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It breaks the jaw of the cause than to treat. Why can the jaw hurt on the right side? Causes of radiating pain

It breaks the jaw of the cause than to treat. Why can the jaw hurt on the right side? Causes of radiating pain

Jaw pain is a fairly common and multidisciplinary problem. This article will talk about possible reasons why the lower jaw hurts on the right side, and about some possible ways treatment.

Anatomy

The jaws and some other structures are part of the chewing apparatus, which is a system of organs and tissues of the oral cavity. It includes the following elements:

apparatus skeleton;
jaw joint;
glands that produce enzymes that carry out the primary biochemical processing of food;
chewing muscles;
structures of blood supply and innervation of the facial part of the skull.

The maxillary bone, unlike the lower one, is immobile. It consists of paired bones that take on the load from the movable lower jaw. Bone columns significantly reduce pressure.

Important! Bones consist of bodies and processes. The body contains an air cavity - maxillary sinus.

At the upper edge of the facial surface of the maxillary bone is the lower orbital opening, where the vessels and nerves pass. On the back surface there is a maxillary tubercle penetrated by nerves and vessels.

The lower jaw is the lower movable part of the face. During intrauterine development, it consists of two parts, which are fused before birth. The mandibular bone consists of a body and branches that end in processes. The branches with the body form an angle, on the inside of which there are roughnesses for attaching the internal pterygoid muscle, and on the outside - for the chewing muscle. The anterior coronary process serves as the site of attachment of the temporal muscle, and the posterior articular process ends with a head for articulation with the temporal bone. The lower bundle of the external pterygoid muscle is attached to the pterygoid fossa on the neck of the head. The processes form the mandibular notch. Through the mental hole, located at the level of the second small molar, the mental vessels and nerves pass. In the middle of the mandibular bone on the inside is a protrusion to which the muscles are attached. Going obliquely along the inner side of the mandibular bone, the jaw line serves as the site of attachment of the jaw-hyoid muscle.

The common carotid artery in the region of the carotid triangle divides into the external and internal carotid arteries. External is involved in the blood supply to the structures of the oral cavity.

By the way. The external artery is divided into branches: maxillary and temporal.

The arteries supplying the teeth enter (loose connective tissue filling the tooth cavity).

Innervation involves secretory, sensory and motor fibers. The jaw part of the facial skeleton is innervated by cranial nerves.

Trigeminal. Mixed (sensory and motor fibers). Carries out innervation of the anterior cerebral regions; mucous membrane and glands located in the oral cavity; facial skin.
Facial. motor fibers. It innervates the muscles involved in facial expressions and some muscle structures of the floor of the mouth. Branches of the intermediate nerve, which connects to the facies inside the temporal bone.
Glossopharyngeal. It consists of taste fibers from the back of the tongue. The area of this cranial nerve: the mucous membrane of the palatine arches, parotid glands and the posterior third of the tongue.
Vagus. Forms branches that connect with branches of the glossopharyngeal and facial cranial nerves.
Sublingual. Innervates own and skeletal muscles of the tongue.

The innervation of the dental structures is carried out by the branches of the autonomic nodes and the trigeminal nerve.

Etiopathogenesis and topography of pain in the jaw area

Pain in the jaw area unilateral or bilateral (bilateral); can be local or irradiating (giving away). Most often, the pain is localized on the right side. It can occur for a variety of reasons. These include the following.

gum disease

Lead to pain in the gums. May be the result of using a too hard toothbrush, improper oral hygiene, which contributes to the development of pathogenic microflora; exposure to external factors that increase the risk of penetration of microorganisms that cause inflammation.

Important! The above refers to dental problems and is solved by going to the dentist.

However, gum pain is sometimes associated with non-dental disorders, for example, with the gastrointestinal tract, with a reaction to an allergen, with endocrine and hematological pathologies. Pain is also caused by inflammatory diseases - gingivitis (dentogingival attachment is disturbed) and a more serious pathology - periodontitis (the gums and the bone part of the jaw skeleton and ligamentous apparatus are involved in the inflammatory process).

Pathology of the TMJ is the result of myological, spatial and occlusive disorders. The coordinated action of the structures that set the jaw in motion is disrupted. Temporal, headache and neck pains are accompanied by clicks, bruxism (gnashing of teeth), tinnitus, violation of the act of swallowing and snoring. The etiology of the disorder is not fully known. There are several theories regarding this.

The articulatory-occlusive theory connects the occurrence of pathology with injuries and malocclusion, pathologies of the dentition, etc.

According to the myogenic theory, such a problem is the result of an excess of mechanical load on the masticatory muscles and tonic spasm.

Interesting! According to the psychogenic theory, neuropsychiatric causes are considered as etiological factors, which then lead to the kinetic, physiological and structural changes described above.

Most experts identify a triad of factors that lead to dysfunction: tonic changes in masticatory muscles, syntopy of joint elements and occlusion (contact of the teeth of the upper and lower rows). With this pathology, first of all, it is necessary to contact a neurologist and a dentist. You should also be examined by a rheumatologist, otorhinolaryngologist, therapist and other specialists, depending on the specifics of the dysfunction. Ignoring is fraught with arthrosis and ankylosis (immobilization in the joint). The therapy is complex. Non-steroidal anti-inflammatory drugs and sedatives are used to relieve pain. They make blockades. In some cases, physiotherapy, psychotherapy, orthodontic and orthopedic interventions are indicated.

Inflammation and purulent processes of the paranasal sinuses, in this case the maxillary sinus. A dull pain appears, aggravated by pressing the cheek ipsilaterally (on the side) of the lesion. The sinus is close to the lacrimal duct. Therefore, sinusitis is accompanied by swelling of the eyelid and pain in the eye area. The temperature has risen. There are general symptoms of malaise. The sense of smell is broken. The symptoms are worse at night.

With a unilateral process, the pain is also unilateral and is given to the ear and neck. Sinusitis is provoked by infectious otorhinolaryngological pathologies.

Important! It is easy to diagnose sinusitis based on anamnesis, however, instrumental diagnostic methods are used to accurately localize the problem: radiography and CT.

For local therapy, drugs are prescribed that improve the outflow from the mucous membrane: vasoconstrictor. Apply inhalation. Antihistamines and antibiotics are used for systemic therapy. The nose is washed with antiseptics. At the risk of complications, invasive methods are used: puncture. The cuckoo method is the infusion into one nostril of the drug and pumping out of the other nostril using a vacuum device that creates negative pressure.

Inflammation of the tonsils (accumulations of lymphatic tissue on the back of the mouth). This inflammatory disease is typical for children from five to fifteen years. Acute tonsillitis is accompanied by fever and sore throat. It can be complicated by rheumatological diseases if the causative agent is group A hemolytic streptococcus. Development of a peritonsillar abscess is possible.

The clinical picture of chronic tonsillitis is characterized by a sluggish course. Some cases are treated with tonsillectomy. Symptoms: swollen jaw and neck lymph nodes, fever, sore throat, headaches, white spots on the tonsils, discomfort (itching and tingling). Children may experience abdominal pain, vomiting, and nausea. With tonsillitis and other inflammatory processes in the otorhinolaryngological organs (pharyngitis), the cause of pain in the jaw is submandibular lymphadenitis.

Important! Diagnosis is carried out by laboratory, bacteriological and anamnestic methods.

Lymphadenitis must be differentiated from metastases of malignant tumors, osteomyelitis, periodontitis (inflammation of the connective tissue that is located between the cementum of the tooth root and the plate). As a treatment for lymphadenitis itself, local anti-inflammatory drugs are first used in the form of ointments, general restorative therapy. In advanced cases, antibiotics are prescribed. It is necessary to eliminate the primary cause of submandibular lymphadenitis.

Neuralgia

Damage to the peripheral nerves, which manifests itself in the form of acute, sharp attacks of pain in the zone of innervation of the affected nerve. With neuralgia of the trigeminal nerve, pain of a cutting nature occurs briefly on one half of the face. The sensitive fibers of the trigeminal nerve are affected, however, during an attack (this pathology is paroxysmal in nature), pain may be accompanied by involuntary contractions of the facial muscles. Most often, the second and third branches of the trigeminal nerve are damaged, so intense sensations are noted in the lips, cheeks, gums and chin.

The symptom occurs in the eye area.

Important! Attacks can occur at any time of the day and often recur. The exact etiology is unknown.

In younger patients, there is a plaque of demyelination of the nerve (myelin is an electrically insulating sheath of nerve fibers). Rarely, the cause of neuralgia is a tumor and shingles (a herpes disease, postherpetic neuralgia). Pharmacological treatment mainly consists in the use of carbamazepine. If drug treatment is ineffective, radiofrequency selective rhizotomy is performed (the fibers that are proximal to the trigeminal node and responsible for attacks are destroyed with an electrode) or glycerin is injected into the trigeminal cavity (the space between the sheets of the hard meningeal membrane in the area of the trigeminal depression of the temporal bone).

Relapse occurs in 30% of cases. Side effect- numbness of the face. Other complications are rare. With neuralgia of the glossopharyngeal nerve, pain is sudden, unilateral, aggravated by pressing trigger points, occurs when swallowing and radiates to the TMJ. It should be differentiated from pulpitis and periodontitis. Localization of pain sensations: lower jaw, pharynx, larynx, tonsils, ear, root of the tongue. Treatment is with carbamazepine (an antiepileptic drug). Less common is trigeminal neuralgia. Damage to the facial nerve is usually associated with trauma. The pain is unilateral. One form is Bell's palsy. Difficulty eating, closing the eyelids and speech.

Inflammatory lesion of large and medium vessels of elastic and replaceable types. Inflammation is initiated in the adventitia (outer connective tissue sheath) and extends to the entire vascular wall. Segmental narrowing of the lumen is characteristic. The carotid arteries (including temporal and orbital) are most often affected. With inflammation of the temporal - temporal arteritis. There is pain in the jaw, face and tongue, accompanied by swelling and local redness. Reduced blood flow in the temporal artery. As a result, atrophic processes in the temporal and lingual muscles are possible. Unilateral headaches are noted. In a relatively small percentage of patients, pain extends to the structures of the visual analyzer.

Diagnosis is carried out by laboratory methods and biopsy. Giant cells (clumps of immune cells) are found histologically. Treatment is with glucocorticoids.

Arthritis TMJ

Inflammatory diseases of the joints, which are accompanied by exudation into the joint cavity. Pain is usually local and sharp, radiating to the ear and temple, in the acute phase is accompanied by redness, swelling, temperature and limitation of movement in the joint. It is diagnosed on the basis of anamnesis, physical examination (palpation), radiography and CT. Treatment is with non-steroidal anti-inflammatory drugs, corticosteroids (intra-articular injections), chondroprotectors and physiotherapy.

It is classified into posterior, anterior and chronic. It is characterized by speech disorders, inability to fully close the teeth, displacement of the chin, pain in the parotid region. With complications, bleeding, swelling of the periarticular tissues, fractures of the mandibular and temporal bones, and bruising are possible.

Diagnosis is by inspection and palpation. X-rays and CT scans are also taken.

Important! The reduction of the dislocation is carried out under anesthesia by an experienced maxillofacial surgeon or orthopedic dentist.

The risk of developing a re-dislocation is significantly reduced if the reduction was carried out in a timely manner, professionally, and if the time allotted for immobilization was not violated.

Angina. myocardial infarction

Pain in the lower jaw on the right may be the result of irradiation of pain due to ischemic myocardial disorders.

Tetanus

Tetanus bacillus enters the body through a cut or wound and spreads within three days. Up to three days, the following early symptoms may develop: headache, difficulty swallowing and stiffness in the jaw and neck areas - jaw trismus. In this case, you need to urgently seek help. Immunoglobulins and tetanus toxoid will be injected into the body. Fortunately, the above symptoms are considered an early manifestation of tetanus, so the prognosis is favorable with timely admission to the hospital.

A rare disease in which a headache is accompanied by redness of the ear. The triggers can be neck movements, chewing and swallowing movements, touching the ear, warmth, sneezing. Etiology: TMJ dislocation, migraine, thalamus syndrome (thrombosis of the thalamo-genicular artery), cervical spondylosis (involution of the anatomical structures of the spine).

Important! May occur without previous structural changes.

Epidermal cyst (atheroma) of the jaw area

A bump is found. Palpation compaction is mobile. To prevent pain symptoms and suppuration, cysts are removed surgically. A lump behind the ear may be the result of otitis media. Therefore, you should be examined by an otorhinolaryngologist for differential diagnosis.

malignant tumor

Innovation comes from bone tissue and odontogenic apparatus. Manifested by pain, deformity of the facial skull, impaired swallowing and TMJ function. They can grow into the sinuses and orbit. For diagnosis, instrumental methods are used: radiography, scintigraphy (functional imaging with radioactive isotopes). They require combined treatment - surgical, radiation.

Since the causes of unilateral pain in the lower jaw are diverse, it is not recommended to eliminate the symptom on your own. Even within the same pathology, consultation with professionals in several areas is necessary. Prevention of this unpleasant sensation is difficult for the same reason. However, compliance with oral hygiene rules, avoiding the frequent use of chewing gum (increases the load on the muscles), preventive examination, refusal of self-treatment and timely contacting a professional significantly reduce the risk of an undesirable prognosis.

Summing up

Pain in the lower jaw on the right side can be caused by various factors. One way or another, if such a symptom occurs, you should immediately consult a doctor so that he can prescribe the necessary treatment.

Video - Jaw restoration

Jaw pain is a common phenomenon that has already been experienced by millions of people around the world. For medical professionals, such pain often becomes a real challenge when it comes to prompt diagnosis and choosing the right therapeutic approach.

Since jaw pain can be caused by a number of different causes, proper diagnosis is extremely important. Doctors need to identify the exact cause, because only in this way can they offer the best solution to reduce or completely eliminate pain.

There are several reasons that can lead to jaw pain. Discomfort in this area of the face can be caused by physical injury, nerve problems, and blood vessel disease.

The most common reason people seek medical attention for jaw pain is temporomandibular joint (TMJ) dysfunction. This condition at one time or another period of life affects about 12% of the world's population. About 5% of such people turn to doctors because the pain becomes very acute and interferes with daily life activities. Most often, dysfunction of the temporomandibular joint is observed in women of childbearing age.

This disease may be associated with a malfunction not only of the joint itself, but also of the muscles responsible for the movement of the jaw. This muscle group is called the chewing muscles.

Other known causes of jaw pain include the following conditions.

Clenching, grinding of teeth, and opening the mouth too wide. In most cases, grinding and clenching of teeth occurs during sleep. Sometimes this leads to damage to the teeth and pain in the jaw. People often experience this phenomenon when they experience severe emotional stress.
Osteomyelitis. This is a condition in which an infection in the body affects the bones and related tissues.
Arthritis. Arthritis conditions, such as osteoarthritis and osteoarthritis, cause the surface of the bones to wear out.
Synovitis or capsulitis. In these conditions, the synovium or joint capsule becomes inflamed.
dental conditions. These may include gum disease, missing teeth, damaged teeth, or abscesses.
Sinus problems. They affect the nasal cavities.
Tension-type headaches. Tension headaches are usually the result of stress and can lead to facial pain.
neuropathic pain. It occurs when nerves become damaged and send pain signals to the brain. This type of pain can be continuous or appear from time to time.
Vascular pain. This type of pain occurs when the blood supply to one of the body parts is interrupted. Vascular pain can be caused by diseases such as giant cell arteritis and carotid artery dissection.
neurovascular pain. This type of pain is caused by conditions that affect both the nervous and cardiovascular systems. Migraines and cluster headaches are examples of such conditions.

In addition, rheumatoid arthritis, hypothyroidism, Lyme disease, multiple sclerosis, lupus, fibromyalgia, and several other conditions can lead to jaw pain.

Note!
Jaw pain can also be caused by lifestyle factors. These factors include, for example, emotional stress, sleep problems, poor or inadequate nutrition, and fatigue.

What are the symptoms of jaw pain?

Jaw pain may be accompanied by toothache, earache, trismus, or swelling of the face

Associated symptoms depend on the individual case. These symptoms may include:

pain in the face, which increases with movement of the jaw;
sensitivity of muscles and joints;
limited movement;
difficulty aligning the jaw;
clicking sounds when opening and closing the jaw;
tinnitus;
ear pain;
headache with or without earache and with pressure behind the eyes;
dizziness;
lockjaw;
dull pain, turning into sharp and piercing;
toothache;
tension headache;
nervous types of pain, such as burning;
fever;
swelling of the face.

Other symptoms may occur, which usually depend on the underlying cause of the pain.

Important!
If acute pain in the jaw is detected, a person needs to see a doctor as soon as possible, who will help determine the cause of the ailment and develop the necessary treatment plan. If everything is done as quickly as possible, then the risk of developing long-term complications will be minimized. Jaw pain can be assessed by dentists, oral surgeons and therapists.

What are the complications of jaw pain?

Possible complications depend on the causes and other factors associated with pain. In particular, the consequences are significantly influenced provides the right choice of therapeutic method. To the number possible complications for jaw pain include:

dental complications;
surgical complications;
infections;
chronic pain;
emotional stress;
change in eating habits.

How is jaw pain diagnosed?

In order for the doctor to make a correct diagnosis and quickly begin to treat jaw pain, he first needs to carry out several diagnostic procedures.

Analyzes and examinations will help the doctor learn more about the cause of the pain. These include:

examination of the patient, during which the work of the nervous system will be assessed, as well as the condition of the cervical vertebrae, jaw, mouth and muscles;
a detailed study of the history of diseases, in particular the conditions that cause pain;
certain laboratory tests, such as an erythrocyte sedimentation rate test. This analysis is widely used in the diagnosis of conditions associated with pain;
certain radiographic imaging modalities, such as x-rays or magnetic resonance imaging;
psychological and psychiatric checks.

Other diagnostic procedures may be needed if the doctor suspects that jaw pain is caused by special cases.

How is jaw pain treated?

If the cause of the pain in the jaw is an infection, the doctor will prescribe antibiotics to the patient.

Treatment for jaw pain depends on the cause of the pain. Therapeutic methods vary from case to case and may include the following:

taking antibiotics if the pain is caused by infections;
surgery to remove a damaged bone, treat an affected nerve
or identifying unknown problems;
use of mouth protection devices, such as mouth guards;
physiotherapy;
muscle relaxants or tranquilizers to relax the affected muscles;
antidepressants, which sometimes help treat painful conditions;
topical capsaicin, which helps in the treatment of certain diseases of the nervous system;
steroid injections to reduce inflammation or swelling;
antiviral therapy for treatment viral infections such as herpes zoster;
painkillers;
oxygen therapy and some prescription drugs for cluster pain;
some blood pressure remedies for migraines;
root canal therapy - a procedure that involves the treatment of infections in the teeth;
extraction of teeth in the event that the cause of pain is an abnormal or infected tooth;
a cooling spray to relieve painful areas in the muscles called trigger points;
local anesthetic injections;
relaxation therapy;
stretching and relaxing the affected muscles;
soft food to ensure moderate work of the affected jaw;
applying warm compresses or cold therapy;
massage and acupuncture;
correct posture to avoid straining the neck or back.

Other treatments for jaw pain are available. All of them are determined by the causes that cause pain. Physicians can discuss the optimal therapeutic approach with each individual, depending on the individual situation.

Prevention of jaw pain

Knowledge of provoking factors is the most important moment in the prevention of any type of pain.

Besides, To prevent jaw pain, do the following:

avoid solid foods and chewing gums;
do not bite fingernails or other hard objects;
Eating soft or liquid foods such as pasta or soups
eat in small pieces or portions;
give up caffeine;
practice massages, meditation, aerobics;
take calcium and magnesium supplements if needed;
avoid yawning;
sleep on your side or back, avoid sleeping on your stomach;
avoid grinding teeth;
avoid carrying bags on your shoulders for a long time, often change shoulders when carrying bags;
monitor posture;
visit the dentist regularly.

People should always discuss preventive measures with their doctor to evaluate their safety and effectiveness in their case.

When should you see a doctor for jaw pain?

A person should seek medical attention if, while treating jaw pain, they find the following:

home therapies do not help relieve pain;
jaw pain interferes with daily life activities;
impaired jaw movement;
when moving, the jaw joint makes sounds;
neck or upper back pain;
hurts behind the eyes;
headache;
tinnitus;
dental problems, such as worn or broken teeth.

People should talk to a dentist or therapist about jaw pain in order to diagnose the cause and begin treatment as soon as possible.

It is quite difficult for a person who is far from medicine to determine the problem that has arisen, therefore it is recommended to seek help from a doctor. Only he, according to the localization of pain and symptoms, will be able to make the correct diagnosis.

Whenon the left, we can talk about the presence of one of the following diseases:

disease of the parotid salivary glands;
pathology of the maxillary sinuses;
the wisdom tooth is hard to climb;
various inflammations of the maxillo-dental apparatus;
jaw injury: dislocation, bruise, fracture;
inflammation of the lymph nodes;
various purulent-inflammatory diseases: abscesses, osteomyelitis, phlegmon;
pathological processes in the temporomandibular joint: arthritis, dysfunction, arthrosis;
pain syndrome, maybe when wearing prostheses;
malocclusion;
with benign and malignant tumors;
neuralgia;
pain is present even with angina pectoris and myocardial infarction.

What to do if the jaw hurts for a long time?

If the pain haunts you for quite a long time and becomes more intense and other signs are added to this:

Teeth began to fall out.
Facial asymmetry appeared.
Serious problems began with chewing and swallowing food.

Urgently contact the clinic, such symptoms indicate the development of very serious diseases. The most dangerous of them is the tumor process.

Types of pain

Depending on the cause that caused it, it can be different:

With a fracture and dislocation - sharp, cutting.
With minor injuries - aching, tolerable.
Purulent inflammations are characterized by twitching pain.
- burning, sharp.
There is a tumor process - intense, growing.
The progression of pulpitis, etc. - gives radiating pain.
With degenerative lesions of the joints, it occurs - aching, paroxysmal.
Arthritis - chronic, nocturnal.
The facial artery is inflamed - paroxysmal, constant.
Inflammation of the maxillary sinuses - acute.
Wisdom tooth - pulsating, etc.

Aching

This is a special kind of pain, which does not torment us as much as acute, for example. But you can't forget about it even at night. With its constancy, it torments a person even more.

There can be many reasons:

due to the tumor, increases as the tumor grows;
arotidinia is a type of migraine;
trigeminal neuritis;
corotidynia;
dental problems, etc.

Crunch

Possible with:

incorrectly fixed: crowns, bridges, prostheses;
consequence of development: reactive arthritis, arthrosis.
diseases of the temporomandibular joint;
injuries, falls, severe bruises;
malocclusion;
developing rheumatism;
decrease in the volume of intra-articular fluid (after surgery);
congenital anomaly;
weakening of the ligamentous apparatus.

How to treat?

Your actions will depend on:

If it is traumatic, gradually increases, the mouth does not open, it is necessary to consult a doctor for help. Because most likely there is a dislocation, or even a fracture of the bones. If there was a slight bruise and there is no swelling or bruising, and the pain does not increase, then ice can simply be applied to the site of the bruise.
Inflammation, or purulent formation- Possibly polio. If the temperature reaches 40 and there is swelling on the left side, call an ambulance. These symptoms are also characteristic of paratonsillar abscess. This is a consequence of severe angina. Call a doctor immediately, otherwise the process will worsen.
If the pain is boring and very sharp Looks like trigeminal neuralgia. You should be examined by a neurologist.
If jaw pain is persistent, may indicate - tumor formation. And as the tumor grows, the pain will only increase.
Sometimes strong painful sensations deliver braces. If the jaw hurts the first time - this is normal. But if you are in a lot of pain, or it drags on for too long, contact.
Arteritis of the facial artery- causes severe pain, you should consult a doctor. It is treated with anti-inflammatory drugs.
Jaw pain manifests itself with otitis media- it is caused by pathogenic microflora, it occurs suddenly: sharp, shooting, behind-the-ear lymph nodes increase, hearing decreases. Prescribes appropriate treatment - otolaryngologist.
An attack of angina pectoris- localized at first behind the sternum, then goes over the front.

Ways

Treatment options will depend on the underlying cause of these pains. To eliminate it, first of all, it is necessary to examine the patient. Carry out X-ray studies, urine and blood tests.

If necessary, a CT or MRI will be performed. You will also need a neurologist.

Ways:

With severe injury- prescribe a cold compress, painkillers.
At- operative intervention is indicated.
If jaw dislocation- a traumatologist or dentist will set it, make a fixing bandage.
Purulent diseases- treated in a hospital, surgical interventions and massive antibiotic therapy are used.
Cure carotidinia- provides for any painkillers and antidepressants.
Abscesses- open surgically and remove the purulent contents, prescribe antibiotics and painkillers.
If the pain was caused by myocardial infarction, then the treatment is carried out in a hospital: thrombolytics: alteplase, streptokinase; anticoagulants; antiplatelet agents; beta-blockers; normalize pressure; relieve pain with narcotic analgesics.
Pain of odontogenic origin- require, it is necessary to treat the existing: pulpitis,

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

Anatomy of the temporomandibular joint, groups of perimaxillary 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:

body;
four surfaces ( anterior, posterior temporal, orbital, nasal);
four shoots ( frontal, zygomatic, palatine, alveolar).

There are eight cells on the alveolar processes ( alveoli) for the occurrence of eight teeth on each side ( only sixteen teeth).

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

The lower jaw consists of:

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

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

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

The lower jaw is involved 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. By its structure, this is one of the most complex joints.

The temporomandibular joint is located at the point of articulation of the lower jaw and the temporal bone of the skull. Every time a person chews, the temporomandibular joint moves, as does swallowing and speaking. Thus, it is one of the most mobile and constantly used joints in the body.

The temporomandibular joint consists of:

articular tubercle of the 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.

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

vertical ( lower jaw goes down and up);
sagittal ( movement of the lower jaw forward and backward);
frontal ( movement of the lower jaw to the side, right and left).

The articular tubercle forms the anterior wall of the articular fossa. 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 orthognathic bite ( when the upper teeth overlap the lower ones) a tubercle of medium size, and with a curve - flat.

It should be noted that when the temporomandibular joint ceases to function in a normal way, this is reflected in all aspects Everyday life person 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. They form lymphocytes.

Lymph nodes are located in the path of lymph flow. The vessels through which the lymph goes to the node are called bringing, and through which it leaves - taking out.

Colloidal solutions of proteins, the remains of destroyed cells, bacteria, and lymphocytes enter the lymphatic vessels from the tissues. Through the afferent vessels, they reach the lymph nodes, foreign particles linger in them, and the purified lymph and lymphocytes exit through the efferent vessels.

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

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

Consider the groups of lymph nodes that are affected when the jaw and temporomandibular joint are disturbed ( 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; chin knots; facial nodes.
*Lymph nodes in the neck*	They are divided into anterior and lateral, as well as superficial and deep lymph nodes.	anterior superficial lymph nodes are adjacent to the anterior jugular vein; anterior deep lymph nodes are located near the organs and have the same name with them ( e.g. lingual, laryngeal, tracheal); lateral deep lymph nodes include supraclavicular, pharyngeal, 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 the 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, acute temporary pain in the jaw joint is caused by acute effusions that appear if a person has kept his mouth open for a long time, for example, when visiting a dentist. When a jaw joint effusion occurs, fluid or blood collects inside the joint. So, for example, the day after a visit to the doctor, a person may have a feeling that the teeth do not fit well on top of each other or pain appears when opening the mouth.

Usually, to eliminate this kind of pain, the imposition of a cold compress and the creation of a gentle load on the temporomandibular joint for several days effectively help, that is, it is necessary to refuse chewing gum and dishes that require intensive chewing. You also need to carefully open and close your mouth ( e.g. coughing, yawning).

Chronic pain that occurs regularly and for no 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 this place, then the chewing load is transferred not to the teeth, but to the bone. Chewing muscles, in turn, begin to squeeze the head of the temporomandibular joint into the articular cavity. This leads to the fact that the joint is too much stress and the person develops chronic pain.

Each person reacts differently to overload of the jaw joint. For most people in these situations, over the course of many years, the restructuring of the joint passes, and the joint gradually degenerates.

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

Most often, with pain in the jaw joint, atypical facial pain and trigeminal neuralgia are misdiagnosed.

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

Why does the temporomandibular joint click when opened?

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

Also, one of the causes of clicks of the temporomandibular joint in children is the growth of lymphoid tissue in the form of palatine tonsils or adenoids. Normally, a person breathes through the nose, and the 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 arch 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 oral breathing, nothing resists the pressure of the cheeks. As a result, there is an imbalance, which ultimately leads to deformation and narrowing of the upper jaw, which acquires a horseshoe or V-shape.

It also interferes with swallowing. When swallowed, the tongue rests on the lateral teeth, preventing their normal eruption ( lateral tongue laying). The constantly open mouth, in turn, leads to the protrusion of the lower incisors ( anterior teeth) up. As a result, there is a deformation of the lower dentition with shortened crowns of premolars ( small molars) and painters ( large molars), as well as advanced lower incisors and canines ( cone teeth). There is a distal step, 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 ( way down). Betrothed upper jaw displaces the lower posteriorly, while the articular head also moves distally, and the articular disc, in turn, moves forward. When the mouth is opened, the disc can move to the articular head, restoring its normal position, and when closed, it can return to the front position again, resulting in a reciprocal click.

It should be noted that a distally displaced mandible and tongue cause an 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.

Clicks when opening the mouth can also be observed with the wrong position of the 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 bite height decreases. In the future, there is a deformation in the joint area, damage or overstretching of the ligamentous apparatus. As a result, the articular disc can become stuck in front of the articular head and cause a click to form when it returns to its original position.

Causes of inflammation of the temporomandibular joint

There are the following reasons for the development of pain in the jaw and temporomandibular joint:

bruised jaw;
dislocation of the lower jaw;
dysfunction of the temporomandibular joint;
arthritis of the temporomandibular joint;
furuncle and carbuncle;
dental diseases;
temporal arteritis;
neuralgia;
erythrootalgia ( red ear syndrome);
alveolitis;
jaw swelling.

Jaw contusion

Jaw contusion is a common injury that is characterized by a violation of soft tissues without damage to the bone and violation of the integrity of the skin.

Causes of a bruised jaw can be:

blow to the face;
fall on the face.

With a bruised jaw, the following symptoms are observed:

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

Dislocation of the lower jaw

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

Dislocation of the mandible can be unilateral ( dislocation of one joint) and two-sided ( dislocation of two joints).

The causes of dislocation of the lower jaw can be:

blow to the jaw area;
opening the mouth wide, such as 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 the elderly, which is most often associated with anatomical features. given age. There is a weakening of the ligaments, as a result of which the person tries to open his mouth wide.

Symptoms of a dislocation of the temporomandibular joint 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 somewhat pushed forward, skewed.

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

jaw fracture

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

There are the following types of jaw fracture:

complete fracture with displacement of fragments of the jaw;
incomplete fracture without displacement ( e.g. a crack in a bone).

A complete fracture of the jaw, in turn, can be open ( with skin lesions) or closed ( without skin damage).

Symptoms of a jaw fracture are:

severe pain in the fracture area;
inability to open mouth especially in fractures of the mandible);
tissue swelling;
bruising ( 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 that cause an 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 as follows:

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

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

crunch in the joint area;
pain in the joint, head, neck and back;
irradiation of painful sensations in the teeth, ears and eyes;
movement disorders in the joint for example, a person cannot open their mouth wide, difficulty chewing food);
grinding of teeth;
sleep apnea ( cessation of breathing during sleep).

Arthritis of the temporomandibular joint

Arthritis of the temporomandibular joint 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 external factors, for example, due to mechanical injury or under the influence of 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;
chewing dysfunction;
speech disorder;
hearing loss.

Osteomyelitis

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

The reason for the development of osteomyelitis is the ingress of pathogenic microorganisms into the bone tissue of the jaw.

The penetration of infection into the bone can occur in the following ways:

odontogenic - through the teeth ( for example, with advanced caries, pulpitis, alveolitis);
hematogenous - through the blood ( e.g., furuncle or carbuncle of the maxillofacial region, 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 ( defeat of one or more teeth, in the zone of the alveolar process);
diffuse ( damage to one or two parts of the jaw).

Symptoms of osteomyelitis include:

increase in 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 the gum, there is a release of purulent contents;
dysfunction of the jaw speech change, difficulty swallowing);
decreased sensitivity of the lower lip and skin of the chin ( with osteomyelitis of the mandible);
enlargement and soreness of regional lymph nodes.

Furuncle and carbuncle

Furuncle is a purulent inflammation of the hair follicle and sebaceous gland. Its size can be from a pea to a walnut.

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

Most often, furuncle and carbuncle are formed in the face and neck, since the skin in these areas is most susceptible to contamination and microtrauma.

The reasons for the formation of a boil or carbuncle are:

violation of the integrity of the skin ( e.g. cuts, scratches, scratching of the skin due to itching);
violation of hygiene;
frequent colds;
infectious and inflammatory processes in the ear, nose, maxillary paranasal sinuses ( e.g. 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 area of the skin;
infiltration ( accumulation of cellular elements, blood and lymph in the tissue) and edema;
purulent plugs are visible, from which a purulent bloody liquid is released;
e.g. weakness, loss of appetite, malaise).

Dental diseases

Jaw pain can occur due to the following dental diseases:

caries ( pathological process in which the destruction of enamel and hard tooth tissue is observed);
pulpitis ( dental pulp injury);
periodontitis ( damage to the periodontium - the tissue located between the tooth and the alveolar process);
periodontal abscess ( purulent-inflammatory lesion of the periodontium);
tooth 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. Painful sensations are pulsating in nature and increase at night.

Temporal arteritis

Temporal arteritis is an autoimmune disease in which cells of the body damage the vascular wall of the temporal artery, which subsequently leads to the development of an inflammatory process and subsequent destruction of the vessel ( with this disease, vessels of large and medium sizes are affected).

The existing inflammation in the vessel leads to thinning of its wall. In some cases, this may contribute to the formation of pathological expansion 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 ( can give to the jaw, neck, tongue and shoulder);
increase in 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;
with damage to the ophthalmic artery, visual impairment, pain and double vision, as well as drooping of the eyelid are observed.

neuralgia

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

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

Trigeminal neuralgia. Nerve that innervates the face and mouth. It divides into three branches, the upper is the ophthalmic nerve, the middle is the maxillary, and the lower is the mandibular. When the middle and lower branches of the nerve are affected, a person experiences severe pain in the region of the upper or lower jaw. Painful sensations occur, as a rule, at night and are of a burning nature. An attack of pain can also occur even with a minor irritant, such as a draft, hot or cold food. Before the onset of a painful attack, a person may experience itching of the skin or a feeling of crawling on the skin.
Neuralgia of the ear. A disease characterized by damage to the ear vegetative ganglion. Its development is usually associated with the presence of infectious and inflammatory processes in the area of the ear node ( e.g., suppurative otitis media, mumps, sinusitis, periodontitis). When the ganglion is affected, a person develops pains of a burning or pulsating nature. Painful sensations can be given to the region of the lower jaw, neck, neck, and shoulders.
Glossopharyngeal neuralgia. This nerve is mixed. It innervates the muscle that lifts the pharynx and parotid gland, and also provides sensitivity to the posterior third of the tongue ( taste sensitivity). For some diseases ( e.g. brain tumor, inflammatory diseases, carotid aneurysm) the work of the glossopharyngeal nerve may be disturbed. In this case, a person will experience pain in the throat, lower jaw and ear.
Neuralgia of the superior laryngeal nerve. With the defeat of this nerve, the patient has severe pain of a pulsating nature. Painful sensations are localized in the region of the larynx and lower jaw ( pain is given to the ear, eyes, temporal region). Often, during a painful attack, a person has a cough and dry mouth, and after it ends, on the contrary, there is profuse salivation.

Erythrootalgia ( 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 the local temperature of the auricle can also be observed ( 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 there is inflammation of the alveolar process. As a rule, the cause of its development is improper tooth extraction and the entry of pathological bacteria into the hole.

Symptoms of alveolitis are:

increasing pain at the site of tooth extraction a few days after the procedure;
severe pain radiating ( bestowing) in the jaw and face;
putrid odor from the mouth;
redness and swelling in the affected area;
increased separation of saliva;
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 reason for the development 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 entry of pathological agents into the tissues of the tongue:

violation of the integrity of the tissue of the tongue;
the use of spicy, as well as very hot food and drinks;
violation of oral hygiene;
decrease in body resistance;
oral dysbiosis.

The symptoms of glossitis are:

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

Sinusitis

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

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

The infection can enter the sinus in the following ways:

hematogenous ( through the blood);
nasal ( due to 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;
observed mucous or purulent discharge from the nose;
headache;
increase in body temperature;
signs of intoxication of the body ( weakness, malaise, sleep disturbance, loss of appetite).

Tumor of the jaw

It is characterized by the formation of a benign or malignant tumor from bone tissue or tooth tissues.

Tumors of the jaw are divided into:

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

With a tumor of the jaw, a person may experience the following symptoms:

pain in the affected area, as well as in the temporomandibular joint;
disruption of the temporomandibular joint;
asymmetric facial change ( due to bone deformity);
tooth shifting and increased tooth mobility.

It should be noted that in initial stages jaw swelling may be asymptomatic.

Diagnosis of the causes of inflammation of the temporomandibular joint

Diagnosis of pain in the jaw depends directly on the cause that caused the pain.

Diagnosis of jaw pain in trauma

For jaw injuries, the following diagnostic methods are performed:

Collection of anamnesis. When collecting an anamnesis, the doctor receives the necessary information about the patient by 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, how exactly it happened ( for example, a person has fallen or been hit). You should also find out what complaints you have, clarify the severity clinical manifestations. After collecting the necessary information, the doctor proceeds to examine the patient.
Medical checkup. On examination, the doctor should pay attention to the state of bite in the patient. On palpation of the jaw, you should find out if there is pain, what kind it is and what intensity it is. It is necessary to examine the skin, to identify the presence of bruising and swelling, whether there is a violation of the integrity of the skin. You should also examine the oral cavity, whether there is a deformation of the teeth and mucous layer, profuse salivation, an admixture of blood in saliva. If there is a fracture of the jaw on palpation in the affected area, bone crepitus will be observed ( characteristic crunch).
X-ray of the jaw. This diagnostic method allows you to determine the nature of the injury ( bruise, dislocation or fracture). When bruising the upper or lower jaw, the integrity of the bone is not violated. With a dislocation, a jaw displacement will be observed on the x-ray. In case of a jaw fracture, an x-ray helps to identify its localization, 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 pain in the jaw in infectious and inflammatory diseases

In infectious and inflammatory diseases of the jaw, the following diagnostic methods are performed:

Collection of anamnesis. When interviewing a patient, the doctor should clarify whether he has any chronic diseases ( e.g. chronic sinusitis, pulpitis), and has recently had an acute infection ( e.g. furuncle). It is necessary to find out when the patient last visited the dentist, as 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 be hyperemic ( redness), edematous. There will be an increase in both local ( skin is hot to the touch) and overall temperature. On palpation of the affected area, severe pain will be noted, and pain will also be observed when the regional lymph nodes are felt. The patient will have a violation of the function of speech, swallowing and chewing. In the presence of an infectious process in the oral cavity, defects, vesicles, sores, serous or purulent discharges can 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 ( examination of the nasal cavity).
Laboratory tests. In order to diagnose the presence of an infectious-inflammatory process in the body, it will be necessary to pass a general blood test. It is given in the morning on an empty stomach from the cubital vein or ring finger. The test results may show leukocytosis ( with a bacterial or viral process, trauma, neoplasms), lymphocytosis ( in a viral process), as well as an accelerated erythrocyte sedimentation rate ( indicates the presence of a pathological process in the body). In the presence of an infectious process in the ear ( e.g. acute otitis media), as well as the upper respiratory tract ( e.g. sinusitis, tonsillitis) the patient may be assigned 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 the sensitivity to the antibiotic for subsequent treatment.
Instrumental diagnostics. In some cases, X-ray examination or computed tomography is used to detect inflammatory lesions of the bone or soft tissues of the jaw ( e.g. sinusitis, osteomyelitis, pulpitis, periodontitis). These studies help to identify the localization and extent of the pathological process, the anatomical features of the teeth, the state of the periodontal and periodontal. Also, their conduct allows to evaluate the effectiveness of the treatment for various diseases.

Diagnosis of pain in the jaw with dysfunction of the temporomandibular joint

The complexity of diagnosing dysfunction of the temporomandibular joint lies in the fact that if its work is disturbed, the pain can be localized outside the joint area ( e.g. pain in the temples, ears, neck).

When visiting a doctor, the patient should first of all tell about his 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 lower jaw mobility, the presence of hyperemia and edema in the area of the affected joint, auscultate hear clicking or crunching of the joint during movement.

On palpation of 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:

temporalis muscles ( usually one side is more sensitive);
lateral pterygoid muscles ( control the position of the jaw, and therefore soreness is usually felt on both sides);
chewing muscles ( these points are especially painful in people suffering from bruxism);
sternocleidomastoid muscle ( usually more sensitive on the right);
the trapezius and posterior occipital muscles are also examined.

Further, 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 articular cavity, as well as to study the structure of bone tissue, which is involved in the formation of the jaw joint.
Computed tomography of the joint. It is a high-precision X-ray diagnostic method, in which a layer-by-layer examination of the jaw is performed in various planes. This research method allows you to identify even minor changes in the joint in the early stages of the disease.
Orthopantomography. This is an X-ray examination method that allows you to take a panoramic picture of the teeth, as well as the tissues of the upper and lower jaws. With the help of 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 ( e.g. arthrosis and arthritis of the joint, anomalies in the development of the jaw).
Phonoarthrography. This diagnostic method using a special device allows you to listen to articular noises and visually track them on the graph. Normally, when listening to a person, soft, uniform and sliding sounds are determined. With 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 of varying intensity.
Electromyography of facial muscles. A diagnostic method that allows using special electrodes to study the electrical activity of the facial muscles and nerves that innervate these muscles.
Arthroscopy of the jaw joint. Using a special device - an arthroscope, the temporomandibular joint is examined. A small incision is made in the joint area, a device is inserted on which there is a camera that transmits the image to the monitor. This study helps not only to diagnose the disease, but also to treat ( for example, flush a joint, remove cartilage or scar tissue, administer 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 soreness on one side.

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

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

You can do it yourself like this:

Place the tips of your index and middle fingers in the temple area on both sides just behind the eye socket area. 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 should be noted on a piece of paper.
Place the fingers of both hands in the pits below the neck behind the corner of the lower jaw, again compare the sensations, 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) on both cheeks in the area between the upper and lower jaws. Again compare your sensations on the right and on the left side and again write down the result.
You need to go down to the neck. Using all your fingers, carefully feel the muscle that runs from the ears to the shoulders. Compare the pain sensations on each side. Make a note on the sheet.
Right hand feel the trapezius muscle on the left shoulder, then with the left hand feel the same muscle on the right shoulder. If pain is felt on at least one side, this should be noted.
At the end, place the tips of the little fingers in the ear canals, opening and closing the mouth, try to feel if pain is felt in the temporomandibular joint, and if it is felt, write it down on a sheet.

At the end of the self-test, examine the results. If soreness was observed at the studied points, then this indicates dysfunction of the temporomandibular joint, and it is recommended to seek help from a doctor.

Diagnosis of jaw pain in neoplasms

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

At the consultation with the doctor, the patient is first questioned, examined and palpated.

On examination, you may find:

facial asymmetry;
swelling and hyperemia of the affected area;
swelling of the bone;
deformation of the affected tissues ( e.g. ulcers, fistulas);
impaired mobility of the lower jaw;
nasal obstruction, purulent or bloody discharge ( when a tumor of the upper jaw grows into the nasal cavity).

On palpation, there may be:

changes in affected tissues softening, compaction, infiltration);
looseness of the teeth and their soreness;
decreased sensitivity of the skin of the chin and lips;
cohesion of the neoplasm with soft tissues;
enlargement and tenderness of regional lymph nodes ( e.g. cervical, submandibular, parotid).

With neoplasms of the upper or lower jaw, the following instrumental diagnostic methods can be prescribed to the patient:

X-ray and computed tomography of the jaw. Computed tomography is a more informative diagnostic method, since a layer-by-layer examination of the jaw is performed. Four to five topographic sections are made with a distance between them of one centimeter. These studies allow you to identify the localization of cancer, the prevalence of the process, as well as determine the degree of destruction of bone tissue.
X-ray and computed tomography of the paranasal sinuses. The paranasal sinuses are hollow, air-filled structures that communicate with the nasal cavity. This diagnostic method is performed in order to study the bone structures of the sinuses, to identify the presence of growths and calcifications ( deposition of calcium salts) in their cavities.
Anterior and posterior rhinoscopy. With neoplasms of the upper jaw, a study of the nasal cavity is performed. For anterior rhinoscopy done with a rhinoscope) it is possible to identify a neoplasm in the nasal cavity, as well as to take a piece of tissue for histological examination or puncture the tumor for cytological examination. Posterior rhinoscopy ( made with a spatula and a mirror), in turn, allows you to determine the germination of the tumor in the nasopharynx.

To confirm the diagnosis for neoplasms of the jaw, morphological diagnostics is prescribed:

cytological examination of the neoplasm punctate and lymph node ( study of the structure of cells under a microscope);
tumor and lymph node biopsy 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-like process, the patient may be assigned consultations with the following specialists:

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

Treatment of pathology of the temporomandibular joint

The algorithm for treating 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 of paramount importance to identify the etiological factor that led to its development and cure it.

Treatment of jaw pain in trauma

Jaw injury	Treatment
*Jaw contusion*	First of all, cold should be applied to the affected area ( in the first twenty four hours), as well as provide peace ( for example, try to talk less, not eat roughage). Anti-inflammatory gels or creams should be applied locally to the bruised area to reduce tissue swelling and eliminate pain ( e.g. Voltaren, Fastum-gel).
*Dislocation of the temporomandibular joint*	*With a dislocation of the lower jaw, the patient initially needs to provide first aid:* apply cold to the affected area; create voice peace; give pain medication e.g. Paracetamol, Ibuprofen); deliver to the hospital. Treatment, in turn, includes reduction of the dislocation ( can be done under anesthesia) and compliance with the rules of nutrition. Food should be consumed in liquid form, as well as in the form of mashed potatoes. The patient in the first days after the injury should observe voice rest and avoid wide opening of the mouth. Of the drugs, topical application of anti-inflammatory creams or gels ( e.g. 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 immobility of the jaw to ensure rest); the introduction of an anesthetic drug; delivery to the hospital. *Treatment for a jaw fracture will depend on the following factors:* patient's age; fracture location; 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; retention. Primarily in the treatment of a fracture, the jaw bones are aligned. The patient is given special devices to immobilize bone fragments. Depending on the severity of the fracture, a temporary ( ligature) and constant ( for example, the imposition of individual plates, splints) immobilization. It should also be noted that compliance with the daily regimen plays an important role in recovery. The patient in the first days must strictly observe bed rest. Food should be complete and high-calorie. Food for fractures of the jaw is served in a grated or semi-liquid form. Depending on the severity of the condition, the patient may be prescribed intravenous infusions ( e.g. 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

In infectious and inflammatory diseases of the jaw, the following treatment can be prescribed:

Antibacterial treatment. In infectious diseases ( e.g. furuncle, facial carbuncle, osteomyelitis, periodontitis) antibiotic therapy is primarily prescribed to inhibit the vital activity of the 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 an effective antibacterial treatment, a bacterial study is initially performed before its appointment ( sowing pus on a special medium) to identify a pathological agent and determine its sensitivity to a particular drug. As a rule, in infectious and inflammatory diseases, broad-spectrum antibiotics from the Penicillin group are prescribed ( e.g. Ampicillin), Quinolones ( e.g. ciprofloxacin) and other pharmacological groups.
Mouth rinse. The patient may be prescribed a mouth rinse, such as a weak solution of potassium permanganate ( potassium permanganate), furacilin ( 3% ) or saline solution.
Compresses. The application of 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 an opening of the infectious-inflammatory focus is made, its washing ( e.g. hydrogen peroxide) and creation 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 an increased loss of proteins from the body. That is why the patient should monitor nutrition. The intake of protein foods should be increased in the diet ( e.g. meat, cottage cheese, legumes). In this case, food should be served in liquid or grated form in order to exclude jaw strain.

In severe infectious diseases, the patient may be shown detoxification therapy ( introduction of glucose solution 5%, sodium chloride 0.9%).

Treatment of jaw pain in temporomandibular joint dysfunction

With dysfunction of the temporomandibular joint, the patient may be prescribed:

bite correction;
dental prosthetics;
wearing an articular splint;
the use of the Myotronics apparatus;
adherence to the regime of the day and diet;
use of medicines.

Correction of bite
Bite correction is carried out by wearing:

braces;
kapp.

Braces are a type of permanent wear that is used to straighten the teeth and correct malocclusion. Braces are metal, ceramic, sapphire, 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.

There are the following types of caps:

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

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

Partial dentures are performed:

in the absence of the crown part of the tooth ( for example, with significant tooth decay by caries);
at total absence tooth.

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

Total prosthetics helps:

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

Wearing an articular splint
Articular splint ( trainer) is an industrially manufactured soft tooth splint ( silicone material), specifically designed to relieve pain symptoms in the initial treatment of temporomandibular joint disorders. Thanks to the wing shape of the bases of the tire, gentle decompression is created and painful sensations in the joint and surrounding muscles are eliminated, as well as the effect of bruxism is effectively removed.

The articular 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.

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

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

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

The reduction in soreness is usually felt within the first days of use, but in some cases it takes several weeks to significantly reduce it. This is individual for each patient. After a few days, you should supplement the daytime wearing mode with a night one. This may be uncomfortable at first for those who have a habit of breathing through their mouths or snoring in their sleep, but it can help to 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 the use of the tire is not enough, an individual program is assigned to eliminate the causes of the pathology.

Application of the device Myotronics
Myotronics devices are devices with the help of which muscle stimulation is carried out. Due to myorelaxation of the muscles, the position of the lower jaw is normalized.

During treatment, the following therapeutic effects are observed:

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

Compliance with the daily routine and diet
In addition to the treatment prescribed by the doctor, it is important for the patient to comply with correct mode day and diet. It is very important to limit the movements of the lower jaw during the treatment period.

The patient must comply with the following recommendations:

provide voice peace ( avoid emotional conversations, raising your voice);
avoid wide mouth opening e.g. laughing, yawning, eating);
during sleep, try to sleep on the 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 prolonged chewing ( e.g. raw hard fruits and vegetables, crackers, bagels);
consume food in grated and liquid form ( e.g. puree soup, cereals, mashed potatoes or peas, cottage cheese);
avoid chewing gum.

Use of drugs
Dysfunction of the temporomandibular joint leads to the fact that a person has 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.

With dysfunction of the temporomandibular joint, the following drugs can be prescribed to eliminate pain:

Paracetamol ( take one to two tablets three times a day);
Ibuprofen ( take one to 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).

Also, these drugs are available in the form of gels, creams and ointments ( e.g. Ibuprofen, Diclofenac, Ketoprofen). They must be applied topically to the affected area two to four times a day.

Treatment of pain in the jaw with neoplasms

For neoplasms of the jaw, the following methods of treatment are used:

Radiation therapy. It is an important aspect in the treatment of benign and malignant tumors. This method of treatment is characterized by the fact that the neoplasm is affected by ionizing radioactive radiation. Under their influence, the development of DNA mutations of 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 down the growth of the malignant process and reducing symptoms. Chemotherapy drugs are usually given in combination. The combination of drugs is prescribed individually depending on the type of tumor present, the stage of the process, and the general condition of the patient. It should be noted that chemotherapy can be used in addition to surgical treatment tumors or radiation therapy.
Surgery. It consists in the surgical removal of a tumor of the upper or lower jaw. Before surgery, orthopedic structures must first be prepared, which will subsequently help keep the jaw in the correct position ( for example, bus Vankevich). Proper orthopedic actions increase the healing rate of the postoperative wound, and also play a big role in the aesthetic aspect.

Physiotherapy

Physical therapy is an effective treatment for jaw pain caused by trauma, infection, or dysfunction of the temporomandibular joint.

Procedure name	Therapeutic effect	Application
microwave therapy (microwave therapy)	blood vessels dilate; improves local blood circulation; muscle spasm decreases; are improving metabolic processes; 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), ENT diseases ( e.g. otitis media, tonsillitis); skin diseases ( e.g. boils, carbuncles).
UHF (exposure to ultrahigh-frequency magnetic field)	improves blood circulation and lymph circulation; tissue swelling decreases; muscle spasm decreases; tissue healing improves; has an analgesic effect.	inflammatory diseases of the musculoskeletal system; diseases of the ear, throat, nose e.g. angina, sinusitis, sinusitis); diseases with localization in the face ( for example, with neuritis of the facial nerve); suppurative diseases ( e.g. abscess, phlegmon).
*Ultraviolet radiation*	an immunostimulating effect is produced; metabolic processes are improved; it has an analgesic and anti-inflammatory effect; regeneration of nervous and bone tissue improves.	diseases ( e.g. arthritis, arthrosis) and injuries of the musculoskeletal system ( e.g. dislocations, fractures); neuralgia; skin diseases ( e.g. ulcers, boils, long-healing wounds).
diadynamic therapy (direct impulse currents of a half-sinusoidal form)	has an analgesic effect; improves lymph circulation and blood circulation; a stimulating effect on the muscles; the process of tissue healing is accelerated.	pain syndrome of various etiologies ( e.g. contusion, dislocation, neuritis, arthritis); joint diseases ( e.g. arthritis).

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 flows from the blood into the tissues of the body. To avoid swelling of the tissues, the vessels of the lymphatic system collect this fluid, and then carry it away with the lymph flow through the lymphatic vessels.

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

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

Pain in the lymph nodes under the jaw is 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 provoke diseases such as:

tonsillitis ( tonsillitis);
glossitis ( inflammation of the tongue);
osteomyelitis ( bone inflammation) 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;
an increase in body temperature.

Why does the 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 upper jaw contains a large air-bearing maxillary or maxillary sinus. On the alveolar process of the upper jaw there are recesses - 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 from the oral cavity), nasal cavity and eye sockets. Also, the upper jaw is involved in the chewing 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
*Maxillary injury*	Characterized by injury 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 injury are:* pain in the upper jaw; swelling; discoloration of the skin at the site of injury ( e.g. 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; pronounced hematomas in the area of the upper lip and cheeks.
*Osteomyelitis of the upper jaw*	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; puffiness and asymmetry of the face; enlargement and soreness of the 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 is 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 of the skin. The etiology of arteritis is unknown. There is a theory that the cause of the disease is a genetic predisposition in combination with adverse environmental factors.
*Pulpitis*	Inflammation of the pulp, neurovascular bundle of the tooth, due to the penetration of pathogenic microorganisms into the tissues. With this disease, the patient feels a strong throbbing pain. Attacks of pain can be short-term or permanent. In advanced form, when the tooth begins to gradually collapse, the pain becomes less severe.
*periodontal abscess*	Purulent inflammation of the gums in the form of an abscess. Often periodontal abscess develops against the background of other dental diseases ( e.g. gingivitis - inflammation of the gums). Also, the disease can develop due to the incompetent actions of the dentist. *Periodontal abscess is usually accompanied by the following symptoms:* swelling and pain in the affected area, aggravated by an attempt to chew food; pain in the jaw, ear, cheeks; headache; dizziness; increase in body temperature; loss of appetite; decrease in performance.
*Osteogenic sarcoma of the jaw*	A malignant tumor that grows from the bone tissue of the jaw. *Symptoms of osteogenic sarcoma of the jaw are:* facial pain; itching in the gums; the appearance of a tumor that interferes with chewing food; swelling of the face.
*Sinusitis*	Inflammation of the mucous membrane of the maxillary maxillary) sinuses. In most cases, sinusitis develops against the background of other infectious diseases of the nasopharynx ( e.g. rhinitis), due to inflammation of the upper teeth, as well as due to trauma to the nasal septum. *Symptoms of sinusitis are:* mucous discharge from the nose; pain in the nose, radiating ( bestowing) in the gums, eye sockets, forehead; severe headaches; loss of appetite; coughing fits; labored breathing; a feeling of strong pressure in the region 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 do their work at the same time. Thanks to the coordinated actions of the temporomandibular joints, movements of the lower jaw are carried out ( side to side as well as forward and backward).

There are a large number of nerve receptors in the joint capsule, which is why a slight violation of its function negatively affects the general well-being of a person. In this case, a frequent symptom is pain in the jaw and temples.

Temporomandibular joint dysfunction is a disease in which the joint suffers directly 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 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 asymptomatically.

Symptoms of temporomandibular joint dysfunction are:

unusual sound ( crunch) in the area of the joint during opening or closing of 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, with wide opening of the mouth;
change in bite;
grinding of teeth;

Pain in the temporomandibular joint can be acute and chronic. Most common cause that cause acute temporary pain are acute effusions - accumulation of fluid ( e.g. saliva, blood) within the temporomandibular joint. They can appear if you keep your mouth wide open for a long time ( e.g. when visiting a 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, which 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 articular cavity. Excessive stress placed on the joint eventually leads to its degeneration.

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

inflammatory diseases of the ear e.g. otitis media);
trauma of the maxillofacial bones;
osteomyelitis of the upper jaw;
trigeminal neuralgia;
arteritis of the facial artery.

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

Pain and other discomfort in the jaw are familiar to many. This symptom is characteristic of many diseases, so you should not ignore it. The fact that the pain syndrome is constantly present, sometimes subsiding a little, then, on the contrary, intensifying, should be especially alert. This condition requires an urgent consultation with a doctor to exclude its dislocation, fracture, purulent inflammation and other no less formidable pathologies. Why it hurts, aches and hurts the jaw on the right or left, including when opening the mouth, the reasons for this and what to do is the topic of our article.

The human jaw is located on the front side of the skull and occupies a fairly large area. It consists of two parts: top - motionless, it contains the maxillary sinuses, and the lower one, on the contrary, mobile. Its bone is connected to the muscles that are needed to process food. In addition, the jaw is needed there to yawn, open the mouth wide, move the chin, and grimace. All these movements are provided by the jaw joints. With their damage, as a rule, severe pain and discomfort are associated.

If you have pain in the upper or lower jaw on the right or left, the reasons for this may be the following:

osteomyelitis - infectious inflammation of bone tissue;
neuralgia;
all types of joint damage, including as a result of injury;
damage to the facial or carotid artery;
carried out the day before, dental manipulations, including the extraction and prosthetics of teeth;
red ear syndrome;
the growth of "wisdom teeth";
wearing braces;
arthritis and arthrosis;
abscess, phlegmon and other purulent diseases of the submandibular region;
all types of injuries and mechanical damage;
carotidinia;
malignant tumors.

Pain in this part of the skull can provoke heart disease, including acute myocardial infarction. Therefore, in the first place, it will be necessary to exclude this.

The jaw quite often hurts and swells in boxers, as well as in athletes involved in different types oriental martial arts. Soft tissue injury is the simplest cause that causes severe discomfort. The pain with it is localized, either on the right or on the left, in the same place where the edema is visualized.

Mouth won't open with jaw pain

Based on the patient's complaints and the question of why the mouth does not open, the jaw hurts on the left side and it hurts to chew, the doctor may suggest fracture. Its characteristic sign will be that the pain does not recede even if you do not move the jaw, since the bone is greatly displaced with it. Dislocation is diagnosed quite often in patients of all ages.. It has such vivid symptoms that an experienced specialist can only look at the unchanging position of the mouth and the incorrect position of the jaw. And if, in addition, the patient complains of impaired swallowing and the appearance of a speech defect, the diagnosis will be obvious. Pain during dislocation is localized at the site of the damaged joint.

On your own, you can only guess the reason why it hurts to open your mouth on one side and the lower jaw hurts. Only the attending physician can accurately diagnose and prescribe a scheme and procedure for adequate treatment, to whom you need to rush at the first manifestations of discomfort.

Features of pain in the lower and upper jaw for various reasons for their appearance

Pain and aches in the jaw is a common symptom that is present in various pathologies and disorders of our body. As already clarified in the previous section, in addition to traumatic injuries of the joint, pain syndrome can provoke:

neoplasms;
purulent infections;
heart disease;
neuralgia.

We will analyze the features of pain in each of these ailments.

Unfortunately, no one is immune from the growth of neoplasms in the skull area. Pain and aches in the jaw are caused by many benign and malignant tumors.. The most annoying thing in this situation is that tangible pain appears only at a late stage of all the above pathologies, which are asymptomatic for a long time. Discomfort with them is most noticeable at night. A little later, a pronounced asymmetry of the face, a change in the thickness of the jaw, the inability to open the mouth, and difficulties with chewing food join it.

Osteogenic sarcoma of the jaw

Concerning sarcomas- the most formidable neoplasm, which is malignant in nature, then its development may indicate pain radiating to the neck and ear when pressing the jaw and severe facial deformity. In the later stages of the disease, there is a decrease in the sensitivity of the affected areas.

Acute pain in the jaws can also provoke inflammation pyogenic bacteria that enter the bone and soft tissues through carious teeth, blood or open wounds.

The most dangerous inflammation is osteomyelitis, in which the infection, moving through the dental canals, penetrates into the deep parts of the jaw, causing lymphadenitis, sore teeth, swelling of the face, headache and general deterioration of well-being.

Other purulent inflammations include:

furunculosis, which is characterized by purulent inflammation on the affected area of \u200b\u200bthe skin and severe soreness;
phlegmon, which is easy to identify by pronounced edema spreading to the ear;
abscess in which tissue necrosis occurs.

Osteomyelitis of the jaw

Often heart pain may radiate to the lower jaw. This happens with acute myocardial infarction which requires urgent hospitalization of the patient. This disease is characterized by damage to the coronary arteries, thrombosis and spasm of the cardiac arteries, which leads to necrosis of the heart muscle. The patient's life depends on urgent medical intervention. In addition to pain in the jaw, a heart attack can be indicated by severe heart pain, lack of air, and excessive sweating.

Reduce the lower jaw can and an attack of angina pectoris, in which the pain increases from the area behind the sternum gradually moving to the face, as well as inflammation of the carotid and facial arteries.

Pain in the jaw often occurs when the trigeminal, superior laryngeal and glossopharyngeal nerves are damaged, as well as congenital or acquired malocclusion.

Pain in the jaw with malocclusion in children

In children, pain syndrome appears against the background of the development of rickets, and in adults, poorly selected dentures can become the cause of discomfort.

How to get rid of jaw pain

Pain in the jaws is an extremely unpleasant and dangerous phenomenon. Therefore, it is necessary to find out the reason for its appearance. The etiology can be very different and, accordingly, the principles of treatment will also be radically different from each other. The first thing to do is to pass a series of examinations:

Analysis of urine;
general blood analysis;
skull x-ray;
MRI.

Of course, an examination of specialists is shown - a dentist, a surgeon, a neuropathologist, a cardiologist, a traumatologist, a therapist. Therefore, to the question of what to do if the lower or upper jaw hurts when you open your mouth, the answer will be obvious - go to see a doctor.

Depending on the cause of the development of the pain syndrome, treatment will be prescribed: dislocation needs a fix, fracture- in immediate operation, injury- in cold compresses. With purulent inflammation you can not do without taking antibacterial drugs, and in case of heart disease - calling an ambulance.

If you have pain in the jaw, you should definitely consult a doctor

Regarding dental reasons treatment will depend on their type and severity. Those teeth that cannot be saved are subject to removal, caries, pulpitis and stomatitis are urgently treated, and if a growing wisdom tooth causes discomfort, sometimes a small incision in the gums is enough to eliminate it.

Symptomatic treatment of pain and jaw aches consists in taking painkillers and analgesics. Sometimes, if it is impossible to identify the cause of pain, the patient is prescribed a course of antidepressants.

Pain in the jaw can be of a different nature, severity and intensity. But the identification of its cause is urgent. Often, she is the first alarming symptom of serious pathologies, on the timely detection and elimination of which the overall prognosis will depend. After all, in this way the body tells us that it needs help. Self-treatment, as a rule, does not bring the desired result. Lotions, compresses, rinses and other methods traditional medicine won't solve problems. Even if they can relieve the condition for a short time, removing soreness and aches, it is only in order to survive the night and go to a specialist in the morning.