It hurts to open your mouth completely. Why might my jaw hurt on the right side? Pathologies of the maxillary sinuses and parotid salivary glands

Every day, without noticing it, a person makes many jaw movements while talking and eating. Sometimes these movements become noticeable and difficult. If your jaw starts to hurt when you open your mouth and when you chew, You should not make sudden movements and you should immediately consult a doctor - a traumatologist, surgeon or therapist.

Jaw pain when chewing and opening the mouth: common causes

Pain in the temporomandibular joint can occur under various circumstances. The most common causes of pathology are listed in the table:

Group of reasons	Possible diagnoses
Injuries to the temporomandibular joint - occur as a consequence of blows, falls, sudden opening of the mouth, chewing hard food, careless actions of the dentist.	A fracture is a violation of the integrity of the upper, lower or both jaws at the same time. Dislocation is damage to a joint with displacement of the articular surface of the bones. Contusion is damage to soft tissue without disruption of skeletal components.
Purulent-inflammatory processes - occur when an infection enters the bone tissue, sometimes after an injury.	Cellulitis and abscess are severe purulent inflammations that can destroy a large area of soft and hard tissue. Furuncle - subcutaneous limited suppuration. Osteomyelitis is inflammation of bone tissue.
Tumors are the growth of tissue due to uncontrolled cell division.	Adamantioma is a growth of jaw tissue. Osteoma is a slowly growing benign tumor. Osteoblatoclastoma is a tumor that can be accompanied by deformation and frequent bone fractures. Sarcoma is a malignant growth of bone or cartilage.
Diseases of the musculoskeletal system	Arthritis is a lesion of the joints with limited movement, often developing against the background of autoimmune diseases. Arthrosis is degenerative changes in joints with destruction of cartilage.

Other causes of jaw pain

In other cases, pain in the jaw on the left or right does not appear due to pathological problems in the jaw tissues, but due to inflammation of nearby structures:

On the left, right or both sides, the jaw may hurt due to otitis media - inflammation of the ear. The more actively the inflammatory process develops, the further the pain spreads. First it radiates into the ears, then into the cheekbones and jaw. Often the pain syndrome has a shooting character.
Pain radiates to the upper jaw and cheekbone due to sinusitis– inflammation of the air sinus.
Pain can be caused by an advanced form of caries when the lesion reaches the pulp chamber and affects the nerve. With some types of pulpitis, it is very difficult to determine the source of pain.
Pain on the right or left side of the jaw near the ear can be caused by a cutting wisdom tooth.
If, after receiving prosthetics, it becomes painful for a person to chew, and his jaw begins to ache on one side of his face, the cause of the symptoms could be the incorrect shape or incorrect installation of the prosthesis.
Neurological problems: neuralgia due to pinching of the glossopharyngeal, trigeminal nerve.
Bruxism is the grinding of teeth at night.

Associated symptoms

Pain in the jaw when yawning, opening the mouth and chewing is a common symptom for numerous diseases. An analysis of the accompanying symptoms helps to find out why the jaw hurts. The presence/manifestation is taken into account:

Increased body temperature.
Runny nose, sore throat, sinuses, ear.
Hearing impairment.
Pain in other joints of the body.
Weakness, dizziness.
Joint and bone deformities.
Ulcers on the skin or in oral cavity.
Toothaches.
A crunching sound in the joint when the mouth opens.
Severe pain: when a fracture occurs, the jaw hurts so much that the mouth cannot open.
Increased pain in the joint when turning the head to the left or right.
Enlarged lymph nodes.

With dysfunction of the temporo- mandibular joint(TMJ) headaches may occur; a person is constantly accompanied by a crunch in the jaw.

Diagnostics

If a person has a sore jaw near the ear and it hurts to open his mouth, he should see a doctor as soon as possible. You should contact a dentist or therapist; if you have an injury, contact a traumatologist or surgeon. If the dentist does not identify a dental cause for the pain, he will refer the patient to an appropriate specialist.

Various tests may be needed for diagnosis:

X-ray of the jaw.
Examination by an otolaryngologist using special instruments.
Blood analysis.
Bacterial culture of purulent discharge.

How to treat pain in the jaw joint when opening the mouth

Jaw pain will not subside until the underlying disease is cured. If a patient takes pain medication but is not diagnosed and treated under the supervision of a doctor, the symptom will worsen. The direction of treatment depends entirely on the diagnosis and is very different in each specific case:

In case of injuries, restriction of joint mobility is indicated; sometimes surgical restoration of the integrity of the jaw and jaw joint is required.
Inflammatory processes in soft and hard tissues, as well as ENT organs, are treated with antibiotics - if it is reliably established that the inflammation is caused by bacterial infection. Surgery may be necessary to remove accumulated pus.
Used for oncological processes in the body special means, controlling cell division and inhibiting tissue growth. Later stages of disease progression are treated with radiation and chemotherapy.
If the structure of bone tissue is impaired, vitamins, complex preparations with vitamins and minerals, anti-inflammatory medications, medications to normalize cartilage tissue, and a special diet are prescribed. Sometimes pain medication is injected directly into the joint.
For neuralgia, injections are given to block the nerve, sedatives and vitamin preparations, physiotherapeutic procedures, and acupuncture are prescribed.
Caries, pulpitis and other dental damage are treated with fillings or tooth extraction. If the prosthesis causes pain, it needs to be replaced.

What to do if your jaw hurts near your ear when you open your mouth and when you chew

Without a diagnosis, a person cannot choose the correct treatment - which is why jaw diseases cannot be treated on their own. In addition, some of the listed pathologies are useless to treat without hospital conditions.

Although the patient himself is not able to cure such a symptom, sometimes urgent help is required at home, as the pain can be very severe. Following these recommendations can help reduce discomfort:

Do not heat the jaw area near the ear: if there is a purulent-inflammatory process, such manipulations will provoke a rapid release of pus and its spread into the bloodstream, which threatens intoxication and general infection. To relieve discomfort, you can apply a cool compress, but only if the pain is not caused by an infection.
Yawning, chewing, and opening your mouth should be done very carefully.
To painful sensations did not intensify, you need to temporarily abandon hard and viscous foods, which require increased chewing load. You can't chew gum.
If it hurts to open your mouth, conversations should be reduced to a minimum.
If a patient has a jaw injury—he cannot open his mouth, yawn, or speak—you need to call ambulance and try to provide maximum rest to the disturbed joint. Moving the jaw and turning the head can cause bones to shift. For open fractures, the skin around the wound is treated with an antiseptic. If there are bone fragments, they should not be touched.

Prevention

Treatment for pain in the jaw near the ear when opening the mouth can be very difficult and lengthy. Therefore, it is better to take care in advance to ensure that such a symptom does not appear. This requires prevention of those diseases that affect the jaw, joint structures and tissues located nearby:

When talking, yawning and biting food, do not open your mouth too wide.
You should not get carried away with too hard and viscous food - it can harm not only your teeth, but also your joints.
It is necessary to avoid drafts and hypothermia, contact with infectiously infected people.
A varied diet is needed to provide bone and cartilage tissue with all the beneficial substances.
After installing the prosthesis on one or both sides, you should carefully check its compliance with the anatomical shape of the jaw: you need to open and close your mouth, try to close your teeth. If discomfort is felt, the prosthesis will have to be adjusted.
It is necessary to treat diseased teeth in a timely manner so that the infection does not penetrate into the maxillary or mandibular bone.
If your jaw suddenly starts to hurt on the left or right side, you should immediately consult a doctor - such a symptom may indicate a dangerous disease that requires urgent treatment.

If your jaw joint hurts when opening your mouth, do not put off going to the dentist. It is not recommended to rely on self-medication, since advanced diseases associated with such symptoms can be life-threatening.

The facial skeleton consists of the upper and lower jaw. The first anatomically consists of two bones with four processes and a body with an air sinus. The lower jaw is unpaired; the temporomandibular joint (hereinafter referred to as the TMJ) is “responsible” for its mobility. Muscles and teeth attached to the facial skeleton are responsible for chewing food, pronouncing sounds, providing facial expressions, etc.

Some people have jaw pain when opening their mouth, and discomfort can also occur when pressing on the bones on one side or both at the same time. Such symptoms indicate various dental and other problems - from jaw fractures and TMJ dysfunction to vascular and heart diseases. Pain in the jaw when opening the mouth - alarm signal, notifying you of the need to visit a doctor.

Causes

There are several groups of etiological factors in the development of pain.

Dental problems

So, if it is painful for a person to open his mouth, this may indicate damage to the integrity of the bone tissue of the lower jaw. Fights, sports, accidents - these are situations in which you can get injured. The list of the most common ones includes:

dislocations;
bruises;
fractures.

It is not difficult to dislocate the mandibular joint - all you need to do is make a sudden, inaccurate movement (for example, open your mouth too wide). When a dislocation occurs, the head of the TMJ “leaves” its place in the articular fossa - as a result, the “victim” of the injury experiences severe pain in the jaw, the mouth does not open completely, the facial muscles become numb, local swelling occurs, and speech becomes slurred.

Bruises - soft tissue injuries - lead not only to jaw pain, but also to the appearance of hematomas, swelling, hyperemia of the affected area, asymmetry of the facial muscles

Important! Visually, a dislocation can be determined because the jaw is shifted to the right or left side, the face is asymmetrical.

Pain in the jaw joint can be caused not only by bone damage, but also by soft tissue bruises. So, in the place where the main blow occurred, a hematoma and swelling appear, the patient cannot open his mouth, and discomfort occurs when chewing. It is noteworthy that, as a rule, the consequences of a bruise go away on their own - after 4-5 days, the unpleasant sensations disappear.

The fact that the mouth does not open, pain appears in the jaw on the left or right, a ache is felt in the teeth, the face becomes asymmetrical - all this may indicate a fracture. Treating such an injury is not easy - restoring damaged bone tissue requires time and effort.

Discomfort when opening the mouth also occurs with many dental problems. First of all, we are talking about inflammation that affects the soft tissues of the oral cavity. The causative agents of inflammation can be bacteria, viruses and fungi. Often the course of a particular dental disease is accompanied by the appearance of purulent formations.

Thus, the most common pathologies of a purulent nature are:

Boils. An abscess is formed when an infection enters a hair follicle (usually through a wound on the skin). Gradually, local inflammation spreads to deeper soft tissues, they fester, and pain may occur in the jaw due to compression of the nerve endings.
Osteomyelitis. Complication of periodontitis, purulent cysts tooth, develops when bacteria from the oral cavity enter during injuries (burns) directly onto the bone tissue. The list of classic signs of osteomyelitis includes: pain in the jaw when you open your mouth wide, hyperthermia, fever, swelling of the face, enlarged submandibular lymph nodes, headaches and toothaches.
Cellulitis, abscesses. Inflammatory processes, the course of which is accompanied by the formation of a large amount of pus, swelling, sharp pain when chewing, opening the mouth and any other functional load on the jaw. With an abscess, a closed inflammation forms, with phlegmon, the focus is blurred. The main complication of such ulcers is high risk self-resolution with subsequent blood poisoning.

Important! Such general symptoms, such as increased body temperature, difficulty chewing and swallowing, pain in the jaw should alert a person and serve as a reason to immediately seek medical help.

TMJ dysfunction is a common cause of pain and jaw crunching when opening the mouth.

When the dentist has poorly secured the bite correction structure or performed poor-quality prosthetics, patients may also experience discomfort in the upper and lower jaw. The classic “provocateurs” of pain are braces - after their installation, most people experience discomfort not only when chewing, moving facial muscles, during a conversation, but even in a calm state.

By the way, such discomfort is a completely normal phenomenon, which, as a rule, disappears after the bone and soft tissues adapt to the constant wearing of the bite-correcting structure. Other causes of jaw pain of odontogenic origin:

caries;
pulpitis with damage to the nerve of the tooth;
periodontitis (inflammation of periodontal tissues);
dental injuries (chips, neck fractures);
gingivitis (inflammation of the gums);
alveolitis (an inflammatory process affecting the alveolar process that develops after tooth extraction).

If the mouth does not open completely, there is pain when chewing, the face is swollen - all this may indicate the appearance of benign or malignant neoplasms. In the early stages, such pathological processes are “silent”, so patients seek help from a doctor only when the abnormal process is quite advanced.

The list of the most common benign formations that cause pain and discomfort in the jaw area includes: osteomas, adamantiomas, osteoblatoclastomas. Dangerous malignant pathologies include: sarcomas (affect connective tissue), osteogenic origin - affecting bones, various types of cancer (localized in the epithelium).

Fluxes, abscesses, phlegmons and other purulent-inflammatory formations are also included in the list of “provocateurs” of jaw pain

It is noteworthy that malignant neoplasms are most often localized on the lower jaw (on the left or right side). Timely diagnosis such pathologies allows you to take the necessary curative measures and avoid the spread of metastases to other organs.

Arthritis, arthrosis of the TMJ are diseases that lead to pain in the lower jaw when opening the mouth (or while chewing), as well as in a calm state. In this case, the discomfort is “tied” to the lesion itself and is localized closer to the auricle. The pain can radiate to the neck, upper jaw, or eye sockets.

X-ray is a diagnostic measure that allows you to timely detect inflammation (signs of dysfunction) of the TMJ on the right or left and select suitable treatment. If nothing is done, arthrosis and arthritis in this area can lead to complete immobilization of the jaw (a person simply will not be able to open his mouth).

Non-dental diseases

Neuralgia and bruxism are the most common causes of jaw pain. In the first case, the trigeminal, superior laryngeal, and glossopharyngeal nerves are affected (pinched). The course of the disease is accompanied by increased pain when chewing and swallowing food, profuse salivation, pain when yawning, and movement of facial muscles.

Involuntary jaw closing and teeth grinding (bruxism) cause frequent stress and other forms nervous disorders, most often people who have an incorrect bite suffer from this problem. Cope with unpleasant symptoms Bruxism, which includes pain in the jaw, is helped by relaxing exercises, massage, and special day and night splints are designed to protect teeth from mechanical damage.

Various types of migraine pain radiate to the ear, eye sockets, upper and lower jaw

Important! Myocardial infarction also causes severe pain in the jaw.

The list of other signs of this serious pathology leading to necrosis of the heart muscle includes acute squeezing pain in the left side of the chest, which lasts for 15–20 minutes and does not go away even after taking painkillers, as well as shortness of breath and increased sweating.

An attack of angina (spasm of the coronary arteries) is another “provocateur” of discomfort in the jaw area. The appearance of symptoms indicating a cardiac disorder is a reason to seek medical help.

Other factors

Why does my jaw still hurt?

Tetanus. Additional signs: convulsions, difficulty swallowing (dysphagia). The patient requires immediate medical attention (administration of antitetanus serum).
Carotidynia (a type of migraine). Symptoms: attacks of pain, the duration of which varies from a few minutes to 2-3 hours. Unpleasant sensations are localized in the lower jaw and radiate to the ears and eye sockets.
Red ear syndrome. Accompanies the course of spondylosis and damage to the pituitary gland.

Jaw pain in children often occurs due to mumps, as well as a violation of calcium-phosphorus metabolism in the body.

Solution

The tactics to combat jaw pain depend on the cause of its occurrence. So, cold compresses are applied to the site of bruises, dislocations are reduced, and if necessary (for example, in case of a comminuted fracture), surgical intervention is performed. For purulent-inflammatory processes, patients are prescribed antibiotic therapy; the abscess itself is opened, the contents are removed, and drainage is installed.

In case of myocardial infarction and other severe cardiovascular pathologies, the patient is hospitalized, thrombolytics, drugs that normalize blood levels are prescribed. blood pressure, analgesics, and blood thinning medications. Painkillers and antidepressants can help relieve symptoms of carotidynia.

Timely treatment of caries, pulpitis, gingivitis and others dental diseases – best prevention pain syndrome in the jaw area

In case of dental problems, the doctor sanitizes the oral cavity, eliminates foci of inflammation, and treats “damaged” teeth. If neoplasms (benign or malignant) are detected, the patient undergoes surgery and is prescribed a course of radiation and chemotherapy.

As you can see, jaw pain is a polyetiological problem (occurs due to various reasons), requiring qualified diagnosis and correct treatment. That is why, if the corresponding symptoms occur, it is recommended not to delay going to the doctor.

Answering the question of why jaw pain occurs, we can offer many options. The reason may be mechanical damage, dental diseases, neuralgia and many other pathologies. Thus, pain when moving the jaws is sometimes a consequence of carious lesions of the teeth or inflammation of the gums, damage to the peripheral nervous system, carotidynia and caused by other reasons. In case of severe pain and severe discomfort, self-medication is not recommended. How can you tell which doctor you should visit based on the type of pain?

Why does your jaw hurt?

The list of reasons why the jaw hurts is quite wide (we recommend reading: why does the jaw cramp and how to eliminate this symptom based on the cause found?). These include:

With absence medical intervention The following types of pathological processes may develop:

Purulent-inflammatory: abscess or phlegmon. Abscess – destruction of soft tissues under the influence of pus. As a rule, the pus is “closed” from the rest of the organs by a membrane, however, if it bursts, there is a risk of sepsis - blood poisoning, which can be fatal. Cellulitis is another type of destructive process that gradually develops, affecting an increasingly larger area.
Infectious pathology caused by a sharp imbalance of microflora;
Metabolic dysfunction caused by electrolyte imbalance;
Neoplasms – malignant and benign;
Mechanical damage caused by trauma. The reason why this happened could be severe bruise, impact or deformation of the jaw muscle when opening the mouth wide. The cause of injury can also be opening bottles, cans, etc. with teeth.

Traumatic disorders and their consequences

The most common cause of damage to the jaw muscles is simple carelessness. Patients come to a traumatologist after fights, falls, car accidents, etc. Their complaints are accompanied by a characteristic symptom - there is not only pain, but also swelling.

On palpation the patient exhibits sharp pains, he is unable to move his jaw to open his mouth, the wound is bleeding. Unpleasant sensations with a bruise, they increase when chewing and trying to open the jaws. The pain radiates to the ear area. Under normal circumstances, the bruise goes away within 5–7 days.

A dislocation, unlike a bruise, is more serious injury. Normal functioning of the jaw with a dislocation is impossible: attempts to talk or chew cause sharp pain in the jaw. different parts heads. The patient may complain of a jaw shift to one side. Often, when a dislocation occurs, extraneous sounds resembling a crunching sound occur. If you suspect a subluxation or dislocation, especially if your jaw is jammed, you should immediately contact a traumatologist.

The most dangerous jaw injury is a fracture. The pain during a fracture is constant and intense. The appearance of the damaged area changes: severe swelling and bruising appear at the site of the impact. If the fracture is in several places (complex), then a crunching sound is heard in each of them. The sooner the patient receives help, the greater the chance of a favorable outcome.

Dental diseases

Dental diseases are pathological processes caused by the proliferation of bacteria in the oral cavity. These include:

Peculiarity dental pathologies is that the peak of discomfort occurs at night. The pain is described by patients as aching, throbbing and sharp. Another reason is eating foods that are too hot or too cold or clenching the jaw. With serious forms of caries, an increase in body temperature to subfebrile levels is observed.

Most dental pathologies lead to the development of purulent processes. They can be caused by viruses or other microorganisms. After the infection penetrates the damaged area, the inflammation spreads to the soft tissues, and a purulent focus is formed. The patient begins to experience severe pain in the cheek and jaw, and cannot eat or speak normally.

Osteomyelitis is an acute process that requires immediate medical intervention. The inflammation already extends beyond the teeth and affects the bones. If treatment is delayed, the bone marrow may also be damaged. The infection can be introduced from the outside or originate within the body itself - in a carious cavity or purulent cyst.

Any purulent process is characterized by a sharp deterioration in the patient’s condition. It can occur in two forms: abscess (closed) and phlegmon (open). Both forms are associated with the formation of pus and are accompanied by sharp pains and the appearance of edema. Clinical picture characterized by fever, pain when opening and closing the mouth or even when pressing lightly. Health care is required immediately, otherwise tissue necrosis may occur.

Trigeminal neuralgia

Biggest cranial nerve called trigeminal. This nerve has branches throughout the face. This explains that any of its pathologies immediately makes itself felt - the pain is felt acutely and almost instantly, localized on the left or right side. Taking analgesics and antispasmodics for trigeminal neuralgia in the jaw does not produce any results. The patient complains that his mouth cannot open, and the pain is felt more strongly at night and in the morning.

Inflammation of the facial artery

Inflammation of the facial artery, or arteritis, is a pathology of one of the walls of the artery. The clinical picture includes the presence of burning pain over the jaw. The mouth does not close, the burning sensation affects the upper lip, cheek, nose or even the eyes. Arteritis is treated with anti-inflammatory drugs; attempts to take conventional painkillers are useless. Most often, therapy includes taking glucocorticoids and cytostatics.

Damage to the temporomandibular joint

Joint diseases - arthritis, arthrosis, etc. - in Lately are affecting more and more people. If earlier representatives of older generations were targeted, now even young people can face arthritis. With arthritis of the temporomandibular joint, it becomes jammed, and the pain appears near the ear near the temple and is aching in nature. When determining arthritis it is necessary instrumental diagnostics.

When the joints of the lower jaw are affected, pain can be felt not only in the ear area, but also in the cheek, temples, or even radiate to the forehead. When you chew, the pain intensifies; when you close your jaws completely, you hear a characteristic clicking sound. Arthritis has different pathogenesis: from malocclusion to infectious joint lesions. Self-treatment is fraught with serious complications.

Carotidynia syndrome

Carotidynia is one of the types of migraine, headaches. The pain occurs sharply, and its location is the upper jaw (right or left). There are several reasons for the development of such a pathology - on the one hand, these are the patient’s experiences, and on the other, any of the diseases mentioned above (caries, sinusitis, trigeminal neuralgia, etc.). Treatment is aimed at relieving all symptoms, and therefore necessarily includes taking antidepressants.

Malignant neoplasms

Only an experienced specialist can distinguish a malignant neoplasm from a benign one.

The symptoms of both phenomena are the same: the patient has pain in chewing, his mouth cannot open, his jaw is jammed, he feels pain in the jaw joint, etc. With timely treatment, there is hope for positive dynamics, so you should see a doctor right away.

Which doctor should I see for jaw pain?

Often people do not know which doctor to go to when their jaw hurts. First of all, if you have pain of unknown pathogenesis, you should make an appointment with a general practitioner (or a pediatrician for young patients). If there is reason to suspect a specific diagnosis, it is better to contact a specialized specialist:

to the dentist - if there is a suspicion of caries, pulpitis or purulent processes in the oral cavity;
orthodontist – for pain associated with improper development of the jaw;
to a traumatologist if the pain was preceded by mechanical damage;
ENT specialists for acute respiratory viral infections and their complications.

Sometimes there is an unusual condition when the jaw does not open completely or does not open well. A person cannot eat properly, talk, and when trying to open his mouth a little wider, pain appears, sometimes of a sharp nature. Trying to sharply open the mouth, a person feels severe pain in the mandibular joint, and it can also radiate to the temporal region. This condition in which the jaw does not open completely is called muscle contracture. Problems in the periarticular tissues of the temporomandibular joint can also be the cause of such complaints.

Severely limited mouth opening is observed with ankylosis of the temporomandibular joint. With this disease, complete or partial fusion of the articular surfaces occurs. Normal eating becomes impossible, bite and breathing are disrupted. The face takes on a “bird-like” appearance. Treatment of this pathology is surgical. Additionally, massage, exercise therapy, drug therapy and a gentle diet.

If contracture of the jaw apparatus appears, it is recommended to consult a specialist. He will be able after additional diagnostic measures determine why the mouth does not open fully, why painful sensations appear, and what to do in this case.

With contracture, there is a sudden difficulty in the mobility of the joint, which is responsible for the movements of the lower jaw, due to pathological processes in the muscle or ligament tissue. Often such processes are triggered by injuries, illnesses, or reflex sharp muscle contractions.

There are certain reasons why it is impossible or difficult to open your mouth:

contracture of the muscles of the jaw apparatus, which occurs as a result of injuries (for example, after a fall, blow), sprains of the muscular apparatus (with prolonged wide opening of the mouth at the dentist);
myositis, which is obtained during the administration of anesthesia (mandibular or torusal), which is used in the treatment or extraction of units on the lower dentition;
an inflammatory process in the muscular system that appears as a result of hypothermia or infection;
rheumatic diseases and, as a result, inflammation in the temporomandibular joint;
injury to the joint or surrounding tissues;
subluxation;
periostitis of the alveolar process and inflammation that has spread to all structures ligamentous apparatus this area;
purulent processes (phlegmon, abscesses) on the mandibular apparatus, which provoke an inflammatory process in the joint itself or in the muscles that move the lower jaw.

All of the above conditions can cause a condition in which the jaw cannot be fully opened, and the range of mouth opening itself fluctuates up to one centimeter.

What to do

If the cause of contracture of the muscular system is the introduction of anesthesia, overstretching of the muscle during prolonged opening of the jaw, such conditions usually go away on their own within a few days and do not require special treatment. If the reasons lie elsewhere, a visit to a specialist is mandatory.

In the event that this pathology is caused by adhesions, scars, tissue fusion, it is advisable to use radical treatment which involves surgery. Surgical treatment consists of excision of modified tissues and replacement of lost areas of tissue. Typically, these procedures are performed by oral and maxillofacial surgeons.

If additional pain occurs

If, in addition to muscle contracture, pain occurs when opening the mouth, there are probable reasons such a state:

Fracture. During it, pain, difficulty moving the jaw, hematoma or bruising occurs. In such a situation, you should immediately visit a specialist.
Osteomyelitis of the jaw. Treatment of the disease must be carried out immediately, as dangerous complications may occur.
Arteritis of the facial artery.
Dysfunctions in the jaw apparatus. They can be congenital (for example, malocclusion), acquired (inflammation of the joint).

Regardless of the cause and severity of symptoms, it is recommended to promptly contact a qualified specialist who can make a diagnosis, determine the cause and prescribe the correct treatment regimen. If the use of conservative treatment options does not bring the desired result, it is advisable to undergo surgical treatment to restore the full function of the temporomandibular joint.

According to the American Dental Association, approximately seventy-five million people in the United States suffer from some type of temporomandibular joint dysfunction. But often these patients do not receive proper diagnosis and suffer for years from radiating chronic jaw pain ( giving) in the head, neck, ears and other areas. Various disorders of the temporomandibular joint function and joint pain are the cause of a wide range of painful symptoms, from moderate to persistent, causing the patient severe discomfort. Sometimes such pain is accompanied by difficulty opening the mouth, impaired jaw function, as well as a painful clicking sound in the joint.

Anatomy of the temporomandibular joint, group of periandibular lymph nodes

Upper and lower jaw

The upper jaw is the facial bone of the skull, consisting of paired bones.

The upper jaw consists of:

bodies;
four surfaces ( anterior, posterior temporal, orbital, nasal);
four branches ( frontal, zygomatic, palatal, alveolar).

The alveolar processes have eight cells ( alveoli) to accommodate eight teeth on each side ( only sixteen teeth).

TO facial area The skull also includes the lower jaw, which is an unpaired and movable bone.

The lower jaw consists of:

bodies;
two branches ( between them is the angle of the jaw).

The branches of the lower jaw consist of the coronoid and zygomatic processes ( there is a cutout between them). On inner surface the branch has a tuberosity for attachment of the pterygoid muscles. On the outer surface, in turn, there is a chewing tuberosity.

The alveolar part of the lower jaw has sixteen cells for teeth.

The lower jaw participates in the formation of the temporomandibular joint.

Temporomandibular joint

The upper jaw is fixedly connected to the skull. The function of the masticatory apparatus is the result of the movement of the lower jaw in the temporomandibular joint. In terms of its structure, this is one of the most complex joints.

The temporomandibular joint is located at the point of articulation between the lower jaw and the temporal bone of the skull. Every time a person chews, the temporomandibular joint moves, and the same thing happens when swallowing and speaking. As such, it is one of the most mobile and constantly used joints in the body.

The temporomandibular joint consists of:

articular tubercle temporal bone;
heads;
disk;
capsules;
ligaments

The disc is fused with the articular capsule and divides the articular cavity into two parts. In the lower part, rotational movements of the articular head predominate, and in the upper part, translational, that is, sliding movements predominate.

In the temporomandibular joint, movements are possible in the following directions:

vertical ( the lower jaw moves down and up);
sagittal ( moving the lower jaw back and forth);
frontal ( movement of the lower jaw to the side, right and left).

The anterior wall of the articular fossa is formed by the articular tubercle. The articular head slides on its surface when the jaw moves. The shape of the articular tubercle depends on the type of bite. For example, with an orthognathic bite ( When upper teeth overlap the lower ones) tubercle average size, and with a curve it is flat.

It should be noted that when the temporomandibular joint ceases to function normally, it affects all aspects of a person's daily life and becomes a source of constant pain and discomfort.

The lymph nodes

Lymph nodes are organs of the immune system. They trap dead cells, foreign particles, microbial bodies, and tumor cells. Lymphocytes are formed in them.

Lymph nodes are located along the path of lymph flow. The vessels through which lymph goes to the node are called afferent, and the vessels through which it leaves are called efferent.

From fabrics to lymphatic vessels arrive colloidal solutions proteins, remains of destroyed cells, bacteria, lymphocytes. They reach the lymph nodes through the afferent vessels, foreign particles are retained in them, and the purified lymph and lymphocytes exit through the efferent vessels.

There are up to eight hundred lymph nodes in the adult body. They are located separate groups. There are groups of nodes of the head, neck, abdominal cavity, pelvic cavities, inguinal and others.

Lymph nodes have different shape, oval, bean-shaped are more common, segmental and ribbon-shaped are less common.

Let's look at the groups of lymph nodes that are affected when the jaw and temporomandibular joint malfunction ( for example, in the presence of an infectious-inflammatory process).

Group of lymph nodes	Description	Name of lymph nodes
*Lymph nodes of the head*	They are divided into superficial and deep.	parotid nodes; occipital nodes; mastoid nodes; submandibular nodes; mental nodes; facial nodes.
*Lymph nodes of the neck*	They are divided into anterior and lateral, as well as superficial and deep lymph nodes.	the anterior superficial lymph nodes are located next to the anterior jugular vein; the anterior deep lymph nodes are located near the organs and have the same name as them ( e.g. lingual, laryngeal, tracheal); lateral deep lymph nodes include supraclavicular, retropharyngeal, and anterior and lateral jugular nodes.

Normally, the lymph nodes are not palpable; if there is an increase in their size, as well as pain, this indicates the presence of a pathological process in this area.

Why does pain occur when opening your mouth?

If a person experiences pain when opening his mouth, this indicates a malfunction of the temporomandibular joint.

Pain in the temporomandibular joint can be:

sharp ( suddenly appear and disappear);
chronic ( regular pain for a long time).

In most cases, the cause of acute temporary pain in the jaw joint is acute effusions that appear if a person holds his mouth open for a long time, for example, when visiting the dentist. When a jaw joint effusion occurs, fluid or blood collects inside the joint. For example, the day after a visit to the doctor, a person may have a feeling that the teeth do not fit well together or there is pain when opening the mouth.

Usually, to eliminate this kind of pain, applying a cold compress and creating a gentle load on the temporomandibular joint for several days effectively helps, that is, you need to give up chewing gum and foods that require intensive chewing. It is also necessary to carefully open and close your mouth ( for example, when coughing, yawning).

Chronic pain that occurs regularly and without apparent reason, may indicate the presence of a pathological process in the jaw joint, for example, with arthrosis of the joint that has developed as a result of the absence of supporting lateral teeth. If there are no molars in a given place, then the chewing load is transferred not to the teeth, but to the bone. The masticatory muscles, in turn, begin to squeeze the head of the temporomandibular joint into glenoid cavity. This results in too much pressure on the joint. huge pressure and the person develops chronic pain.

Each person reacts differently to overload of the jaw joint. Most people in such situations undergo joint remodeling over many years, and the joint gradually degenerates.

It should also be noted that pain in the jaw joint can be caused by diseases of the middle ear and certain bone diseases.

The most common cases of pain in the jaw joint are atypical facial pain and trigeminal neuralgia.

Clinical and instrumental diagnostics, as well as careful questioning about the nature of the pain experienced, make it possible to diagnose accurate diagnosis pain of the temporomandibular joint, separating it from other etiological factors that cause pain in the skull.

Why does the temporomandibular joint click when opening?

Clicking when opening the jaw is possible when the movements in the jaw are asymmetrical. This is due to the fact that the masticatory muscles located on the right and left can have different lengths. As a result of this, movements in the joint become asymmetrical and when opening the mouth, clicks occur on one side.

Also, one of the causes of clicking of the temporomandibular joint in children is overgrowth lymphoid tissue in the form of palatine tonsils or adenoids. Normally, a person breathes through the nose, but excessive growth of this tissue reduces the volume of the airways and the person begins to breathe through the mouth. Over time, this leads to the fact that the lower jaw drops, and the tongue, following the jaw, leaves the roof of the palate and lies behind the lower teeth.

During normal nasal breathing, when the tongue occupies the vault of the palate, the pressure from the cheeks is balanced by the tongue. With the mouth type of breathing, nothing resists the pressure of the cheeks. As a result, an imbalance occurs, which ultimately leads to deformation and narrowing upper jaw, which takes on a horseshoe or V-shape.

Swallowing function is also impaired. When swallowed, the tongue rests on lateral teeth, preventing their normal eruption ( lateral tongue thrust). A constantly open mouth, in turn, leads to protrusion of the lower incisors ( front teeth) up. As a result, deformation of the lower dentition occurs with shortened premolar crowns ( small molars) and painters ( large molars), as well as extended lower incisors and canines ( cone teeth). A distal step occurs, that is, a decrease in the lower dentition behind the canines.

As a result of such deformation of the upper and lower dentition, contacts arise that displace the lower jaw from the physiological trajectory distally ( down). The narrowed upper jaw displaces the lower jaw posteriorly, while the articular head also moves distally, and the articular disc, in turn, moves forward. When the mouth opens, the disc can move to the articular head, restoring its normal position, and when closing, it can return to the anterior position, resulting in a reciprocal click.

It should be noted that a distally displaced lower jaw and tongue cause even greater narrowing of the airways. In order to open the airways, the neck begins to move forward and the head tilts back. This increases the load on the spine and muscles, which subsequently leads to the development of pain in the neck, back and shoulders.

Clicking sounds when opening the mouth can also be observed when not correct position jaws. Violation of the correct position of the jaw can cause parafunctional muscle activity, in the form of teeth grinding, that is, bruxism. Over time, bruxism can lead to excessive tooth wear ( pathological abrasion). As a result, the teeth become even shorter, the lower jaw moves even more distally, and the height of the bite decreases. Subsequently, deformation occurs in the joint area, damage or overstretching of the ligamentous apparatus. As a result, the articular disc may become stuck in front of the articular head and cause a clicking sound when it is returned to its original position.

Causes of inflammation of the temporomandibular joint

Exist following reasons development of pain in the jaw and temporomandibular joint:

jaw bruise;
dislocation of the lower jaw;
dysfunction of the temporomandibular joint;
arthritis of the temporomandibular joint;
boil and carbuncle;
dental diseases;
temporal arteritis;
neuralgia;
erythroothalgia ( red ear syndrome);
alveolitis;
jaw tumor.

Bruised jaw

Jaw contusion is a common injury that is characterized by disruption of soft tissue without affecting the bone or compromising the integrity of the jaw. skin.

The causes of a jaw bruise can be:

blow to the face;
falling on your face.

When a jaw is bruised, the following symptoms are observed:

pain in the jaw area;
bruise;
dysfunction of the jaw ( speech impairment, difficulty chewing food).

Dislocation of the lower jaw

When the temporomandibular joint is dislocated, there is a displacement of the articular surfaces relative to each other.

Dislocation of the lower jaw can be unilateral ( with dislocation of one joint) and two-way ( with dislocation of two joints).

The causes of dislocation of the lower jaw can be:

blow to the jaw area;
wide opening of the mouth, for example, when trying to bite great product, yawning, laughing, coughing, vomiting.

In children, dislocation of the lower jaw is less common than in adults. As a rule, it occurs in older people, which is most often associated with the anatomical features of this age. There is a weakening of the ligaments, as a result of which the person tries to open his mouth wide.

Symptoms of temporomandibular joint dislocation are:

severe pain in the area of the affected joint ( may radiate to the ear, temporal or occipital region);
the mouth is open, when you try to close it, severe pain occurs;
salivation;
speech disorder;
the lower jaw is slightly pushed forward and skewed.

A person may also experience chronic subluxations. They are formed due to the fact that the joint capsule is fibrous, and fibrous tissue, in turn, is not elastic and, once stretched, it is no longer able to firmly fix the joint, therefore, with accompanying factors, a person experiences joint subluxation.

Jaw fracture

A jaw fracture is characterized by a violation of the integrity of the bone.

There are the following types of jaw fracture:

complete fracture with displacement of jaw fragments;
incomplete fracture without displacement ( for example, a crack in a bone).

Complete fracture the jaws, in turn, can be open ( with facial skin damage) or closed ( without damaging the skin of the face).

Symptoms of a jaw fracture are:

severe pain in the area of the fracture;
inability to open mouth ( especially with a fracture of the lower jaw);
tissue swelling;
bruise ( with a fracture of the upper jaw, bruising under the eyes).

Temporomandibular joint dysfunction

Dysfunction of the temporomandibular joint can occur under the influence of various forces causing overload of this joint. The easiest way to understand the nature of these forces is to consider the function of the temporomandibular joint in relation to the function of the teeth, jaw and surrounding muscles.

The most common causes of temporomandibular joint dysfunction are:

malocclusion ( can lead to the development of jaw pain);
lack of teeth;
improperly performed dental or orthodontic treatment ( for example, poor-quality dental prosthetics);
improper swallowing inherited from childhood, in which the lower jaw unnaturally moves back;
habits like mouth breathing, bruxism ( teeth grinding);
neurotic clenching of teeth, leading to overload of the muscles surrounding the jaw;
abnormal jaw development, in which the upper or lower jaw is underdeveloped;
head, neck and spine injuries;
some degenerative diseases such as osteoarthritis.

With temporomandibular joint dysfunction, a person may experience the following symptoms:

crunching in the joint area;
pain in the joint area, head, neck and back;
irradiation of painful sensations into the teeth, ears and eyes;
violation of movements in the joint ( for example, a person cannot open his mouth wide, difficulty chewing food);
grinding of teeth;
sleep apnea ( sleep apnea).

Arthritis of the temporomandibular joint

Temporomandibular joint arthritis is an inflammation of the joint that connects the lower jaw to the temporal bone of the skull. The development of this disease begins as a result of exposure to external factors, for example, due to mechanical trauma or infection.

Arthritis of the temporomandibular joint causes symptoms such as:

pain in the area of the affected joint;
increase in local and general temperature;
swelling of the soft tissues of the face;
hyperemia ( redness) skin in the area of the affected joint;
violation of chewing functions;
speech disorder;
hearing loss.

Osteomyelitis

Osteomyelitis is an inflammation of the bone marrow and tissues surrounding the bone.

The cause of the development of osteomyelitis is the penetration of pathogenic microorganisms into the bone tissue of the jaw.

Penetration of infection into the bone can occur in the following ways:

odontogenic - through teeth ( for example, with advanced caries, pulpitis, alveolitis);
hematogenous - through the blood ( for example, with a boil or carbuncle of the maxillofacial area, acute otitis media);
mechanical - due to direct trauma to the jaw.

This disease can be localized in the upper or lower jaw.

According to the prevalence of the process, osteomyelitis can be:

limited ( damage to one or more teeth in the area of the alveolar process);
diffuse ( damage to one or two parts of the jaw).

The following symptoms may occur with osteomyelitis:

increased body temperature;
sleep disturbance;
pain in the affected area ( may radiate to the temporal region, ear or eyes);
swelling of the gums and skin in the area of the affected teeth;
between the affected tooth and gum there is a discharge of purulent contents;
dysfunction of the jaw ( change in speech, difficulty swallowing);
decreased sensitivity of the lower lip and skin of the chin ( with osteomyelitis of the lower jaw);
enlargement and pain of regional lymph nodes.

Furuncle and carbuncle

A furuncle is a purulent inflammation of the hair follicle and sebaceous gland. Its size can range from a pea to a walnut.

A carbuncle is a purulent-necrotic inflammation of several hair follicles located nearby.

Most often, boils and carbuncles form in the face and neck, since the skin in these areas is most susceptible to contamination and microtrauma.

The causes of the formation of a boil or carbuncle are:

violation of the integrity of the skin ( for example, cuts, scratches, scratching the skin due to itching);
violation of hygiene;
frequent colds;
infectious and inflammatory processes in the ear, nose, maxillary paranasal sinuses ah nose ( for example, otitis media, sinusitis, chronic rhinitis).

With a boil or carbuncle, a person may experience the following symptoms:

soreness ( depending on the location on the face, the pain radiates to the upper or lower jaw);
redness of the affected skin area;
infiltration ( accumulation of cellular elements, blood and lymph in tissue) and swelling;
purulent plugs are visible, from which purulent-bloody fluid is released;
for example, weakness, loss of appetite, malaise).

Dental diseases

Jaw pain can occur due to the following dental diseases:

caries ( pathological process, in which there is destruction of the enamel and hard tissue of the tooth);
pulpitis ( damage to the dental pulp);
periodontitis ( damage to the periodontium - the tissue located between the tooth and the alveolar process);
periodontal abscess ( purulent-inflammatory periodontal disease);
dental cyst ( damage to bone tissue with the formation of a sac, covered on the outside with connective tissue and filled with pus inside);
limited osteomyelitis of the jaw;
dental trauma ( bruised, dislocated or fractured tooth).

With these diseases, pain in the teeth often radiates to the upper or lower jaw. The pain is pulsating and increases at night.

Temporal arteritis

Temporal arteritis is an autoimmune disease in which the body cells damage the vascular wall of the temporal artery, which subsequently leads to the development of an inflammatory process and subsequent destruction of the vessel ( This disease affects large and medium-sized vessels).

The existing inflammation in the vessel leads to thinning of its wall. In some cases, this may contribute to the formation of pathological dilation of the vessel. Over time, an aneurysm formed ( extension) can burst and lead to the development of cerebral hemorrhage.

Symptoms of temporal arteritis are:

severe pain in the temporal region of a pulsating nature ( may radiate to the jaw, neck, tongue and shoulder areas);
increased body temperature;
weakness and malaise;
pain in the temporomandibular joint when chewing or talking;
pain when touching the scalp;
hyperemia ( redness) and swelling of the temporal region;
when the ophthalmic artery is damaged, blurred vision, pain and double vision, as well as drooping of the eyelid are observed.

Neuralgia

Neuralgia is a disease characterized by damage to peripheral nerves and manifested by severe pain in the area of innervation of the affected nerve.

Pain in the jaw develops with neuralgia of the following nerves:

Trigeminal neuralgia. Nerve innervating the face and oral cavity. Divided into three branches, the top one is ophthalmic nerve, the middle one is the maxillary, and the lower one is the mandibular. When the middle and lower branches of the nerve are affected, a person experiences severe pain in the upper or lower jaw. Painful sensations usually occur at night and are burning in nature. An attack of pain can also occur even with a minor irritant, for example, a draft, or eating hot or cold food. Before the onset of a painful attack, a person may experience itching of the skin or a feeling of goosebumps crawling on the skin.
Neuralgia of the ear ganglion. A disease characterized by damage to the ear autonomic ganglion. Its development is usually associated with the presence of infectious and inflammatory processes in the area of the ear node ( For example, purulent otitis media, mumps, sinusitis, periodontitis). When the ganglion is damaged, a person develops burning or pulsating pain. Painful sensations can radiate to the lower jaw, back of the head, neck, and shoulders.
Neuralgia of the glossopharyngeal nerve. This nerve is mixed. It innervates the levator pharynx muscle and parotid gland, and also provides sensation to the posterior third of the tongue ( taste sensitivity). For some diseases ( for example, brain tumor, infectious inflammatory diseases, aneurysm carotid artery ) the work of the glossopharyngeal nerve may be impaired. The person will experience pain in the throat, lower jaw and ear.
Neuralgia of the superior laryngeal nerve. When this nerve is damaged, the patient experiences severe throbbing pain. Painful sensations are localized in the larynx and lower jaw ( pain radiates to the ear, eyes, temporal region). Often, during a painful attack, a person experiences a cough and dry mouth, and after it ends, on the contrary, profuse salivation.

Erythroothalgia ( red ear syndrome)

A syndrome characterized by severe pain in the ear, which can radiate to the lower jaw, frontal and occipital regions. In this case, redness and an increase in local temperature may also be observed. auricle (red ear).

The causes of the development of this syndrome can be cervical spondylosis, neuralgia of the glossopharyngeal nerve, dysfunction of the temporomandibular joint.

Alveolitis

A disease in which inflammation of the alveolar process occurs. As a rule, the cause of its development is improper tooth extraction and the entry of pathological bacteria into the socket.

Symptoms of alveolitis are:

increasing pain at the site of tooth extraction several days after the procedure;
severe radiating pain ( giving) in the jaw and face;
putrid breath;
redness and swelling in the affected area;
increased salivation;
increase in local and general temperature;
enlargement of regional lymph nodes;

Glossitis

A disease characterized by the development of an inflammatory process in the tongue.

The cause of glossitis is the ingress of pathological microorganisms ( bacteria, viruses) in the tissue of the tongue, which subsequently leads to the development of the inflammatory process.

The following factors can contribute to the penetration of pathological agents into the tissues of the tongue:

violation of the integrity of the tissue of the tongue;
consumption of spicy and very hot food and drinks;
poor oral hygiene;
decreased body resistance;
dysbacteriosis of the oral cavity.

Symptoms of glossitis are:

burning and pain in the tongue ( may radiate to the lower jaw);
redness and swelling of the tongue;
softening of the tongue;
disturbances in speech, swallowing and chewing;
increase in general and local temperature;
salivation;
the appearance of bubbles on the tongue, after opening, which form erosions ( if glossitis is caused by a virus).

Sinusitis

This disease is characterized by inflammation of the mucous layer of the maxillary sinus ( maxillary) sinuses.

The cause of sinusitis is the entry of infectious agents into the maxillary sinus.

Infection can enter the sinus in the following ways:

hematogenously ( through blood);
nasally ( due to an infection in the nose);
odontogenic ( in the presence of an inflammatory process in the teeth of the upper jaw).

severe pain in the affected sinus, radiating to the upper jaw, eyes and bridge of the nose;
nasal breathing disorder;
mucous or purulent discharge from the nose;
headache;
increased body temperature;
signs of body intoxication ( weakness, malaise, sleep disturbance, loss of appetite).

Jaw tumor

Characterized by the formation of a benign or malignant tumor from bone or dental tissue.

Tumors of the jaw are divided into:

odontogenic - formed from dental tissue ( eg ameloblastoma, cementoma, odontogenic fibroma or sarcoma);
non-odontogenic - formed from bone, cartilage, connective tissue ( e.g. osteoma, osteoblastoclastoma, chondroma, hemangioma).

When a person has a tumor of the jaw, they may experience the following symptoms:

pain in the affected area, as well as in the temporomandibular joint;
dysfunction of the temporomandibular joint;
asymmetrical facial change ( due to bone deformation);
tooth shift and increased tooth mobility.

It should be noted that in the initial stages, a jaw tumor may be asymptomatic.

Diagnosis of the causes of inflammation of the temporomandibular joint

Diagnosis of jaw pain depends directly on the cause of the pain.

Diagnosis of jaw pain due to injuries

For jaw injuries, the following diagnostic methods are used:

Anamnesis collection. When collecting anamnesis, the doctor obtains the necessary information about the patient through questioning. If you suspect an injury to the upper or lower jaw, it is paramount to find out what the patient was doing at the time of the injury and how exactly it occurred ( for example, a person fell or was hit). You should also find out what complaints there are and clarify the severity of clinical manifestations. After collecting the necessary information, the doctor proceeds to examine the patient.
Medical checkup. During the examination, the doctor should pay attention to the condition of the patient’s bite. When palpating the jaw, you should find out whether there is pain, what its nature is and what intensity it is. It is necessary to examine the skin, identify the presence of bruising and swelling, and whether there is a violation of the integrity of the skin. You should also examine the oral cavity to see if there is deformation of the teeth and mucous layer, excessive salivation, or blood in the saliva. If there is a jaw fracture, bone crepitus will be observed during palpation in the affected area ( characteristic crunch).
X-ray of the jaw. This diagnostic method allows you to determine the nature of the injury ( bruise, dislocation or fracture). When the upper or lower jaw is bruised, the integrity of the bone is not compromised. If there is a dislocation, the x-ray will show a displacement of the jaw. In case of a jaw fracture, an x-ray helps to identify its location, whether it is single or multiple, the condition of the roots of the teeth and alveolar processes, as well as the presence of displacement of bone fragments.

Diagnosis of jaw pain in infectious and inflammatory diseases

For infectious and inflammatory diseases of the jaw, the following diagnostic methods are used:

Anamnesis collection. When interviewing a patient, the doctor must clarify whether he has any chronic diseases ( for example, chronic sinusitis, pulpitis), and also recently suffered an acute infection ( for example, a boil). It is necessary to find out when the patient last visited the dentist, since improper orthodontic treatment increases the risk of developing infectious complications (for example, improper tooth extraction can lead to the development of alveolitis).
Medical checkup. In infectious and inflammatory diseases, the skin in the affected area will become hyperemic ( redness), edematous. There will be an increase in both local ( skin is hot to the touch), and general temperature. When palpating the affected area, severe pain will be noted, and pain will also be observed when palpating the regional lymph nodes. The patient will experience dysfunction of speech, swallowing and chewing. If there is an infectious process in the oral cavity, defects, blisters, ulcers, serous or purulent discharge may be observed on the mucous membranes. For diseases of the ear or nose, an ENT doctor ( otolaryngologist) can perform otoscopy ( ear examination), as well as anterior or posterior rhinoscopy ( nasal cavity examination).
Lab tests. In order to diagnose the presence of an infectious-inflammatory process in the body, it will be necessary to take a general blood test. It is given in the morning on an empty stomach from the cubital vein or ring finger. The study results may show leukocytosis ( with a bacterial or viral process, trauma, neoplasms), lymphocytosis ( with a viral process), as well as accelerated erythrocyte sedimentation rate ( indicates the presence of a pathological process in the body). If there is an infection in the ear ( for example, acute otitis media), as well as the upper respiratory tract ( for example, sinusitis, tonsillitis) the patient may be prescribed a bacteriological examination of the discharge. This analysis allows you to identify the type of bacterial agent that caused the infectious process, as well as determine sensitivity to the antibiotic for subsequent treatment.
Instrumental diagnostics. In some cases, it is used to identify inflammatory lesions of the bone or soft tissues of the jaw. X-ray examination or computed tomography ( for example, with sinusitis, osteomyelitis, pulpitis, periodontitis). These studies help to identify the localization and extent of the pathological process, the anatomical features of the teeth, the condition of the periodontium and periodontal tissue. They also make it possible to evaluate the effectiveness of treatment for various diseases.

Diagnosis of jaw pain due to dysfunction of the temporomandibular joint

The difficulty in diagnosing dysfunction of the temporomandibular joint lies in the fact that if its function is disrupted, pain can be localized outside the joint area ( for example, pain in the temples, ears, neck).

When visiting a doctor, the most important thing for a patient is to tell them about their complaints. The doctor will collect an anamnesis of life and illness, clarify whether there were inflammatory diseases or injuries of the face and jaw, visually determine the presence of facial asymmetry, the degree of mobility of the lower jaw, the presence of hyperemia and swelling in the area of the affected joint, and auscultately hear the clicking or crunching of the joint when moving.

When palpating the temporomandibular joint, the doctor can feel its displacement, swelling of the surrounding tissues, and also identify the presence of pain.

Then the doctor proceeds to the procedure of palpation of various muscle groups:

temporal muscles ( as a rule, one side is more sensitive);
lateral pterygoid muscles ( control the position of the jaw, and therefore pain is usually felt on both sides);
masticatory muscles ( these points are especially painful for people suffering from bruxism);
sternocleidomastoid muscle ( usually more sensitive on the right);
The trapezius and posterior occipital muscles are also examined.

Next, the doctor may prescribe the following diagnostic methods:

X-ray of the temporomandibular joint. Allows you to evaluate the ratio of the articular head to the glenoid cavity, as well as study the structure of the bone tissue that is involved in the formation of the jaw joint.
Computed tomography of the joint. It is a high-precision x-ray diagnostic method that performs a layer-by-layer examination of the jaw in various planes. This research method allows us to detect even minor changes in the joint early stages diseases.
Orthopantomography. This is an x-ray research method that allows you to make panoramic shot teeth, as well as tissues of the upper and lower jaws. Using this study, it is possible to diagnose pathological processes in the jaw bones, determine the condition of the teeth, and also identify dysfunction of the temporomandibular joint ( for example, arthrosis and arthritis of the joint, abnormalities in the development of the jaw).
Phonoarthrography. This diagnostic method using a special device allows you to listen to joint noises and visually track them on a graph. Normally, when a person listens, soft, uniform and sliding sounds are detected. For dysfunction of the temporomandibular joint ( for example, with displacement of the articular heads, arthrosis) pronounced noises are observed, as well as crepitus and clicking sounds different intensity.
Electromyography of facial muscles. A diagnostic method that allows using special electrodes to study the electrical activity of the facial muscles and the nerves that innervate these muscles.
Arthroscopy of the jaw joint. The temporomandibular joint is examined using a special device, an arthroscope. A small incision is made in the joint area, and a device is inserted, which has a camera that transmits an image to a monitor. This study helps not only to diagnose the disease, but also to provide treatment ( for example, rinse a joint, remove cartilage thickening or scar tissue, inject a drug).

It should also be noted that before visiting a doctor, a person can independently test the temporomandibular joint by palpation. In parallel, it is necessary to check both the left and right sides. For symptoms of temporomandibular joint dysfunction, a common symptom is more pain on one side.

Self-diagnosis
Before starting the study, it is essential to prepare a pen and a piece of paper.

Self-diagnosis involves testing the sensitivity of six points of the face and neck.

You can do this yourself as follows:

Place the tips of your index and middle fingers on both sides of your temples, just behind your eye sockets. Press lightly and compare the sensations on the right and left sides, whether the sensitivity of the sides is the same or not. The result must be noted on a piece of paper.
Place the fingers of both hands in the depressions below the neck at the corner of the lower jaw, compare the sensations again, whether there is increased sensitivity on one side or the other in this area, write down your sensations.
Place the tips of all four fingers ( except for the big one) on both cheeks in the area between the upper and lower jaw. Compare your sensations on the right and left sides again and write down the result again.
You need to go down to the neck. Using all your fingers, carefully feel the muscle that runs from your ears to your shoulders. Compare the pain on each side. Make a note on the sheet.
With your right hand, feel the trapezius muscle on your left shoulder, then with your left hand feel the same muscle on your right shoulder. If there is pain on at least one side, this should be noted.
At the end, place the tips of your little fingers in the ear canals, opening and closing your mouth, try to feel whether there is pain in the temporomandibular joint, and if it is felt, write it down on a sheet.

At the end of the self-diagnosis, examine the results. If pain was observed at the points being examined, this indicates dysfunction of the temporomandibular joint, and it is recommended to seek help from a doctor.

Diagnosis of jaw pain due to neoplasms

In the early stages of a jaw tumor ( benign and malignant), as a rule, are asymptomatic, so these diseases are diagnosed in most cases in the later stages.

During a consultation with a doctor, the first priority is to interview the patient, examine and palpate.

Upon examination, the following may be revealed:

facial asymmetry;
swelling and hyperemia of the affected area;
bulging bone;
deformation of the affected tissues ( for example, the presence of ulcers, fistulas);
impaired mobility of the lower jaw;
impaired nasal breathing, purulent or bloody issues (when a tumor of the upper jaw grows into the nasal cavity).

On palpation you may notice:

changes in affected tissues ( softening, hardening, infiltration);
loose teeth and pain;
decreased sensitivity of the skin of the chin and lips;
adhesion of the neoplasm to soft tissues;
enlargement and tenderness of regional lymph nodes ( for example, cervical, submandibular, parotid).

For neoplasms of the upper or lower jaw, the patient may be prescribed the following: instrumental methods diagnostics:

X-ray and CT scan jaws. Computed tomography is more informative method diagnostics, as a layer-by-layer examination of the jaw is performed. Four to five topographic sections are made with a distance of one centimeter between them. These studies allow us to identify the localization cancer formation, the prevalence of the process, and also determine the degree of destruction of bone tissue.
X-ray and computed tomography of the paranasal sinuses. The paranasal sinuses are hollow structures filled with air and communicating with the nasal cavity. This diagnostic method is carried out for the purpose of research bone structures sinuses, identifying the presence of growths and calcifications ( deposition of calcium salts) in their cavities.
Anterior and posterior rhinoscopy. For neoplasms of the upper jaw, the nasal cavity is examined. With anterior rhinoscopy ( performed using a rhinoscope) it is possible to identify a tumor in the nasal cavity, and also to take a piece of tissue for histological examination or puncture the tumor for cytological examination. Posterior rhinoscopy ( done using a spatula and a mirror), in turn, makes it possible to determine tumor germination in the nasopharynx.

To confirm the diagnosis of jaw tumors, morphological diagnostics are prescribed:

cytological examination of punctate tumor and lymph node ( study of cell structure under a microscope);
biopsy of the tumor and lymph node for histological examination ( study of the cellular composition of tissues under a microscope).

Depending on the clinical manifestations, as well as on the localization of the tumor process, the patient may be prescribed consultations with the following specialists:

ophthalmologist;
surgeon;
neurologist;
otolaryngologist ( ENT doctor).

Treatment of pathology of the temporomandibular joint

The treatment algorithm for jaw pain directly depends on the cause that caused the appearance of this symptom. Therefore, in order to eliminate the manifestation of pain, it is paramount to identify the etiological factor that led to its development and cure it.

Treatment of jaw pain due to injuries

Jaw injury	Treatment
*Bruised jaw*	First of all, apply cold to the affected area ( in the first twenty-four hours), and also ensure peace ( for example, try to talk less, don’t eat rough food). Anti-inflammatory gels or creams should be applied locally to the area of the bruise to reduce tissue swelling and eliminate pain ( for example, Voltaren, Fastum-gel).
*Dislocation of the temporomandibular joint*	*If the lower jaw is dislocated, the patient initially needs to provide first aid:* apply cold to the affected area; create vocal peace; give painkiller ( e.g. Paracetamol, Ibuprofen); deliver to the hospital. Treatment, in turn, includes reduction of the dislocation ( can be performed under anesthesia) and compliance with nutritional rules. Food should be consumed in liquid form, as well as in puree form. In the first days after the injury, the patient must maintain vocal rest and avoid wide opening of the mouth. Medications may include topical application of anti-inflammatory creams or gels ( for example, Diclofenac, Ketoprofen). These drugs reduce pain, have an anti-inflammatory effect, and also reduce tissue swelling.
*Jaw fracture*	*First aid for a broken jaw is:* immobilization of the affected jaw ( creating jaw immobility to ensure rest); administration of an anesthetic drug; delivery to the hospital. *Treatment for a jaw fracture will depend on the following factors:* patient's age; location of the fracture; type of fracture ( open or closed); displacement of bone fragments; degree of damage to surrounding tissues. *Treatment of a jaw fracture includes three stages:* matching ( reposition) bone fragments; fixation; hold. The first step in treating a fracture is to align the jaw bones. The patient is given special devices to immobilize bone fragments. Depending on the severity of the fracture, temporary ( ligature) and constant ( for example, application of individual plates, splints) immobilization. It should also be noted that adherence to a daily routine plays an important role in recovery. In the first days the patient must strictly adhere to bed rest. Nutrition should be complete and high-calorie. Food for jaw fractures is served in ground or semi-liquid form. Depending on the severity of the condition, the patient may be prescribed intravenous infusions (for example, solutions of calcium chloride, glucose), vitamin therapy and antibacterial treatment ( to prevent the development of infectious complications).

Treatment of jaw pain in infectious and inflammatory diseases

For infectious and inflammatory diseases of the jaw, the following treatment may be prescribed:

Antibacterial treatment. For infectious diseases ( e.g. boil, facial carbuncle, osteomyelitis, periodontitis) antibiotic therapy is primarily prescribed to suppress the activity of bacteria that caused the pathological process. The type of drug, method of administration and duration of treatment are prescribed individually depending on the disease, its severity and the general condition of the patient. Also, to establish effective antibacterial treatment, a bacterial study is initially performed before prescribing it ( sowing pus onto a special medium) to identify a pathological agent and determine its sensitivity to a specific drug. As a rule, for infectious and inflammatory diseases, broad-spectrum antibiotics from the Penicillin group are prescribed ( for example, Ampicillin), quinolones ( for example, Ciprofloxacin) and other pharmacological groups.
Mouth rinse. The patient may be prescribed a mouth rinse, e.g. weak solution potassium permanganate ( potassium permanganate), furatsilin ( 3% ) or soda solution.
Compresses. Compresses with ointments, for example, Levomekol ( has an antibacterial effect), Solcoseryl ( improves metabolism and tissue regeneration).
Surgery. If necessary, surgical intervention is performed, in which the infectious-inflammatory focus is opened and washed ( for example, hydrogen peroxide) and creating the necessary conditions ( drainage) for unhindered outflow of purulent contents.

It should be noted that infectious diseases are accompanied by the formation of pus, which, in turn, leads to increased loss of proteins from the body. That is why the patient should monitor his diet. The diet should include increased consumption of protein foods ( for example, meat, cottage cheese, legumes). In this case, food should be served in liquid or ground form to prevent overstrain of the jaw.

In case of severe infectious diseases, the patient may be indicated for detoxification therapy ( administration of a solution of glucose 5%, sodium chloride 0.9%).

Treatment of jaw pain due to temporomandibular joint dysfunction

For temporomandibular joint dysfunction, the patient may be prescribed:

correction of bite;
dental prosthetics;
wearing a joint splint;
use of the Myotronics device;
adherence to daily routine and diet;
use of medications.

Bite correction
Correction of the bite is carried out by wearing:

braces;
kapp.

Braces are a type of permanently worn non-removable technique that serves to straighten teeth and correct malocclusion. Braces can be metal, ceramic, sapphire, or plastic, depending on the material from which they are made. The duration of wearing braces is individual and depends on the complexity of the clinical situation.

Mouthguards are removable devices made of transparent plastic.

The following types of mouth guards exist:

individual mouth guards, which are made after taking an impression of the teeth;
thermoplastic mouth guards, which are standard.

Dental prosthetics
Dental prosthetics can be partial or total. This procedure allows you to normalize the position of the lower jaw in case of dysfunction of the temporomandibular joint.

Partial prosthetics are performed:

in the absence of the crown part of the tooth ( for example, with significant tooth destruction by caries);
at complete absence tooth

Total prosthetics is prosthetics in which all teeth are involved. Teeth can be covered, for example, with inlays, onlays, and crowns.

Total prosthetics helps:

eliminate constant wearing of mouth guards;
achieve normalization of the position of the lower jaw;
restore aesthetic function ( beautiful smile, straight teeth);
eliminate dysfunction of the temporomandibular joint.

Wearing a joint splint
Joint splint ( trainer) is an industrially manufactured soft dental splint ( silicone material), specifically designed to eliminate pain symptoms in the initial treatment of temporomandibular joint disorders. Thanks to the wing-shaped base of the splint, a mild decompression is created and pain in the joint and surrounding muscles is eliminated, and the effect of bruxism is effectively removed.

The joint splint has the following therapeutic effects:

effectively and quickly eliminates pain in the jaw;
relaxes the muscles of the jaw and neck;
relieves pressure in the temporomandibular joint;
limits bruxism;
relieves chronic pain in the neck.

A standard joint splint fits ninety-five percent of adult patients and does not require custom casts. It is effective and easy to use.

As a rule, immediately after installation of the splint, there is an immediate relaxation of the muscles due to their lengthening, which leads to a significant reduction in muscle tension in the jaw and neck.

For the first few days, you should wear the joint splint for at least an hour a day to get used to it.

A reduction in soreness is usually felt within the first days of use, but in some cases it takes several weeks for a significant reduction. This is individual for each patient. After a few days, you should supplement the daytime wearing regimen with a nighttime one. This may initially cause discomfort for those who have a habit of mouth breathing or snoring in their sleep, but it can help correct the problems that have arisen and subsequently eliminate them.

Treatment of dysfunctions of the temporomandibular joint should be carried out under the supervision of a physician. If using a splint is not enough, it is prescribed individual program aimed at eliminating the causes of pathology.

Using the Myotronics device
Myotronix devices are devices that provide muscle stimulation. Due to muscle relaxation, the position of the lower jaw is normalized.

During treatment, the following therapeutic effects are observed:

muscle relaxation occurs;
pain associated with dysfunction of the temporomandibular joint is eliminated;
movement of the lower jaw is restored;
normalization of occlusion occurs ( teeth closing).

Maintaining a daily routine and diet
In addition to the treatment prescribed by the doctor, it is important for the patient to follow the correct daily routine and diet. It is very important to limit the movements of the lower jaw during treatment.

The patient must follow the following recommendations:

provide vocal rest ( avoid emotional conversations, raising your voice);
prevent wide mouth opening ( for example, when laughing, yawning, eating);
When sleeping, try to sleep on healthy side;
When talking on the phone, make sure that the phone does not put pressure on the affected joint;
Avoid eating hard foods that require long chewing ( For example, durum varieties raw fruits and vegetables, crackers, bagels);
consume food in ground and liquid form ( for example, cream soup, porridge, potato or pea puree, cottage cheese);
Avoid the use of chewing gum.

Use of medications
Dysfunction of the temporomandibular joint causes a person to experience acute or chronic pain. To eliminate them, the patient may be prescribed painkillers or non-steroidal anti-inflammatory drugs. The latter, in turn, also have analgesic and antipyretic effects.

For temporomandibular joint dysfunction, the following medications can be prescribed to relieve pain:

Paracetamol ( take one or two tablets three times a day);
Ibuprofen ( take one or two tablets three to four times a day);
Diclofenac ( take 25 mg three to four times a day);
Ketoprofen ( take 100 – 300 mg two – three times a day).

These drugs are also available in the form of gels, creams and ointments ( for example, Ibuprofen, Diclofenac, Ketoprofen). They must be applied topically to the affected area two to four times a day.

Treatment of jaw pain due to neoplasms

For jaw tumors, the following treatment methods are used:

Radiation therapy. It is an important aspect in the treatment of benign and malignant tumors. This treatment method is characterized by the fact that the neoplasm is exposed to ionizing radioactive radiation. Under their influence, the development of DNA mutations in cancer cells occurs, as a result of which they die.
Chemotherapy. Treatment of the oncological process is carried out through medicines (e.g. Methotrexate, Cisplatin). The action of these drugs is aimed at destroying the tumor cell, slowing the growth of the malignant process and reducing symptoms. Chemotherapy drugs are usually prescribed in combination. The combination of drugs is prescribed individually depending on the type of tumor present, the stage of the process, as well as the general condition of the patient. It should be noted that chemotherapy can be used in addition to surgical treatment of the tumor or radiation therapy.
Surgery. It consists of surgical removal of a tumor of the upper or lower jaw. Before surgical intervention Orthopedic structures must first be prepared, which will subsequently help keep the jaw in the correct position ( for example, Vankevich tire). Correct orthopedic actions increase the rate of healing postoperative wound, and also play a big role in the aesthetic aspect.

Physiotherapy

Physiotherapeutic treatment is effective in treating jaw pain caused by injury, infection, or temporomandibular joint dysfunction.

Name of procedure	Therapeutic effect	Application
Microwave therapy (microwave therapy)	are expanding blood vessels; local blood circulation improves; muscle spasm decreases; metabolic processes improve; has an anti-inflammatory effect; produces an analgesic effect.	degenerative-dystrophic, as well as inflammatory diseases of the musculoskeletal system ( for example, with arthrosis, arthritis, osteochondrosis), diseases of the ENT organs ( for example, with otitis media, tonsillitis); skin diseases ( for example, with a boil, carbuncle).
UHF (exposure to ultra-high frequency magnetic field)	blood and lymph circulation improves; tissue swelling decreases; muscle spasm decreases; tissue healing improves; has an analgesic effect.	inflammatory diseases of the musculoskeletal system; diseases of the ear, nose and throat ( for example, sore throat, sinusitis, sinusitis); diseases localized in the facial area ( for example, with neuritis facial nerve ); suppurative diseases ( e.g. abscess, cellulitis).
*Ultraviolet radiation*	an immunostimulating effect is produced; metabolic processes improve; has an analgesic and anti-inflammatory effect; regeneration of nerve and bone tissue improves.	diseases ( for example, arthritis, arthrosis) and musculoskeletal injuries ( for example, dislocations, fractures); neuralgia; skin diseases ( for example, ulcers, boils, long-healing wounds).
Diadynamic therapy (constant pulse currents of half-sinusoidal shape)	has an analgesic effect; lymph circulation and blood circulation improves; a stimulating effect on the muscles is produced; the tissue healing process is accelerated.	pain syndrome of various etiologies (for example, bruise, dislocation, neuritis, arthritis); joint diseases ( for example, arthrosis).

Why do the lymph nodes under the jaw hurt?

The lymph node is the most important organ of the lymphatic system. Every day, a large amount of fluid enters the body tissues from the blood. To avoid tissue swelling, the vessels of the lymphatic system collect this fluid, and then carry it through the lymphatic vessels with the lymph flow.

In its movement, lymph passes through the lymph nodes. These nodes contain many cells that filter the lymph in order to remove the infectious agents present in it. Purified lymph returns to the circulatory system through the subclavian vein. Thus, lymphatic system drains and cleanses about three liters of lymph per day.

The human body contains from four hundred to one thousand lymph nodes. Depending on their location, they are all distributed into groups. Thus, the lymph nodes that are located in the submandibular region form a group of submandibular lymph nodes. Normally, the lymph nodes are painless.

Painful sensations in lymph nodes under the jaw are most often a sign of an inflammatory process, which usually develops as a result of an infectious disease of a nearby organ. Pain with lymphadenitis ( inflammation of the lymph node) occurs due to stretching of the connective tissue capsule covering the surface of the lymph node.

Pain in the submandibular lymph nodes can be caused by diseases such as:

tonsillitis ( tonsillitis);
glossitis ( inflammation of the tongue);
osteomyelitis ( inflammation of bone tissue) jaws;
boil ( acute purulent inflammation of the hair follicle) on the face;
carbuncle ( acute purulent inflammation of several hair follicles ) on the face;
pulpitis ( inflammation of the neurovascular bundle of the tooth);
periodontitis (
irritability;
increase in body temperature.

Why does my upper jaw hurt?

The upper jaw is a paired bone. It consists of a body and four processes - alveolar, palatine, zygomatic, frontal. The body of the maxilla contains a large air-bearing maxillary or maxillary sinus. On the alveolar process of the upper jaw there are depressions - dental alveoli, in which the roots of the teeth lie. The upper jaw takes part in the formation of the hard palate ( bony wall separating the nasal cavity and the oral cavity), nasal cavity and orbits. The upper jaw also participates in the functioning of the masticatory apparatus.

Pain in the upper jaw can occur due to the following diseases and pathological processes:

upper jaw injury;
osteomyelitis of the upper jaw;
trigeminal neuralgia;
arteritis of the facial artery;
pulpitis;
periodontal abscess;
osteogenic sarcoma of the jaw;
sinusitis.

Diseases that cause pain in the upper jaw	Description
*Upper jaw injury*	Characterized by a bruise ( trauma without breaking the integrity of the skin) or a fracture of the upper jaw, for example, due to a strong blow to the face with various hard objects or as a result of a fall on the face. *The main signs of a bruise are:* pain in the upper jaw; swelling; change in skin color at the site of injury ( eg bruising, redness). *A fracture of the upper jaw is accompanied by the following symptoms:* severe pain in the upper jaw; chewing disorder; speech disorder; violation of the closure of the dentition; severe hematomas in the area of the upper lip and cheeks.
*Osteomyelitis of the maxilla*	This disease is characterized by the presence of an infectious purulent-inflammatory process in the bone tissue of the jaw. The main cause of osteomyelitis of the upper jaw is the penetration of infection into the bone tissue through a damaged tooth. *With osteomyelitis of the upper jaw, the patient usually complains of:* throbbing pain in the upper jaw; headache; chills; increase in local and general temperature; swelling and asymmetry of the face; enlarged and painful lymph nodes.
*Trigeminal neuralgia*	This disease is characterized by sudden second attacks of acute, cutting, burning pain that occurs in the areas of innervation of the trigeminal nerve, usually on one side of the face. The upper jaw is innervated by the maxillary nerve, which represents the middle branch of the trigeminal nerve. Often an attack of pain is caused by the slightest tactile irritation ( for example, when stroking the skin of the face). The mechanism of development of this disease is not fully understood. However, some experts argue that the main cause of this neuralgia is compression of the trigeminal nerve by nearby vessels.
*Arteritis of the facial artery*	This disease is characterized by inflammation of the wall of the facial artery. In this case, the patient may feel a burning pain in both the upper and lower jaw. Pain may also be accompanied by a feeling of tingling or numbness in the skin. The etiology of arteritis is unknown. There is a theory that the cause of the disease is genetic predisposition in combination with unfavorable environmental factors.
*Pulpitis*	Inflammation of the pulp, the neurovascular bundle of the tooth, due to the penetration of pathogenic microorganisms into the tissue. With this disease, the patient feels severe throbbing pain. Attacks of pain can be short-term or constant. In an advanced form, when the tooth begins to gradually decay, the pain becomes less severe.
*Periodontal abscess*	Purulent inflammation of the gums in the form of an abscess. Often, a periodontal abscess develops against the background of other dental diseases ( for example, gingivitis - inflammation of the gums). The disease can also develop due to the incompetent actions of the dentist. *A periodontal abscess is usually accompanied by the following symptoms:* swelling and pain in the affected area, which intensifies when trying to chew food; pain in the jaw, ear, cheeks; headache; dizziness; increased body temperature; loss of appetite; decreased performance.
*Osteogenic sarcoma of the jaw*	A malignant tumor growing from the bone tissue of the jaw. *Symptoms of osteogenic sarcoma of the jaw are:* facial pain; itching in the gum area; the appearance of a tumor that interferes with chewing food; swelling of the face.
*Sinusitis*	Inflammation of the maxillary mucosa ( maxillary) sinuses. In most cases, sinusitis develops against the background of other infectious diseases of the nasopharynx ( for example, rhinitis), due to inflammation upper teeth, as well as due to trauma to the nasal septum. *Symptoms of sinusitis are:* mucous discharge from the nose; pain in the nasal area, radiating ( giving) in the gums, eye sockets, forehead; severe headaches; loss of appetite; coughing attacks; labored breathing; a feeling of strong pressure in the bridge of the nose, which increases when the head is tilted; chills; sleep disturbance; general malaise, lethargy, weakness; increased fatigue.

Why does my jaw and temples hurt?

Simultaneous pain in the jaw and in the temporal region is most often caused by damage to the temporomandibular joint due to various diseases or injuries.

The temporomandibular joint is a paired joint. It is formed by the mandibular fossa of the temporal bone and the head of the mandibular bone. In humans, these are the only joints that perform their work simultaneously. Thanks to the coordinated actions of the temporomandibular joints, movements of the lower jaw are carried out ( from side to side, as well as forward and backward).

The joint capsule contains a large number of nerve receptors, which is why minor violation its function negatively affects the overall well-being of a person. Wherein common symptom is pain in the jaw and temples.

Temporomandibular joint dysfunction is a disease in which the joint itself suffers due to underdevelopment of the upper or lower jaw and malocclusion. According to studies, about eighty percent of patients suffer from this disease.

During the formation of a malocclusion, an incorrect position of the lower jaw occurs, which, in turn, causes pathology in the joint. In this case, the disease can occur with severe symptoms or asymptomatic.

Symptoms of temporomandibular joint dysfunction are:

unusual sound ( crunch) in the joint area when opening or closing the mouth;
limitation of the amplitude of mouth opening;
difficulty swallowing;
headache;
pain, noise and ringing in the ears;
pain and pressure in the eye area;
neck and back pain;
pain in the temporal region when chewing, during yawning, when opening the mouth wide;
change in bite;
grinding of teeth;

Pain in the temporomandibular joint can be acute or chronic. Most common cause causing acute temporary pain are acute effusions - accumulation of fluid ( e.g. saliva, blood) inside the temporomandibular joint. They can appear if you keep your mouth wide open for a long time ( for example, when visiting the dentist).

Pain in the jaw and temples that appear regularly and for no apparent reason may indicate pathological changes in the temporomandibular joint, for example, with arthrosis that has developed as a result of the absence of supporting lateral teeth. In this case, the entire chewing load is transferred to the head of the mandibular joint, which, under the influence of the masticatory muscles, is displaced into the glenoid cavity. Excessive stress placed on the joint eventually leads to joint degeneration.

Also, pain in the temporomandibular joint can be caused by the following diseases and pathological processes:

inflammatory diseases of the ear ( for example, otitis media);
trauma to the maxillofacial bones;
osteomyelitis of the upper jaw;
trigeminal neuralgia;
arteritis of the facial artery.

Most often for pain in jaw joints and temples are mistakenly diagnosed with trigeminal neuralgia and atypical facial pain. However, clinical instrumental diagnostics and careful questioning of the patient about the nature of the pain experienced make it possible to diagnose temporomandibular joint pain, separating it from other causes of pain in the facial area.