The reasons behind painful problems with jaw joints
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Painful problems with jaw joints are surprisingly common, as oral and maxillofacial consultant, Mr Parkash Ramchandani explains
Facial pain can be the result of various common dental issues such as toothache or impacted teeth. It can also be attributed to sinus disease, neuralgias, burning mouth syndrome, problems affecting the lining of the mouth such as mouth ulcers and infections, atypical facial pain and also jaw joint disorders.
Jaw joint problems are actually very common, as common as a sprained ankle. For most people the problem will typically last about a month before improving. Symptoms can include noises such as clicking, cracking, crunching, grating or popping, a dull ache in and around the ear or along the cheekbone or downwards in the neck, headaches and limited mouth opening. Most jaw joint problems are made worse by chewing and are aggravated by stress.
In the main, treatment is aimed at reducing the workload of the muscles by allowing the disc or cartilage to return to a normal position within the joint. Initially, we’d always advise resting the jaw by avoiding yawning if possible, having a soft diet, taking anti-inflammatory pain relief and applying heat to the joint. Identifying and treating habits such as teeth clenching and grinding will also drastically diminish any jaw or facial pain long term.
Learning techniques to control tension and stress, physiotherapy and using a clear plastic splint that fits over the teeth (usually at night) can all help. Occasionally, a prescribed injection of Botox into the muscles might be offered as treatment. If these measures don’t help, we would look at surgery, which in most cases is minimally invasive telescopic surgery but can be total jaw joint replacement if the disease is severe.
In some cases it can be difficult to determine the cause of a patient’s mouth or facial pain. In these instances it is always important to exclude rare conditions, including cancer in the mouth, throat, behind the nose and in the skull base.
On average 5,000 people are diagnosed with mouth cancer every year in the UK, which kills more people than cervical and testicular cancer put together. The positive news is that people who are diagnosed with small mouth cancers have a greater than 90 per cent survival rate.
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Pain is not usually present in the early stages of these types of cancer so it’s important to look out for possible warning signs. Symptoms of mouth cancer can include:
• An ulcer or a white, red or speckled patch that doesn’t heal within three weeks
• A swelling in the mouth that doesn’t go away or a lump in the neck
• Ear ache
• Numbness in the mouth and tongue
• Limited ability to open the mouth
• Difficulty in swallowing, chewing or moving the tongue
• A hoarse voice
• Unexplained loose teeth
There are no other cancers so strongly linked with lifestyle factors, so to put it simply: drink in moderation, avoid smoking and have a healthy diet with lots of fruit and vegetables. Dentists also have a major role to play in primary prevention, so regular dental check-ups are also vital.
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