of autoantibodies in the blood;
- determination of the level of uric acid in the blood;
- radiography of the mandibular joint;
- examination of synovial fluid.
Evaluation of clinical data
If the appearance of pain in the joint was preceded by a mechanical injury or injury, then the diagnosis is beyond doubt. In other cases, the doctor must carefully examine the patient, evaluate all existing clinical manifestations and establish or suggest the cause of the inflammation.Possible changes in the OAC due to inflammation of the mandibular joint
| Indicator under study | What does it mean | Norm | Possible changes in TMJ arthritis |
| Red blood cell concentration | Red blood cells are red blood cells that carry oxygen throughout the body. | Men
(M
)
:
4.0 – 5.0 x 10 12 /l. | A decrease in the number of red blood cells and a decrease in hemoglobin levels can be observed in severe forms of systemic lupus erythematosus, as well as in severe systemic purulent-inflammatory diseases. |
| Women(AND):
3.5 – 4.7 x 10 12 /l. |
|||
| Total hemoglobin level | Hemoglobin is a complex of iron with the pigment heme, which is part of red blood cells. It is this complex that is responsible for binding oxygen and delivering it to the tissues of the body. | M: 130 – 170 g/l. | |
| AND: 120 – 150 g/l. | |||
| Platelet concentration | Platelets are directly involved in the process of stopping bleeding. | 180 – 320 x 10 9 /l. | A decrease in platelet concentration may occur in systemic lupus erythematosus as a result of the production of antiplatelet antibodies. |
| Leukocyte concentration | Leukocytes are the cells of the immune system that protect the body from foreign infections. When infectious agents of any kind enter the body, leukocytes begin to actively multiply and fight them, as a result of which their overall concentration increases. | 4.0 – 9.0 x 10 9 /l. | An increase in the concentration of leukocytes more than 10 x 10 9 /l indicates the presence of infection in the body. At the same time, a decrease in the total number of leukocytes can be observed in systemic lupus erythematosus, which is due to the formation of antilymphocyte antibodies. |
| Neutrophil count | Neutrophils are responsible for the destruction of pathogenic bacteria. They absorb and digest small particles and structural components of destroyed bacterial cells. Normally, there are 2 forms of neutrophils in the blood - segmented ( mature, involved in immune processes) and rod ( young, released into the bloodstream from the bone marrow). | Segmented forms:
ESR can increase several times in both infectious and systemic inflammatory diseases. That is why this indicator must be assessed in conjunction with data from a clinical examination and other tests. |
|
| AND: 5 – 15 mm/hour. |
Determination of proteins in the acute phase of inflammation
This biochemical indicator is of particular interest for the diagnosis of inflammatory diseases. Acute phase proteins are special substances that are released into the bloodstream during any inflammatory processes in the body, and the increase in their concentration is directly proportional to the activity of the inflammatory process.Proteins of acute phase of inflammation
| Indicator | Norm |
| C-reactive protein | No more than 5 mg/l. |
| Serum amyloid A | No more than 0.4 mg/l. |
| Haptoglobin | 0.8 – 2.7 g/l. |
| A 2-globulin | (M): 1.5 – 3.5 g/l. |
| (AND): 1.75 – 4.2 g/l. | |
| Ceruloplasmin | 0.15 – 0.6 g/l. |
| Fibrinogen | 2 – 4 g/l. |
| Plasminogen | The level of activity in plasma is 80 – 120%. |
| Lactoferrin | 150 – 250 ng/ml. |
| Ferritin | M: 12 – 300 ng/ml. |
| AND: 12 – 150 ng/ml. |
Determination of autoantibodies in blood
If an infectious cause of inflammation is excluded, it is recommended to more carefully examine the patient for the presence of systemic inflammatory diseases. For this purpose, a number of studies are carried out, the purpose of which is to determine various autoantibodies in the patient’s blood ( that is, immunoglobulins directed against the body’s own tissues), characteristic of certain rheumatological pathologies.
If a systemic inflammatory disease is suspected, it is recommended to investigate:
- Rheumatoid factor. Formed in most patients with rheumatoid arthritis, as well as in some patients with systemic lupus erythematosus. Represents immune complexes formed by abnormal ( structurally changed) and normal antibodies.
- Antinuclear antibodies. This term refers to a complex of autoantibodies that bind to the nucleic acids of cell nuclei, causing their destruction and cell death. This type of antibody is characteristic of patients with systemic lupus erythematosus, and also occurs in approximately 10% of patients with rheumatoid arthritis.
- Antiplatelet and antileukocyte antibodies. Characteristic of systemic lupus erythematosus.
This study is performed if the gouty nature of arthritis is suspected. Under normal conditions, uric acid is constantly formed in the body, but is immediately excreted in the urine, as a result of which its concentration in the blood is maintained at a certain level. The formation and deposition of uric acid crystals in tissues and joints is possible only with a long-term and pronounced increase in the concentration of this substance in the blood ( more than 350 µmol/l in women and more than 420 µmol/l in men), which can easily be detected with a special biochemical study.
X-ray of the mandibular joint
The principle of this method is to illuminate the temporomandibular region with X-rays. These rays penetrate freely through the air and are slightly delayed ( are absorbed) soft tissues of the body ( muscles, ligaments) and are almost completely absorbed by bone formations, which makes it possible to examine the bones of the body for the presence of cracks, fractures, displaced fragments, and so on.A radiological sign of an acute inflammatory process is widening of the joint space ( space between two surfaces of articular bones), caused by tissue swelling and accumulation of exudate in the joint cavity. When the acute process transitions to chronic, the exudate gradually resolves, and thinning of the articular cartilage is often observed, as a result of which the joint space decreases.
The disadvantages of the method include relatively low accuracy ( simple radiography does not reveal microcracks, as well as minor deformations of the articular surfaces of bones), which is why the main indication for its use is the suspicion of a fracture or dislocation of the articular head of the lower jaw after injury.
Computed tomography
This is a high-precision research method that combines x-rays and computer technology. The principle of the method is as follows: the patient is placed in a computed tomograph and lies motionless for several seconds. At this time, an X-ray machine rotates in a spiral around the area of the body being examined, producing many images. After completion of the procedure, the information received is processed on a computer, as a result of which the doctor receives a detailed three-dimensional image of the joints and bones.This method allows you to identify microcracks, dislocations and subluxations of the articular head of the lower jaw, determine the presence of a fracture and the degree of displacement of bone fragments. The disadvantages of the method include radiation exposure and higher cost ( compared to conventional radiography).
Magnetic resonance imaging
The principle of this method is based on the phenomenon of nuclear magnetic resonance - if a certain tissue is exposed to a strong electromagnetic field for some time, after the influence ceases, the nuclei of atoms emit a certain energy, which is recorded by special sensors. Depending on the cellular composition, all tissues of the body react differently to the influence of the electromagnetic field, as a result of which a fairly clear and detailed image of all components of the joint can be obtained.MRI can detect injuries such as rupture of the capsule and ligaments of the joint. Also, using this study, it is possible to identify minor damage to the articular surfaces of the temporal bone and lower jaw, observed in rheumatoid arthritis and other rheumatological diseases. There is no radiation exposure, so the only drawback is the high cost of the method, which significantly limits its use in everyday practice.
Synovial fluid examination
This study involves puncture ( piercing) joint cavity with a needle and collecting a small amount of intra-articular fluid for further examination in the laboratory. This procedure carries a risk of joint infection, so it should be performed by an experienced specialist and only with sterile instruments.
Examination of synovial fluid may reveal:
- Changes in color and transparency. Normally, synovial fluid is clear, colorless or slightly yellowish. Its turbidity, the appearance of foreign particles and impurities, the detection of leukocytes, as well as staining in a different color usually indicate the addition of an infection.
- Presence of rheumatoid factor. Evidence in favor of rheumatoid arthritis or systemic lupus erythematosus.
- Uric acid crystals. Their presence allows us to confirm the diagnosis of gout.
- Blood cells. This indicates damage to the blood vessels and hemorrhage into the joint cavity.
First aid for acute pain in the temporomandibular joint
First aid may be needed in case of acute traumatic injury to the joint, as well as in the case of infectious inflammation, when the pain syndrome is severe. It is immediately worth noting that injury, severe pain or limited mobility in the mandibular joint requires qualified medical care, so the measures described can only be used as a temporary measure before going to the doctor. First aid for pain in the mandibular joint includes:
- immobilization ( immobilization) affected joint;
- use of cold;
- taking anti-inflammatory drugs.
Immobilization of the affected joint
Regardless of the cause, the acute inflammatory process is characterized by tissue swelling, the formation of exudate in the joint cavity and increased pain in all structures of the affected area. Also, as a result of the influence of pro-inflammatory mediators, the sensitivity of the nerve endings at the site of inflammation increases, as a result of which the patient feels severe pain with the slightest movements.In addition, if inflammation develops after an injury, there is a high probability of a fracture. If the joint remains mobile, the bones or their fragments can damage nearby tissues, which will further increase the pain and aggravate the patient’s condition. That is why the first thing to do in case of acute pain in a joint is to immobilize it, that is, stop eating and keep conversations with others to a minimum until the exact cause of the inflammation is determined.
Using cold
As mentioned earlier, at the site of inflammation there is an increase in local temperature, expansion of blood vessels and tissue swelling. These adverse effects can be eliminated by applying cold to the area of the inflamed joint. Cold causes spasms ( narrowing) blood vessels and increasing the permeability of the vascular wall, thus preventing the leakage of fluid into the joint cavity and surrounding tissues. In addition, cooling reduces the sensitivity of nerve endings, which also effectively eliminates pain. It has been scientifically proven that the use of cold during the first minutes after a joint injury reduces the severity of inflammatory phenomena in the future and promotes a speedy recovery of the patient.To cool the inflamed joint, you can use an ice bag, a cold water bottle, or simply a cold compress ( which should be changed every 2 – 3 minutes). It is important to remember that contact of ice directly with the skin is extremely undesirable, as this can cause hypothermia of surrounding tissues. It is best to wrap an ice bag with a handkerchief or thin towel and then apply it to the inflamed joint for 5 to 15 minutes ( no more).
Taking anti-inflammatory drugs
You can begin independent drug treatment of joint pain if the measures described above are ineffective or simultaneously with them ( if the pain is particularly severe). To quickly relieve swelling and pain, drugs from the group of non-steroidal anti-inflammatory drugs can be used ( NSAIDs) .NSAIDs used for pain in the temporomandibular joint
| Name of the medication | Mechanism of therapeutic action | Directions for use and doses |
| Diclofenac | They inhibit the activity of the cyclooxygenase enzyme at the site of inflammation, preventing the formation of pro-inflammatory mediators. They have anti-inflammatory, antipyretic and analgesic effects. They also inhibit the formation of cyclooxygenase in the gastrointestinal tract, which causes the development of a number of side effects ( gastritis, stomach ulcers and so on). | To eliminate pain, a single intramuscular injection of 50–100 mg of the drug is allowed, after which they switch to taking tablet forms. The maximum daily dose should not exceed 150 mg. |
| Indomethacin | Intramuscularly at a dose of 60 mg 1 – 2 times a day. The maximum permissible duration of intramuscular use is 2 weeks. | |
| Nimesil(nimesulide) | It has more pronounced anti-inflammatory and analgesic effects and at the same time has a weaker effect on cyclooxygenase outside the site of inflammation ( that is, it causes fewer side effects than diclofenac or indomethacin). | Take 100 mg orally ( 1 tablet or 1 sachet, dissolved in 100 ml of warm boiled water) 1 – 2 times per knock. The analgesic effect develops within 30–60 minutes and lasts for 6–8 hours. The maximum permissible duration of treatment is 2 weeks. |
Is surgery necessary for inflammation of the temporomandibular joint?
Surgery is performed if it is the only possible method of treatment, and also if without surgery the risk of complications increases. The main indication for surgical treatment is purulent arthritis of the mandibular joint. In this case we are talking about infectious inflammation of the joint caused by pyogenic microorganisms ( staphylococci, streptococci and others). The resulting pus fills the joint cavity, significantly disrupting its function. In addition, suppurative arthritis can cause melting and necrosis ( death) intra-articular components ( cartilage, articular surfaces of bones, etc.), which will lead to complete loss of joint function. There is also a high risk of infection spreading to neighboring organs and tissues ( in the ear, in the neck area, in the cranial cavity) or penetration into the blood and spread throughout the body, which can lead to the death of the patient.
Preoperative preparation includes performing the necessary tests ( general blood test and general urine test, determining the state of the blood coagulation system). The operation itself is performed under general anesthesia in a sterile operating room. After making a skin incision and gaining access to the joint, the joint capsule is opened, and the joint cavity is cleared of purulent masses and necrotic ( dead) fabrics. The integrity of intra-articular structures and the degree of spread of pus to adjacent tissues are also assessed. After the operation is completed, the joint cavity is drained ( that is, a thin rubber band or tube is installed in it, thanks to which blood or inflammatory fluid accumulating in the joint will be released out), after which the joint capsule and skin are sutured.
In the postoperative period, the patient is prescribed:
- Broad-spectrum antibiotics ( for example, ceftriaxone 1 gram 1 time per day intramuscularly).
- Narcotic painkillers ( for example, 1 ml of 1% morphine solution intramuscularly).
- Nonsteroidal anti-inflammatory drugs ( ketorolac, indomethacin)
- Physiotherapy may be prescribed from 2–3 days after surgery ( UHF therapy, dry heat, electrophoresis and others).
- Strict diet, including exclusively liquid foods.
It is also worth noting that surgical treatment may be necessary for traumatic inflammation of the joint, if the injury resulted in a fracture of the articular surfaces of the bones, rupture of the joint capsule or ligaments, and other serious damage. Such patients are prescribed long-term immobilization of the joint in the postoperative period ( for a period of 1 – 2 to 4 – 5 weeks).
Treatment of post-traumatic inflamed temporomandibular joint
If the inflammation of the joint is caused by a bruise or other minor injury, it can go away on its own without any consequences for the patient. However, more often than not, without appropriate treatment, the acute inflammatory process does not subside or does not subside completely, turns into chronic inflammation and causes the development of complications. That is why if the pain and discomfort in the joint area does not go away within 2 - 3 days ( including while taking anti-inflammatory drugs), it is recommended to consult a doctor as soon as possible. In the treatment of post-traumatic inflammation of the temporomandibular joint, the following is used:
- immobilization;
- drug treatment;
- physiotherapy.
Immobilization
Immobilization as a first aid method for joint inflammation has been described previously. If, after examination, the doctor reveals a fracture, dislocation or sprain of the mandibular joint, this is an indication for longer and more thorough immobilization ( after appropriate treatment - comparison of bone fragments, reduction of dislocation, and so on).Methods of immobilization of the mandibular joint
| Method name | Description | Photo |
| Soft chin sling | It is one of the simplest and easiest ways to immobilize the mandibular joint. Consists of a soft part ( slings), which is applied to the chin area, and two wide rubber bands, which are placed behind the back of the patient’s head and fixed there to one another. |  |
| Sling bandage for the lower jaw | You can make a sling-shaped bandage yourself using improvised materials ( from an elastic or regular bandage folded into several words). There should be 2 strands extending from the corners of the sling on each side. The sling is placed at the level of the chin, after which its upper ends are brought behind the neck ( below the ears) and fix ( tie). The lower ends of the bandage are passed in front of the ears and fixed on the parietal region. |  |
| Parietal-chin bandage | To apply a bandage, use a wide bandage, rounds ( rpm) which are carried out alternately around the circumference of the head ( from frontal to occipital region), then around the chin and occipital bone ( bypassing the ears from behind) and around the chin and parietal bones ( bypassing the ears in front). This bandage is quite fragile and usually moves 1 to 2 hours after application. To prevent this, you can use an elastic bandage instead of a regular bandage. |  |
In addition to the described temporary immobilization methods, permanent ones are also used ( long-term). They are used in the presence of fractures of the articular surfaces of the lower jaw or temporal bone, when for healing the defect ( callus formation) more time is needed ( 4 – 5 weeks).
For the purpose of long-term immobilization, the following are used:
- Various methods of intermaxillary ligature fastening ( that is, the teeth of the upper and lower jaws are fastened together using wire). The procedure itself is performed under local anesthesia.
- Application of dental splints, which can be fixed to the teeth and other parts of the oral cavity ( the procedure is also performed under local anesthesia).
Drug treatment
The main goal of drug therapy is to eliminate pain, as well as prevent the progression of the inflammatory process.Drug treatment of post-traumatic inflammation of the mandibular joint
| Group of drugs | Representatives | Mechanism of therapeutic action | Directions for use and doses |
| Diclofenac | The mechanism of action and methods of application have been described previously. | ||
| Indomethacin | |||
| Nimesil | |||
| Non-narcotic painkillers | Paracetamol | By inhibiting the formation of cyclooxygenase in the central nervous system, it reduces the sensitivity of pain centers in the brain, thereby reducing pain. | If it is not possible to take it orally, it is administered into the rectum in the form of rectal suppositories 2–4 times a day. The dose is determined by the patient's age:
|
| Narcotic painkillers | Morphine | Acting at the level of the central nervous system, it blocks the transmission of painful nerve impulses to the brain, and also reduces the psycho-emotional response to pain. | Intramuscularly 10 mg 4–6 times a day ( depending on the severity of the pain syndrome). |
| Tramadol | A synthetic drug, similar in structure to narcotic painkillers. It disrupts the transmission of pain impulses in the central nervous system and also has a weak sedative effect. | Administered intravenously or intramuscularly at a dose of 50–100 mg ( for adults). If the analgesic effect is insufficient, the injection can be repeated after 30–40 minutes. The maximum daily dose is 400 mg. Children are prescribed at a dose of 1 – 2 mg/kg. The maximum daily dose for children is 4 – 8 mg/kg. |
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Physiotherapy
If the inflammation is caused by a bruised joint, physiotherapeutic procedures can be applied after 3 to 4 days. In case of more serious damage ( fractures, dislocations, rupture of the joint capsule or ligaments) the time of appointment of procedures is determined by the attending physician.Physiotherapeutic methods for treating post-traumatic inflammation of the mandibular joint
| Method name | Description of the method and assignment rules |
| UHF therapy | The principle of the method is to expose tissue to an ultra-high frequency electric field. The energy emitted by this field is absorbed by cells in the affected area, which leads to tissue warming, improved blood and lymph circulation, and normalization of nervous and endocrine processes. The positive effects of UHF therapy are:
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| Electrophoresis | The essence of this method is the combined use of direct electric current and various medications. Once in the area of action of such a current, medications begin to move from one electrode to another, thus penetrating deep into the tissue, which allows for the best therapeutic effects to be achieved. Direct exposure to direct electric current causes:
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| Phonophoresis with hydrocortisone | The principle of the method is similar to electrophoresis, only ultrasound is used instead of direct electric current ( high frequency sound waves). The medication hydrocortisone is applied to the surface of the skin in the area of inflammation ( steroidal anti-inflammatory drug) penetrates deep into tissues, providing anti-inflammatory and analgesic effects. The course of treatment includes 7 – 10 procedures, each of which lasts 5 – 15 minutes. |
| Diadynamic therapy | The principle of the method is to expose human tissue to direct currents of various frequencies ( from 50 to 100 hertz). At the site of application of such currents, restoration processes are activated at the cellular level, the activity of the inflammatory process decreases, and the sensitivity of the nerve endings at the site of inflammation decreases, which causes an analgesic effect. To achieve an optimal therapeutic effect, 2 procedures should be performed ( 15 – 30 minutes each) 2 times a day. The course of treatment is no more than 10 procedures. If necessary, a repeat course can be prescribed no earlier than 2 weeks later. |
Treatment of inflammation of the temporomandibular joint caused by rheumatic diseases.
Treatment of arthritis in this case is carried out simultaneously with treatment of the underlying disease. For arthritis caused by rheumatic diseases, the following is used:
- drug treatment;
- developmental exercises.
Drug treatment
Drugs from various pharmacological groups are prescribed, the purpose of which is to reduce the activity of the inflammatory process and prevent further damage to body tissues. The method of use and dosage regimen of drugs is determined by a rheumatologist individually in each specific case and depends on the nature and severity of the disease, the activity of the inflammatory process and other factors.Drug treatment of rheumatoid arthritis
| Group of drugs | Representatives | Mechanism of therapeutic action |
| Nonsteroidal anti-inflammatory drugs | Diclofenac | The mechanism of action has been described previously. |
| Nimesulide | ||
| Celecoxib | It is an anti-inflammatory drug that exclusively blocks cyclooxygenase at the site of inflammation. It has a pronounced anti-inflammatory effect, and also suppresses the formation of exudate and proliferation ( proliferation) fibrous tissue of the joint. | |
| Steroidal anti-inflammatory drugs | Prednisolone | They inhibit the activity of leukocytes, thereby reducing the activity of inflammatory processes in the body. Prevents the formation of exudate and structural changes in tissue in inflamed joints. |
| Methylprednisolone | ||
| Cytostatics | Methotrexate | They block the formation of leukocytes, thereby reducing the activity and severity of inflammatory processes and preventing their reoccurrence. |
| Leflunomide | ||
| Cyclophosphamide | ||
| Azathioprine | ||
| Sulfasalazine | ||
| Hydroxychloroquine | ||
| Monoclonal antibodies | Infliximab | In the human body, these drugs bind to and neutralize the so-called tumor necrosis factor, a biologically active substance involved in the development and maintenance of autoimmune and inflammatory processes. |
| Adalimumab | ||
| Etanercept |
Developmental exercises
Most rheumatic diseases increase the risk of developing ankylosis ( fusions) affected joints, that is, impaired mobility in it. This is due to the proliferation of tissue in the joint cavity, which is observed during long-term autoimmune and inflammatory processes.A set of simple exercises that must be performed daily 3 to 4 times a day throughout the course of treatment will help prevent ankylosis of the temporomandibular joint. It is worth noting that it is recommended to start performing these exercises only after the acute inflammatory process has subsided and the pain has relieved.
To prevent ankylosis of the mandibular joint, it is recommended to perform the following exercises:
- Lightly pressing your chin from below with your hand, you must slowly open your mouth, lowering the lower jaw as low as possible. After this, without stopping the pressure on the chin, you need to slowly close your mouth.
- Grasping the protruding part of the chin with your fingers, you need to slowly lower and raise the lower jaw, trying to push it down and back.
- Lightly pressing your fingers on the side of your chin, you need to move your jaw to the right and left. After this, you need to press on the chin on the other side and repeat the exercise.
- Pressing on the front edge of the chin ( pushing him back) you need to push the lower jaw forward as much as possible.
Treatment of inflammation of the temporomandibular joint caused by infection
Antibacterial drugs are used to treat infectious diseases. First, broad-spectrum antibiotics are prescribed, which are active against a large number of different microorganisms. After identifying a specific pathogen, drugs are prescribed that most effectively fight this type of infection. Drug treatment for arthritis caused by infection
| Group of drugs | Representatives | Mechanism of therapeutic action | Directions for use and doses |
| Penicillins | Amoxicillin | They disrupt the formation of structural components of the bacterial cell wall, which leads to their death. | Inside, regardless of meals, with a glass of water. Children over 10 years of age and adults are prescribed 500 mg ( 1 tablet) 3 – 4 times a day. |
| Benzylpenicillin sodium salt | Intramuscular or intravenous 1 - 2 million action units ( ED) 4 times a day. | ||
| Tetracyclines | Tetracycline | Penetrating into bacterial cells, the drugs disrupt the synthesis of intracellular components responsible for division processes ( reproduction). | Orally 250–500 mg every 6 hours. |
| Doxycycline | Intravenously, by drip, dissolving 100–200 mg of the drug in 250–500 ml of 0.9% sodium chloride solution. | ||
| Anti-tuberculosis drugs | Streptomycin | It disrupts the activity of intracellular components of Mycobacterium tuberculosis, preventing their further reproduction. | Intramuscularly at a dose of 1–2 grams per day ( in 1 – 2 doses). The course of treatment is at least 3 months. |
| Isoniazid | Inhibits the synthesis of structural components of the cell wall of Mycobacterium tuberculosis. | Orally, after meals, 200–300 mg 3 times a day. The treatment is long-term. | |
| Antifungal drugs | Nystatin | Slows down reproduction and leads to the death of pathogenic fungi. | The drug is taken orally, 3 – 4 times a day.
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| Fluconazole | Blocks the activity of enzyme systems of pathogenic fungi, which leads to their death. | Inside. The initial dose is 400 mg once a day, after which 200–400 mg are taken every day. |
What can be the complications and consequences of inflammation of the jaw joint?
Prognosis and consequences for inflammation ( arthritis) of the mandibular joint are largely determined by the cause of its occurrence, as well as the timeliness and adequacy of the treatment. With the right approach, the disease can disappear without a trace within a few days. At the same time, in the absence of treatment, serious, often irreversible complications can develop. To treat inflammation of the mandibular joint, the following is used:
- Anti-inflammatory herbal tea. To prepare the collection, take 20 grams of black elderberry flowers, 80 grams of birch leaves and 100 grams of willow bark. All ingredients are crushed and mixed thoroughly, after which 4 - 5 tablespoons of the collection are poured with 1 liter of boiling water and infused for 2 - 3 hours. Should be taken 3-4 times a day, 100 ml ( half a glass) before eating. In addition to anti-inflammatory, it also has an analgesic and antibacterial effect.
- Burdock root infusion. To prepare the infusion, add 400 milliliters of boiling water to 1 tablespoon of crushed root and leave for 2 to 3 hours. Strain thoroughly and take 1 - 2 tablespoons 3 - 4 times a day. Has anti-inflammatory and analgesic effects.
- Infusion of yarrow. Yarrow also has a pronounced anti-inflammatory effect. To prepare the infusion, pour 2 tablespoons of dry crushed herbs into 200 milliliters ( 1 glass) boiling water. After cooling, filter and take 50–100 ml 3–4 times a day.
- Infusion of hernia fragrant. The fresh herb of this plant has a pronounced antibacterial and anti-inflammatory effect. To prepare the infusion, pour 1 tablespoon of chopped herbs into 500 ml of boiling water and infuse for an hour. After cooling, the infusion must be filtered and taken 50–100 ml 3 times a day. This recipe is especially effective for inflammation caused by infection or rheumatic diseases.
- Propolis tincture. It has a pronounced analgesic and anti-inflammatory effect. 100 grams of propolis should be poured with 500 ml of vodka and infused in a dark place at room temperature. After 2 - 3 weeks, the tincture must be carefully filtered and taken orally, 10 - 20 drops 2 times a day.
Is there an effective prevention of inflammation of the temporomandibular joint?
Specific preventive measures aimed at preventing inflammation of the mandibular joint have not been developed. The only effective method of prevention is prevention and timely elimination of the causes that can lead to the development of the disease. Inflammation of the temporomandibular joint can be caused by:
- Trauma. In case of injury to joint components ( fracture of articular bones, soft tissue bruises, etc.) an inflammatory process develops, characterized by tissue swelling, severe pain and dysfunction of the joint. As a result of the release of certain biologically active substances at the site of inflammation ( serotonin, histamine, bradykinin and others) there is an expansion of blood vessels and the release of liquid plasma from the vascular bed. Inflammatory fluid ( exudate) can accumulate in the joint cavity, increasing pressure on the swollen tissues and further damaging them.
- Infection. Infection can enter the joint cavity in various ways ( when a joint is injured, when bacteria spread from nearby or distant foci). Infection of the joint is also accompanied by the development of an inflammatory process with all the adverse effects described earlier. In addition, when infected with pyogenic microorganisms ( for example, staphylococci) the progression of the purulent-inflammatory process can lead to the destruction of intra-articular structures, which will lead to irreversible dysfunction of the joint.
- Rheumatic diseases. Rheumatic diseases are characterized by excessive activity of the human immune system, resulting in the development of systemic inflammatory reactions that damage various tissues of the body ( first of all the joints). Also, in some diseases of this group, malfunctions of the immune system occur, resulting in damage to the body’s tissues by the body’s own immune cells.
- Treat traumatic injuries promptly. Immediately after an injury, apply a cold compress or ice to the joint area. If necessary, you can take anti-inflammatory drugs ( for example, nimesil at a dose of 100 mg). If the pain does not go away after 1–2 days, it is recommended to consult a traumatologist or orthopedist.
- Treat infectious diseases in a timely manner. Even if the source of infection is far from the joint, infectious agents can enter the blood and spread throughout the body. That is why, if a bacterial infection is detected, it is necessary to start taking antibacterial drugs as early as possible. You should also follow the duration of treatment prescribed by your doctor. If you stop taking antibiotics immediately after the clinical manifestations of the disease disappear, there is a high probability that some of the pathogenic bacteria will not die, but will remain in various tissues of the body, which can lead to relapse ( re-exacerbation) infections.
- Timely and adequate treatment of rheumatic diseases. Treatment of systemic inflammatory diseases should be prescribed by a rheumatologist after a thorough examination of the patient, taking into account the individual characteristics of the patient and the course of the disease. Self-medication is often ineffective and can also lead to the development of a number of dangerous complications.
Is it possible to cure inflammation of the mandibular joint at home?
Arthritis treatment ( inflammation) of the mandibular joint can sometimes be performed at home. However, it is worth remembering that often the cause of inflammation can be another, much more serious disease or pathological condition. That is why, if self-medication is ineffective, as well as if the patient’s condition worsens, it is necessary to consult a doctor as soon as possible. The cause of inflammation of the temporomandibular joint can be:
- injury;
- infection;
- rheumatic diseases ( rheumatoid arthritis, systemic lupus erythematosus, gout and some others).
To treat arthritis of the jaw joint after injury it is necessary:
- Immobilize the joint. It is recommended to talk as little as possible, and also to avoid eating rough and hard foods that require thorough chewing.
- Apply a cold compress. Exposure to cold reduces the severity of inflammation in the joint, reduces tissue swelling, reduces the risk of complications and speeds up the healing process.
- Eliminate pain. For this purpose, non-steroidal anti-inflammatory drugs can be prescribed ( for example, nimesulide at a dose of 100 mg every 6 – 8 hours), which can be bought without a prescription at any pharmacy.
Treatment of infectious inflammation of the mandibular joint is carried out with antibiotics. The patient can take them independently at home, but a doctor should prescribe these drugs after a comprehensive examination. Anti-inflammatory drugs may also be used to relieve pain.
Treatment of rheumatological diseases involves the use of various medications ( hormonal anti-inflammatory drugs, immunosuppressants and others), which themselves can cause a number of adverse reactions. That is why treatment must be carried out under the supervision of a specialist; the patient must strictly follow the rheumatologist’s instructions and regularly undergo all tests prescribed by the doctor.
When the jaw hurts, people experience many unpleasant sensations: it becomes difficult to chew, yawn, and speak. This symptom can accompany various diseases, so to diagnose the pathology you need to visit three doctors: a dentist, a surgeon and a neurologist. Depending on the diagnosis, treatment tactics are developed and medications are prescribed.
Most often the lower jaw hurts. Discomfortable sensations can be localized on one side or throughout the entire joint, radiating to the ear and other parts of the body. Various pathologies can cause this condition:
- Diseases of the gums, maxillodental apparatus or mandibular temporal joint. In this case, the jaw may hurt on both sides and radiate to the ear. The problem is solved by a dentist or surgeon.
- Disturbances in the functioning of the air-circulating sinuses. A purulent process may develop in them. The treatment is carried out by an otolaryngologist.
- Inflammation or infection in the tonsils, adjacent tissues or throat. Eliminates the ENT doctor.
- Diseases of the peripheral nervous system.
- Inflammation in the lymph nodes.
- Pain in the lower jaw on the left side may indicate angina pectoris or the development of myocardial infarction.
Inflammation in the lymph nodes can also cause jaw pain
The basis of the facial skeleton is made up of the lower and upper jaws. The upper paired part includes 2 bones, 4 processes and a body with an air sinus.
The lower part has no pair and forms the basis of the temporomandibular joint. Muscles and teeth are attached to bone tissue; they are involved in the process of chewing food and pronouncing sounds. The jaw moves with the help of the temporomandibular joint. With some diseases, pain occurs in it, especially when moving, when a peculiar click occurs when opening the mouth.
The video simulates the structure of the lower jaw:
Larisa Kopylova
Dentist-therapist
Sometimes discomfort occurs when pressing on the jaw, and an unpleasant sensation can be observed on one side or the entire jaw responds. The cause may be damage to bone tissue or joints. For example, pain in the heart often radiates to the joint below.
Pain may occur due to joint damage or fractures. In this case, the mouth practically does not open. These reasons require immediate contact with a medical center, since serious illnesses quickly develop complications and significant deterioration in health.
Sometimes diseases occur that have nothing to do with the facial skeleton. However, they can also cause discomfort. Sometimes rare diseases can also be the source.
If the jaw cramps, the person may be suffering from one of the following diseases:
- Tetanus. Muscle cramps and pain when swallowing develop. You should consult a doctor immediately. Antitetanus serum will relieve symptoms of the disease.
- Red ear syndrome. Occurs with damage to the thalamus and cervical spondylosis.
- In childhood, the problem can be caused by mumps or mumps, a violation of the metabolism of calcium and phosphorus in the body.
Below we will look at less common reasons why the jaw hurts.
Oncological factor
Cancer pain often occurs on the right side. In the worst case, it can signal cancer in the bone tissue or osteogenic sarcoma.
Larisa Kopylova
Dentist-therapist
Before the main signs of the disease appear, the nerve endings lose sensitivity, and significant numbness appears in the jaw area. After this, pain in the jaw appears.
With atheroma - a benign tumor - unpleasant sensations also appear in the facial area. Most often, a lump appears near the ear or behind it. This occurs due to the growth of the lymph node. When you palpate this place, you can detect a movable subcutaneous ball. This condition does not pose a threat to health, but if it is not eliminated, an inflammatory or purulent process may begin.
In this case, it hurts near the ear, the general condition worsens, the body temperature rises, and the head begins to hurt. The formation near the ear turns red. If not treated promptly, pus can move throughout the body, causing blood poisoning. Often, a lump behind the ear is formed as a result of otitis media, so it is worth being examined by an otolaryngologist.
Pain while chewing
If it appears while chewing food, then the patient probably has a dislocated jaw or osteomyelitis. In addition, there are other diseases with similar symptoms:
- periodontitis;
- caries complicated by an inflammatory process in the nerve ending;
- pulp damage.
The pain radiates to the jaw in a pulsating manner, often occurring at night.
Symptoms of diseases
It is quite difficult to diagnose damage to the temporomandibular joint on your own, since usually the pain is not limited only to the jaw area. There are no nerve endings in this section, so signs of the disease may appear as follows:
- When pressing in the ear area, pain occurs in the jaw.
- Soreness in the neck area.
- Headache, temporal part, occipital region.
- Pain in the area of the shoulder blades.
- When you open your mouth, a characteristic crunching sound may appear, causing tinnitus.
Neck pain often accompanies diseases that cause jaw pain
You should pay special attention to the clicking sound when opening your mouth, even in the absence of pain in the lower jaw. It can be heard even by others. This condition often indicates misalignment or unnatural tension in the discs and muscles that support the jaw joint when chewing food.
Possible complications
Negligent treatment of this symptom can cause serious complications.
Larisa Kopylova
Dentist-therapist
With an accompanying symptom, expressed in congestion of one ear or ears, it can lead to partial or complete hearing loss. Due to the fact that the jaw cannot be fully opened, it shifts. Over time, this will lead to dental problems, cause enamel wear, and teeth will become more sensitive.
Increased tension in muscle tissue leads to consequences such as:
- back pain;
- dizziness;
- poor sleep;
- depression;
- disorientation;
- increased sensitivity to light (photophobia);
- pain in the eyes;
- decreased vision.
Principles of treatment and prevention
Now we’ll tell you what to do if your jaw hurts. The basis of treatment is diagnosis of pathology, pain relief and a complex of therapy depending on the diagnosis.
- If there is a bruise and a cramp in the jaw, then cold compresses are used.
- The surgeon corrects the dislocations.
- For fractures, if there are displaced bone fragments, surgery is performed.
- If there is a purulent disease, then the abscess is often opened, after which a course of antibacterial therapy is prescribed.
- It happens that jaw pain occurs as a result of carotidynia, a type of migraine. With this disease, pain spreads to the ears, eye sockets and jaw area. In this case, painkillers and antidepressants are prescribed.
- Against the background of myocardial infarction, pain is felt in the jaw; with obvious symptoms of such a pathology, immediate hospitalization is required. Already in a hospital setting, the patient will be prescribed thrombolytics, drugs that lower blood pressure and blood thinning analgesics.
- If the cause of pain is problems with teeth and periodontal tissues, then oral cavity sanitation is carried out. Cysts, pulpitis, and periodontitis are eliminated through surgery. If pain in the jaw and ear occurs due to wearing braces, then at first this is a natural process. If it is impossible to tolerate it, the dentist will tighten or, conversely, lower the locks. Or prescribe painkillers. Sometimes pain in the jaw area occurs due to wisdom teeth that are not erupting properly. In this case, surgical treatment will also be required.
- Oncological diseases are treated surgically or with mixed therapy based on taking chemicals and irradiating cancer cells.
If the pain is caused by a dislocation, it is enough to straighten the joint for treatment.
The video explains why the lower jaw hurts and how to treat the problem:
To avoid pain in the jaw, it is necessary to promptly treat bruises in this area. Malocclusions also require treatment from a specialist. It is recommended to correct dental problems in a timely manner. You should not chew chewing gum for a long time; it creates excessive tension in the jaw muscles. It is advisable to sleep on your back or side. You should not clench your jaw when angry; this can seriously affect your health in the future.
It is not recommended to carry a heavy load on one shoulder, as this causes asymmetry in the neck and back area, which can also move the jaw, subsequently leading to pain in this area. A heavy bag needs to be moved from one shoulder to the other from time to time.
That's all. Now you know why your jaw cramps and pain appears in its different parts, what are the reasons for their appearance and what to do in this case. Be healthy!
If it is in the jaw area - upper or lower, right or left - it is a rather frightening symptom. It may indicate diseases of a large number of organs and structures. These can be teeth, ears, gums, air sinuses, lymph nodes, and soft tissues of the face. Pain from inflammation of the internal organs may radiate to the jaw, but only a few.
To understand the possible causes of jaw pain, let's look at them using an algorithm. This, of course, does not cancel a trip to the doctor, because only a specialist with a medical education can objectively assess the color of the throat, the presence of carious cavities, reflexes, facial symmetry, heart rhythm or other indicators. Several different laboratories and various instrumental methods can come to his aid at the right time.
Main causes of jaw pain
Pain syndrome localized in the jaw can be caused by diseases:
- dentofacial apparatus, gums, temporomandibular joint, thanks to which the lower jaw moves, soft tissues under the lower jaw. Such problems are dealt with by dentists in public and private dental clinics, as well as maxillofacial surgeons - operating dentists who solve the problems of jaw abscesses and phlegmon that has developed as a result of dental diseases;
- air sinuses. In the area of the upper jaw, on both sides of the nose, there are the maxillary (maxillary) sinuses, and behind the ear there is the temporal bone with a process, inside of which there is a cavity. The mucous membrane that lines them can become inflamed and suppurate; tumors can grow from it. An ENT doctor deals with such diseases;
- throat, tonsils and tissues near the tonsils. Purulent-inflammatory and infectious diseases and tumors can develop here. Otolaryngologists (ENT doctors) deal with such pathologies;
- peripheral nervous system: inflammation or irritation of nerve fibers and nodes in which processes and bodies of nerve cells accumulate;
- lymph nodes located along the perimeter of the lower jaw. They can become inflamed when they collect infected lymph from various organs: nose, throat, eyes, soft tissues of the face. They can contain cancer cells due to malignant tumors of bones, mucous membranes, soft tissues in the face and back of the head. Normally, the lymph nodes are not palpable and do not hurt. Their diseases are dealt with by a therapist (for children, a pediatrician).
Depending on the development mechanism, one of the following types of diseases may develop in each location:
- Purulent-inflammatory pathologies:
- abscess - purulent melting of tissue, delimited by a capsule from surrounding tissues; is fraught with the development of sepsis - blood poisoning;
- phlegmon is a bacterial melting of tissue that is not delimited by a capsule, but tends to spread deep into and along similar tissues. It spreads especially easily through fiber.
- Infectious pathologies that occur when the bacterium does not cause tissue melting.
- Dysmetabolic disorders - associated with changes in the balance of electrolytes or other substances.
- Injuries. In the case of the jaw, this is not only a blow or bruise, but also a sharp or strong opening of the mouth, movements of the jaw aimed at opening bottles or hard packaging with the teeth.
- Tumors – malignant and benign.
- Diseases of peripheral vessels and nerves.
If your jaw hurts after dental procedures
If not even a month has passed since a person was given a braces system or removable dentures, the lower jaw “has the right” to hurt. At the same time, teeth may become more mobile and headaches may occur periodically. This is due to the formation of a correct bite. If this condition does not go away after 2 months, you need to be examined by an orthodontist.
Neuralgia of the superior laryngeal nerve
The superior laryngeal nerve innervates the root of the tongue, larynx, and upper pharynx. When it is irritated, pain appears, localized under the lower jaw. It is accompanied by coughing and drooling. The pain radiates to the face, ear, shoulder and chest. An attack is provoked by swallowing, coughing, turning the head.
Neuralgia of the glossopharyngeal nerve
Here the pain is felt in the tongue, but radiates to the jaw, chest, and larynx. Attacks of pain last no longer than three minutes and may be accompanied by dry mouth. The pain intensifies when pressing on the lower jaw. There is no violation of the general condition, the temperature remains normal.
Odontogenic pain
Pulpitis (inflammation of the neurovascular bundle localized inside the tooth), caries (destruction of tooth enamel), and incipient periodontal abscess (an abscess near the tooth) are manifested by severe pain in a local area of the upper or lower jaw, worsening at night, and having a pulsating character. In this case, the area of the root of the diseased tooth is painful on palpation, and it hurts when food is bitten by the tooth. It also responds with pain when cold or hot drinks come into contact with it.
Osteogenic sarcoma
It is a malignant tumor, like cancer. Only tumors that grow from mucous membranes are called cancer, and those that grow from bone, fat, nerve or vascular tissue are called sarcomas. In this case we are talking about a tumor originating from the bone of the lower or upper jaw. It manifests itself as a deformation of the jaw, occurring after a period of pain in the jaw and throughout the face. In addition, you can find a point in the chin area or under the eye where maximum pain is felt.
Osteoid osteoma
Pain in one of the jaws is almost always observed only at night. For a long time there are no other symptoms; with sufficient growth of this malignant tumor, facial asymmetry becomes noticeable.
Arteritis of the facial artery
In this case, the pain spreads from the chin and lower jaw to the upper lip. The pain is severe, burning.
If, in addition to pain, the temperature has increased
This symptom requires a more detailed analysis, depending on the location.
Pain in the upper jaw
These may be the following pathologies (almost all symptoms are discussed above):
- Osteomyelitis of the maxilla. It is associated with tooth extraction, incorrect tooth extraction, installation of an implant in the upper jaw, incorrect sinus lift. It can hurt either in the left jaw or on the right.
- Sinusitis. Usually this disease develops on one side - right or left. It is provoked by hypothermia, trauma to the nose or skull, pulpitis of the upper molars, and periodontitis of the upper jaw. Symptoms of the pathology: pain radiates to the jaw, head, or eye socket, but you can find the point of maximum pain near the nose. In addition, half of the nose is blocked, mucus or pus flows from it (or from both nostrils), the voice becomes nasal, and mucus flows down the back wall of the throat.
- Cellulitis or abscess in this area, accompanied by swelling and tenderness of the soft tissues. The disease is preceded by an open (with deprivation of the integrity of the skin) injury to this area, or treatment of the teeth of the upper jaw.
- Gingivitis is inflammation of the mucous membrane of the gums. Inflamed gums, and with them the entire jaw, hurt, the temperature rises, and bad breath appears. Read more.
- Alveolitis is an inflammation of the tooth socket after its removal.
Pain in the lower jaw
Pain in the lower jaw with increased temperature may be a consequence of:
- osteomyelitis;
- gingivitis;
- alveolitis – complications after tooth extraction;
- submandibular phlegmon or abscess;
- glossitis - inflammation of the mucous membrane of the tongue, which occurs as a result of its infection due to burns (chemical or thermal) or injuries. With this disease, not only the tongue hurts and the taste ceases to be felt, but also the jaw aches;
- if it is localized near the ear and is accompanied by an increase in body temperature, it is most likely. In this case, there may be discharge of pus or light fluid from the ear, and hearing impairment. Otitis media is indicated by weakness, fatigue, loss of appetite. A characteristic symptom: the pain intensifies when pressing on the tragus of the ear (a particularly protruding cartilage on the inside).
Ear and jaw pain
The symptom of pain in the ear and jaw indicates:
- dysfunction of the temporomandibular joint. People over 30 years of age are more susceptible to this disease, especially those who have suffered trauma, arthritis of this joint, or have a pathology of the bite or masticatory muscles. It manifests itself as a headache in one half of the head, pain in the jaw, which radiates to the cheek, forehead, and temple. Jaw movements occur along a disturbed trajectory. With active movements of the jaw, a crunching and clicking sensation is felt in the joint near the ear. The jaw may suddenly lock.
- arthrosis of the temporomandibular joint. Here the pain is constant, aching. There is a crunching sensation when you open your mouth. Opening wide becomes painful, as does closing your jaw too tightly. Chewing on this side also hurts. It is especially difficult to open your mouth in the morning, but then it becomes easier.
- arthritis of the temporomandibular joint. Leading symptoms: pain near the ear, crackling, noise, clicking, crunching in the joint area, poor mobility, especially in the morning.
- otitis, that is, inflammation of the ear: external or middle, located deeper than the eardrum;
- carotidynia - irritation of the nerve endings near the carotid artery. This pain is paroxysmal, begins in the upper jaw, radiates to the neck, ear, oral cavity, and spreads throughout the face. Pressure on the side of the neck from the side and just below the Adam's apple causes acute pain. Causes of carotidini: tumors of soft tissues located near the carotid artery, dissection of the temporal artery;
- neuralgia of the ear ganglion. In this case, paroxysmal burning pain occurs. This pain goes from the temple, past the ear, reaches the lower jaw, chin, and radiates to the teeth. Clicking in the ear also appears, and salivation increases. The cause of the condition is hypothermia, sinusitis;
- erythroothalgia syndrome. Here the ear hurts more, not the jaw. The pain radiates to the forehead, lower jaw, and back of the head. In addition, the ear turns red. Causes of the syndrome: cervical spondylosis, dysfunction of the temporomandibular joint, damage to the thalamus and some others.
If pain occurs when chewing
Pain in the jaw when chewing is a sign of:
- dysfunction of the temporomandibular joint;
- arthritis of this joint;
- arthrosis of the temporomandibular joint.
All these diseases are described in detail above.
Also, pain when chewing can occur with adamantinoma, one of the benign tumors that develops in the thickness of the lower, and less commonly, the upper jaw. The jaw increases in size, making it difficult to chew. At the same time, pain appears and increases.
Pain is felt under the jaw
Pain under the jaw is a sign of many diseases:
- Submandibular lymphadenitis. This is the name for inflammation of the submandibular lymph nodes. This happens when an infection occurs here due to tonsillitis, periodontitis, conjunctivitis, facial furunculosis, or a carbuncle that appears on the face. To confirm the diagnosis, painful, elastic and mobile lymph nodes are palpated here. If the latter has a hard consistency, does not move or is painless, you need to look for where the cancer is metastasizing from.
- Infectious mononucleosis. This is a viral disease that affects many groups of lymph nodes, including the submandibular one. The pathology is accompanied by a rise in temperature and mild symptoms of intoxication (weakness, drowsiness, nausea, loss of appetite). Read more about.
- Glossalgia or tongue hypersensitivity. Here the pain radiates to the lower jaw and occurs after chewing rough food, as well as eating sour, spicy, hot or cold foods.
- Glossitis is inflammation of the tongue. The tongue is noticeably thickened and bright red. If the pathology is not treated, submandibular phlegmon or an abscess may develop.
- Sialadenitis is inflammation of the salivary glands located under the jaw. In this case, the temperature rises, weakness appears, salivation increases, and appetite decreases. At the angle of the jaw, a dense elastic painful formation is determined.
- Sialolithiasis. In this case, stones are detected in the salivary glands. Under the lower jaw - on the left or right - a swelling is detected, purulent discharge is released into the mouth, the amount is insignificant, and the person does not feel it, but the smell in the mouth becomes unpleasant.
- Pharyngitis is inflammation of the mucous membrane of the throat. Symptoms: cough and pain that can radiate to the jaw.
- Sore throats are inflammations of the tonsils. In this case, the throat hurts greatly, the temperature rises, and it becomes painful to swallow. Pain from the throat can radiate to the jaw and ear.
- Tumors of the salivary glands, which are manifested by aching pain of low intensity, localized under the jaw. If the tumor is malignant, the pain becomes more intense, the temperature rises, the submandibular lymph nodes enlarge, weakness increases, and body weight decreases.
- Tumors of the larynx, in which irritation of the laryngeal nerve occurs. Pain in this case appears in the throat, it spreads to the chest, the area under the lower jaw, and the ear. A person is also bothered by a lump in the throat, difficulty swallowing first solid and then liquid food.
- Fracture of the lower jaw. Its symptoms are described below.
If it hurts to open your mouth
Pain when opening the mouth can be:
- acute, when it occurred sharply and suddenly;
- chronic: exists for a long time.
Acute pain
Typical for the following cases:
- Bruise, fracture or dislocation of a joint. Then it occurs after a blow, a strong opening of the mouth, or a fall on the face. The characteristic symptoms are described above, in the section “Pain appeared after injury.”
- Cellulitis, abscess or osteomyelitis. In this case, it occurs after an injury, or against the background of prolonged pain in a tooth, sore throat, chicken pox, or tooth extraction. Its symptoms can also be found in the section “After dental intervention” or “After injury”.
- If the jaw hurts after visiting the dentist, when the person kept his mouth wide open for a long time, this means that effusion has formed in the joint– excess fluid produced by the joint membrane. In this case, you need to spare the joint for several days without loading it with chewing solid food. Also periodically apply cold bandages to the joint area for 2-3 days. If this condition is not corrected, arthrosis, a degenerative joint condition, may develop.
- Arthritis. Pain can occur against the background of hypothermia, a common infectious disease. When chewing, clicking, crunching, and noise in the joint are felt. The pain may radiate to the ear.
Chronic pain
If it hurts to open your mouth in the morning, then this condition goes away during the day, it could be arthrosis of the temporomandibular joint. It most often occurs in people who are missing molars, placing the stress on the bones rather than the teeth. If there are no teeth on the right, it will be painful to open the right half of the mouth. If on the left, then left.
Temporomandibular joint dysfunction and arthrosis of the joint described above also cause pain when opening the mouth. It hurts to chew and open your mouth too much. Movement is constrained in the morning, but then it goes away.
Trigeminal neuralgia. It is described in the section “When there are no other symptoms other than pain.”
When jaw pain is accompanied by worsening condition
| Right | Left | The temperature has risen | Weakness, drowsiness | Other symptoms | |
| Pain in the upper jaw | Temporal arteritis (large vessels coming from the carotid artery become inflamed) | No | Yes |
|
|
| Osteoblastoclastoma (bone tumor) | Yes | Yes | Pain in the jaw increases, and appears on the skin of the face. A pale pink swelling is visible on the gums | ||
| Cancer (tumor developing from the skin and mucous membranes) | Stays normal for a long time | In the final stages | Jaw pain that gets worse | ||
| Osteomyelitis | Yes | Yes | — | ||
| Abscess or cellulitis | Yes | Yes | Severe swelling of the jaw, making it difficult to open your mouth. There may be nausea and vomiting due to intoxication | ||
| Pain in the lower jaw | The same diseases as in the upper jaw | ||||
| — | No | No | The pain occurs when walking quickly, walking against the wind, and is accompanied by pain either in the left side of the chest, or in the left arm (or just the little finger). It becomes easier after a short rest, taking a Nitroglycerin tablet | ||
| — | Yes | Yes | The pain is very strong, localized more in the left half of the sternum, and significant in extent. It is triggered by emotional stress or physical activity. May be accompanied by loss of consciousness or arrhythmia | ||
| — | Yes | Yes | The pain is greater on the right under the rib, it radiates to the right lower jaw. Bitterness in the mouth, loose stools or constipation, and aversion to fatty foods are also noted. | ||
The symptom of pain in the jaw is not “trifling”, because it can indicate not only caries (which can be complicated by phlegmon of the maxillofacial area). Malignant bone tumors also show the same sign. Only doctors - dentists, neurologists, otolaryngologists or cardiologists - can accurately determine the cause of pain in the jaw. Even people with higher medical education who are not included in these three categories go for examination to their colleagues, since it is impossible to establish the etiology on their own.
Popularly, the articular organ consisting of the lower and upper jaws, connected by the temporomandibular joint, is called the “jaw.” Often people turn to dentists because of characteristic pain and crunching in this area. Pathology occurs for many reasons; it is important to identify them in time and cope with the problems.
Pain accompanies the patient while chewing food as a result of jaw movement and pressure on it. Unpleasant sensations are most often localized on the left or right side, less often on both simultaneously. The process cannot be started; the lack of proper treatment is fraught with serious complications.
Causes of pain
Don't underestimate the problem be sure to visit the dentist. Sometimes pain in the jaw area signals the progression of serious diseases that require the attention of a specialist.
Correctly identifying a specific ailment that results in pain in the jaw obliges the doctor to find the cause of the pathology. Accurate diagnosis and the help of a qualified doctor are the key to a positive outcome of the disease, the risk of complications is minimized.
There are many causes of acute pain; for convenience, doctors divided them into several groups, according to the main diagnostic criterion. Thanks to the classification, you will quickly understand the possible factors that influenced the development of the pathology. A clear clinical picture facilitates diagnosis and speeds up the treatment process. The following groups are considered the most common causes of pain in the jaw area.
Various injuries
Mechanical damage is easily confused with manifestations of other diseases. Injury can be determined in the presence of obvious pathology only with the help of a qualified specialist. There are several types of injuries:
- dislocation– provoked by a sudden movement of the joints;
- fracture– occurs after severe mechanical trauma, the pathology refers to the upper, lower jaw, sometimes to both at once;
- injury– the damage is not severe enough for a fracture, but the characteristic symptoms are similar to a serious problem.
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Purulent-inflammatory diseases
- Osteomyelitis. The disease is characterized by an inflammatory process and the appearance of a large amount of pus. Bone tissue is affected, the disease appears as a result of injury, infectious dental disease without proper treatment.
- Furuncle. Doctors mean a fairly large formation with pus in the soft tissues. Usually the problem is visible immediately, although the center of the boil is under the skin. The formation can reach enormous sizes, as a result of which it puts pressure on the nerve endings, causing pain.
- Phlegmon, abscess. Both complications pose a huge danger to human health. An abscess is characterized by a closed focus of inflammation; without proper treatment, phlegmon spreads further through the blood vessels, affecting more and more tissues. A mandatory symptom is the appearance of sharp pain in the jaw area.
Important! The above problems require immediate doctor intervention.
Orthodontics and the consequences of wearing braces or dentures
Dental structures for correcting dental problems in most cases cause mild pain when worn. The process is connected with the correction of the bite; roughly speaking, braces and various other devices are designed to change the formed position of the teeth in the jaw.
Before installing dental products, the doctor must warn the patient about possible discomfort. The phenomena are often temporary and are considered the norm. Doctors consider discomfort to be a sign of proper orthodontic installation. The pain appears due to the displacement of the dentition in the desired direction, the correction of the bite; previously this state of affairs was not typical for this person - hence the discomfort.
Similar symptoms accompany the patient immediately after installation of a removable denture. It takes a person a little time to get used to it, after a few weeks the pain subsides, and eventually goes away completely.
Sometimes the cause of jaw pain lies in a congenital disorder of the jaw structure (bad bite). The patient often suffers from discomfort while chewing food. Unpleasant symptoms indicate an urgent need to visit a doctor; only an experienced specialist will carefully study the problem and prescribe an appropriate solution.
It is impossible to correct a malocclusion on your own. No folk remedies will help solve the problem; visit the dentist in a timely manner to avoid complications.
Neoplasms
Tumors can be benign or malignant. Contact a specialist. The pathological process occurs with mildly expressed symptoms, which is typical for various formations.
Benign tumors are divided into several groups:
- osteoma - sharp discomfort appears at the beginning of the appearance of the tumor, as it grows the pain intensifies;
- adamantioma – pathology provokes a noticeable increase in jaw size, which leads to discomfort during meals. Initially, the symptoms are mild, but the discomfort intensifies over time;
- osteoblastoclastoma - characterized by an almost asymptomatic course, aching pain over time develops into acute sensations that are difficult to tolerate.
Malignant formations are also divided into several groups. It is impossible to independently distinguish a benign tumor from a “bad” one: the symptoms are too similar. Often the problem is localized in the lower jaw; malignant types include sarcoma, cancer, and osteogenic sarcoma.
Pain near the ear
Painful sensations accompany every meal, and there is a high probability of discomfort in the ear area. Symptoms characteristic of such diseases: arthritis, arthrosis, sometimes problems are confused with otitis media (inflammation of the ear can radiate to the jaw area).
Painful sensations are a signal to action; advanced cases lead to complete immobilization of the jaw. Diagnosis in such cases is difficult; the doctor performs x-rays to identify the exact cause.
Neuralgia
Often discomfort is caused by neuralgic problems. A pinched nerve for any reason leads to pain in the jaw; the pathology manifests itself especially sharply during meals. Damage to the trigeminal, glossopharyngeal, and superior laryngeal nerves leads to sharp pain, increased salivation, discomfort also manifests itself during yawning and blowing the nose.
Anyway pinching requires immediate intervention. Over time, the pain will increase and irreversible consequences will begin to occur.
Infrequent causes of pain include:
- bruxism (inability to clench the jaw during sleep; the patient is characterized by grinding, which causes problems with proper bite);
- advanced caries. The infection spreads in the oral cavity, causing inflammation and pain in the jaw area.
Diagnostics
It is often difficult to identify the cause of pain. The patient comes to the doctor with severe discomfort; the course of many ailments is similar in symptoms. Many specialists are involved in making the correct diagnosis: they conduct a thorough examination of the oral cavity, talk with the patient, and carefully study complaints. Additionally, the results of radiography, computed tomography, and MRI are used.
Methods and methods of treatment
Each specific ailment requires a special approach; a detailed treatment plan depends on the individual characteristics of the patient’s body. Advanced cases require surgical intervention.
In some cases, the problem will disappear after the elimination of dental problems, for example, treatment of caries, correction of bite, replacement of dentures and other useful manipulations. Physiotherapeutic procedures provide excellent results.
Correction of TMJ defects is accompanied by treatment with anesthetic and anti-inflammatory medications. It is prohibited to prescribe any medications on your own, Use only medications prescribed by your doctor.
How to relieve the condition at home
Unconditional adherence to the following rules will help to significantly alleviate the condition or completely eliminate the pain syndrome:
- stop chewing gum;
- eat exclusively soft foods (soups, various cereals, finely chopped lean meats are excellent);
- try to strain your jaw as little as possible: do not open your mouth wide;
- A hot compress relieves pain. Just apply a bottle of warm water to the sore spot, after a few minutes the discomfort will begin to subside;
- during the inflammatory process hot compress is contraindicated, use cold, no more than 15 minutes. Between treatment procedures, take a break of at least one hour;
- Decoctions of calendula, nettle, chamomile, and sage will help relieve pain. It is allowed to take mild painkillers (no-spa, Spazmalgon and others);
- For bruxism, use a special mouth guard; the product protects the teeth from abrasion and relieves pain in the jaw area.
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Therapeutic gymnastics drives blood into the jaw area and helps reduce pain:
- Move your jaw from its natural position to the left and right up to 10 times.
- Place the brush on your jaw and push it away until it stops. Resistance trains muscles, develops them, and relieves pain.
It is advisable to prevent diseases of the maxillofacial system by following a number of simple rules:
- consult a doctor promptly for treatment of dental problems;
- the occurrence of infectious diseases of the upper respiratory tract - treatment is mandatory;
- toughen up, lead a healthy lifestyle, improve your immunity.
It is important to be careful about your health; failure to follow simple rules leads to frequent pain in the jaw area and other complications. If pathology does manifest itself, immediately visit the dentist’s office; only an experienced specialist will solve the problem.
Video about the causes and methods of treating pain in the jaw joint:
In cases of injury to the lower jaw, the bite and reaction to palpation are initially checked. A visual inspection is carried out for the presence of bruising, swelling, and closed deformities.
Infectious diseases include: dental abscess, osteomyelitis, actinomycosis. With a dental abscess, hypermia of the mucous membrane and the appearance of a painful new formation of a loose structure are observed. In some situations, the disease appears externally on the skin of the lower jaw. The lymph nodes in the neck become enlarged, gingivitis (inflammation of the gums) and caries appear. Acute osteomyelitis is characterized by problems with swallowing, the mouth is difficult to close due to muscle swelling. As a result, there is pain in the lower jaw, tissue hyperemia, and pain when swallowing. Actinomycosis is characterized by the presence of many passages with greenish-yellow contents located in the lower corner of the jaw.
Dysfunction of the temporomandibular joint is accompanied by spasm of the masticatory muscles and trismus, in which the jaws close tightly. Rheumatoid arthritis causes pain during examination and swelling in the joint, and osteoarthritis limits the movement of the joint with the formation of swelling. In patients with dislocation of the temporomandibular joint, the mouth does not close; during palpation, condyles are discovered that are displaced forward from the articular tubercle.
Why does pain appear under the lower jaw?
There are a huge number of anatomical formations located under the lower jaw. Their diseases often manifest as painful echoes in the lower jaw. Pain under the lower jaw occurs:
- due to pathologies of the lymph nodes. For example, with lymphadenitis - an infectious inflammatory process. The acute process occurs with cutting pain, fever, and severe weakness;
- with the formation of metastases - tumors of the submandibular lymph nodes. The pain becomes chronic, body temperature rises slightly and lasts for a long period. Patients experience general weakness, weight loss, and malaise;
- during attacks of glossalgia (severe sensitivity of the tongue), provoked by a long conversation, eating spicy, sour, hot or cold foods, chewing rough food, etc.;
- Glossitis is an inflammatory disease of the tongue. During the examination, a bright red, thickened tongue is observed;
- sialadenitis is an inflammatory process of the salivary glands. Provokes pain under the lower jaw, increased temperature, malaise;
- sialolith – salivary stone disease. Characteristic symptoms are: swelling of the lower jaw area (only on the right or only on the left), the gland in the oral cavity secretes pus (the appearance of an unpleasant odor), temperature, mild pain in the lower jaw area, weakness;
- for pharyngitis, sore throat, tonsillitis;
- tumors of the larynx - pain increases gradually, moves to the chest, ear area, lower jaw. There is a feeling of “coma”, sore throat, foreign body sensations, cough, voice changes. Large tumors make breathing difficult;
- neuralgia of the glossopharyngeal nerve is a rare problem that starts from the root of the tongue or tonsils, moves to the ear, under the jaw, sometimes with pain in the eye, cervical region. Attacks of pain are manifested by dry mouth, cough;
- with jaw fractures, severe pain under the jaw appears, hemorrhages, swelling, and difficulty chewing;
- damage to the facial artery begins with burning pain in the lower jaw;
- diseases of teeth and gums.
