Jaw Pain: Common Causes and When It Is Serious

Where jaw pain comes from

The lower jaw (mandible) hinges on the skull at the temporomandibular joints (TMJs), just in front of each ear. Powerful chewing muscles attach to the jaw and the side of the head. Teeth, gums, sinuses, ears, salivary glands and nerves all sit close by, and the heart's pain signals can be referred to the jaw through shared nerve pathways. That is why jaw pain has so many possible causes.

Common causes

TMJ disorders

Temporomandibular joint disorders affect the joint, its cartilage disc and the chewing muscles. Signs include:

• an ache in front of the ear, the jaw or temple, worse with chewing, talking or yawning
• clicking, popping or grating sounds
• limited opening or a jaw that catches or locks
• ear fullness or ringing without an ear infection
• headaches

TMJ disorders are most common in women aged 20 to 40 and often linked to stress and clenching. Most improve within weeks to months with simple care.

Teeth grinding and clenching (bruxism)

Bruxism, often during sleep, overworks the jaw muscles. It causes morning jaw pain, tension headaches, tooth sensitivity, flattened or chipped teeth and sometimes a partner hearing grinding at night.

Dental problems

• Tooth decay and pulpitis: pain triggered by hot, cold or sweet foods.
• Dental abscess: throbbing pain, a swollen gum or face, a bad taste and sometimes fever.
• Impacted or infected wisdom teeth (pericoronitis): pain and swelling at the back of the jaw, bad breath and difficulty opening the mouth.
• Gum disease and cracked teeth.
• Dry socket a few days after a tooth extraction.

Sinus and ear problems

Sinusitis of the maxillary sinuses can cause aching upper teeth and jaw, worse when bending forward. Ear infections cause pain that radiates to the jaw. Conversely, TMJ pain often feels like ear pain.

Injury

A blow to the face can bruise, dislocate or fracture the jaw. Signs of a fracture include teeth that no longer fit together, numbness of the lower lip, and pain and swelling along the jawline.

Serious causes of jaw pain

Heart attack and angina

Reduced blood flow to the heart can cause pain in the jaw, often the left side or both sides, sometimes without chest pain. This is more common in women, older adults and people with diabetes. Suspect the heart when jaw pain:

• comes on with exertion, cold or stress and eases with rest
• comes with chest pressure, breathlessness, sweating, nausea or lightheadedness
• spreads to the neck, arm, shoulder or back

See heart attack and angina.

Giant cell arteritis

Giant cell arteritis inflames arteries of the head in people over 50. Jaw claudication, pain in the jaw muscles after a minute or so of chewing that eases with rest, is a classic sign. It often comes with a new headache, scalp tenderness and fatigue. Untreated, it can cause sudden permanent blindness, so it needs same-day assessment and steroids.

Nerve pain

Trigeminal neuralgia causes brief, severe, electric-shock pains in the jaw, cheek or lips, triggered by touch, chewing, talking or brushing teeth.

Other serious causes

• Osteomyelitis (infection of the jaw bone), sometimes after dental infection or radiation.
• Medication-related osteonecrosis of the jaw, linked to some bone-strengthening and cancer medicines.
• Salivary gland stones or infection, with swelling under the jaw at mealtimes.
• Tumors of the jaw, mouth or salivary glands, rarely.

Left side vs right side jaw pain

One-sided jaw pain is usually local, but any jaw pain with heart warning signs is an emergency regardless of side.

How jaw pain is diagnosed

A dentist or doctor will ask where the pain is, what triggers it, how long it lasts, and about grinding, injuries, chest symptoms and headaches. They will examine the jaw joints, chewing muscles, bite, teeth and gums, ears and neck.

Tests may include dental X-rays or a panoramic X-ray, CT or MRI of the TMJ, an ECG and blood tests if heart pain is possible, and blood tests (ESR, CRP) with a temporal artery ultrasound or biopsy for giant cell arteritis.

Relief and treatment

Home care for TMJ and muscle pain

• Eat soft foods and cut food into small pieces. Avoid gum, chewy candy and very wide opening.
• Apply moist heat or a cold pack for 10 to 20 minutes, several times a day.
• Take ibuprofen or acetaminophen (paracetamol) at the label dose.
• Rest the jaw: keep teeth apart and the tongue resting behind the upper front teeth.
• Gently massage the jaw muscles and do jaw stretching exercises from a physical therapist.
• Manage stress and avoid resting your chin on your hand.

Professional treatments

• Night guard (occlusal splint) from a dentist for grinding and TMJ disorders.
• Dental treatment for decay, abscesses or wisdom teeth, plus antibiotics for spreading infection.
• Physical therapy and cognitive behavioral therapy for chronic TMJ pain.
• Muscle relaxants or low-dose tricyclic antidepressants for persistent muscle pain, prescribed by a doctor.
• Medicines such as carbamazepine for trigeminal neuralgia.
• Joint injections or surgery for a small number of severe TMJ cases.

Frequently asked questions

What causes jaw pain?

The most common causes are TMJ disorders, teeth grinding or clenching, and dental problems such as decay, abscesses and wisdom teeth. Sinusitis, ear infections, nerve pain and injuries also cause jaw pain. Less often, it signals a heart attack or giant cell arteritis.

Can jaw pain be a sign of a heart attack?

Yes. Heart pain can spread to the jaw, often on the left side, and occasionally the jaw is the main site of pain. Call 911 if jaw pain comes with chest discomfort, shortness of breath, sweating, nausea or lightheadedness, or comes on with exertion.

Why does my jaw hurt when I chew?

Pain with chewing is usually from a TMJ disorder, overworked jaw muscles, or a dental problem such as a cracked tooth or abscess. In people over 50, jaw pain that builds after a minute of chewing and eases with rest can be a sign of giant cell arteritis.

Why do I have jaw pain and ear pain together?

The TMJ sits directly in front of the ear, so TMJ disorders commonly cause ear pain, fullness and ringing. Ear infections and dental infections at the back of the mouth can also cause both. A doctor or dentist can examine both areas to find the source.

How long does TMJ jaw pain last?

Most episodes of TMJ pain improve within a few weeks with soft foods, heat, anti-inflammatory medicine and jaw rest. Some people have recurring or chronic symptoms that benefit from a night guard, physical therapy and stress management.