Facial Pain
Facial pain can result from an acute injury to the face (car accident, fall, object hits the face) or from continuous trauma (repetitive movements – i.e. grinding/clenching the teeth) often stress related.
Certain conditions are autoimmune in nature and others are genetically transmitted while others have environmental components.
Pain symptoms range from mild to severe. They can be momentary pain to continuous unrelenting. Some occur unprovoked while others are a result of an exaggerated response to a benign movement.
Pain can be a dull ache to throbbing/pulsating pain, burning/itching sensations and intense sharp stabbing pain.
The structures affected are: Facial muscles, Temporomandibular joints, Ears, Dental/tooth, Nerve, Sinus.
Facial Muscle Pain:
Pain and muscle fatigue and limited ability to open the mouth or chew foods.
Mental – Emotional Stress:
Shoulder, neck and facial muscles tend to accumulate tension and stress leading to tight, painful muscles and muscle cramps.
Nerve disorder:
Abnormality in the nerve structure can cause shock-like intense facial pain. Trigeminal neuralgia is one such painful disorder
Nerve Damage:
The trigeminal nerve is the largest cranial nerve responsible for relaying sensory information to the brain. This nerve affects the upper part of the face (forehead, scalp, and upper eyelids), maxilla (upper jaw, cheeks, lip, and nasal cavity), and the mandible (lower jaw, ears, lower lip, and chin). This means that muscle damage around the jaw joint can affect all these structures.
Migraines:
Throbbing pain, often on one side of the face/head usually accompanied by light sensitivity, visual changes and nausea.
Infections:
Viral infections such as shingles can lead to painful postherpetic neuralgia.
Sinusitis and deviated nasal septum:
Inflammation of the sinus can lead to facial pain and pressure in addition to runny and stuffy nose.
Dental:
Decayed and abscessed infected tooth can cause intense sharp pain as well as throbbing pain often aggravated by eating or biting down.
Atypical facial pain
Reserved for unidentifiable source of existing facial pain.
Given the range of possible causes, proper diagnosis and treatment is best done at a Orofacial Pain/TMJ specialist, neurologist or otolaryngologist.
Did You Know?
The trigeminal nerve is the largest cranial nerve responsible for relaying sensory information to the brain. This nerve affects the upper part of the face (forehead, scalp, and upper eyelids), maxilla (upper jaw, cheeks, lip, and nasal cavity), and the mandible (lower jaw, ears, lower lip, and chin). This means that muscle damage around the jaw joint can affect all these structures.
Frequently Asked Questions:
Do I have TMD?
While only a dentist can accurately diagnose you with TMD, you may be affected by TMD if you have one or more of the following symptoms:
- Jaw pain
- Problems biting and chewing
- Pain while biting and chewing
- Tooth pain
- Facial pain
- Inability to open or close the mouth completely
- Popping or clicking noises when the mouth opens/closes
- Headaches/migraines
- Ear pain/tinnitus
Your temporomandibular joints are found on either side of the jaw, just below the ear and are responsible for connecting the mandible (lower jaw) to the maxilla (upper jaw). The joint itself contains bones, muscles, tendons, ligaments, and nerves; all of which can cause dysfunction.
To be evaluated for TMD, schedule a consultation with our office today.
How is TMD diagnosed?
TMD can be tough to diagnose since it can stem from problems with the teeth, muscles, and/or joint itself. Therefore, our office will perform a comprehensive evaluation of these structures. We also make use of advanced diagnostic technology such as:
BioEMG
Electromyography (EMG) is a diagnostic technique that uses electrodes attached to the skin to record the electrical activity of muscle tissue. By measuring the electrical activity of a particular muscle, EMG provides information about which muscles are resting properly and which muscles are hyperactive. This information is then used to develop a treatment plan that balances muscle tone with proper bite position to reduce TMD symptoms.
How is TMD treated?
At our office, we treat TMD by first determining the specific cause of the problem and then addressing the source of the problem, rather than just muting symptoms. Your individual treatment will depend on your specific diagnosis, however here are some potential treatments for TMD:
Oral Appliances
A custom-fitted oral appliance, also sometimes known as a night guard, is fabricated from medical silicone or plastic and worn over the teeth to reposition the jaw and discourage teeth grinding. This appliance is fabricated using the diagnostic information obtained from the digital intraoral scan.
Medication
Severe pain may be managed by prescribing muscle relaxants or antidepressants to manage painful symptoms.
Physical Therapy
Seeing a physical therapist with training in TMD may be recommended to work on upper body posture, as well as the various muscle and joint movements around the jaw joint.
Trigger Point Injections (TPI)
Saline, local anesthetics, or corticosteroids are injected into specific muscles in order to relieve painful symptoms.
Temporomandibular Joint Disorder (TMD)
Your temporomandibular joints are found on either side of the jaw, just below the ear and are responsible for connecting the mandible (lower jaw) to the maxilla (upper jaw). The joint itself contains bones, muscles, tendons, ligaments, blood vessels and nerves; all of which can cause dysfunction.
Frequently Asked Questions:
Do I have TMD?
The following are symptoms of TMD
- Jaw pain
- Problems biting and chewing
- Pain while biting and chewing
- Tooth pain
- Facial pain
- Inability to open or close your mouth completely
- Popping or clicking noises when the mouth opens/closes
- Headaches/migraines
- Ear pain/tinnitus
To be evaluated for TMD, schedule a consultation with our office today.
How is TMD diagnosed?
TMD can be tough to diagnose since it can stem from problems with the teeth, muscles, and/or joint itself. Therefore, our office will perform a comprehensive evaluation of these structures. We also make use of advanced diagnostic technology such as:
BioEMG
Electromyography (EMG) is a diagnostic technique that uses electrodes attached to the skin to record the electrical activity of muscle tissue. By measuring the electrical activity of a particular muscle, EMG provides information about which muscles are resting properly and which muscles are hyperactive. This information is then used to develop a treatment plan that balances muscle tone with proper bite position to reduce TMD symptoms.
Ultrasound evaluation of the joints
How is TMD treated?
At our office, we treat TMD by first determining the specific cause of the problem and then addressing the source of the problem, rather than just muting symptoms. Your individual treatment will depend on your specific diagnosis, however here are some potential treatments for TMD:
Oral Appliances
A custom-fitted oral appliance, also sometimes known as a joint stabilizing/orthotic, is fabricated from medical silicone or plastic and worn over the teeth to reposition the jaw and discourage teeth grinding. This appliance is fabricated using the diagnostic information obtained from the auscultation and palpatic evaluation and ultrasound so that the jaw is at its most optimal position.
Medication
Severe pain may be managed by prescribing muscle relaxants or antidepressants to manage painful symptoms.
Physical Therapy
Seeing a physical therapist with training in TMD may be recommended to work on upper body posture, as well as the various muscle and joint movements around the jaw joint.
Trigger Point Injections (TPI)
Saline, local anesthetics, or corticosteroids are injected into specific muscles in order to relieve painful symptoms.
Self Help
Specific custom exercises, thermal therapy, avoidance protocols.
TMJ Screening Questionnaire (updated 2022)
TMJ/TMD
There are multiple factors that can contribute to the development of TMJ disorders, including acute trauma, continuous trauma and systemic conditions.
What is TMJ/TMD?
Temporomandibular joint disorder (TMJ/TMD) is a condition that affects the joint connecting your lower jaw to your skull. You have two temporomandibular joints, one on each side of your face. This joint is essential in speaking, eating, and yawning.
Your temporomandibular joint consists of bones, muscles, blood vessels, nerves, and connective tissue. Problems with these components can create issues with proper joint function.
How do I know if I have TMJ?
Symptoms of TMJ can occur on one or both sides of your face. They can be temporary or can last for months or even years. Some men and women experience only mild symptoms, while others find their symptoms to be unbearable.
Some things to keep an eye out for include:
- Pain or sensation of tenderness in your jaw, face, ear, neck, or shoulder
- Increase in discomfort when you speak, chew, or yawn
- Inability to open your mouth wide or move your jaw from side to side
- Tired feeling in your face
- Difficulty chewing or a sudden change in your bite
- Swelling on one side of your face
- Ringing in your ears
- Popping, clicking, or grating sounds when you open or close your mouth
- Jaws that become stuck in an open or closed position
Don’t ignore changes or discomfort in your jaw. These are joints that play essential roles in daily life, and TMJ can disrupt your normal routines.
What causes TMJ or TMD?
Additional causal factors include high levels of stress, grinding or clenching your teeth, and movement of the disc that cushions the connection of the ball and socket of the joint” to “High levels of stress, grinding or clenching your teeth, and movement of the disc that cushions the connection of the ball and socket of the joint are some of the causes of TMJ syndrome.
How is temporomandibular joint disorder treated?
The first step is a thorough diagnostic exam. We collect digital imaging of your teeth and bite, and X-ray imaging to visualize the bones of your temporomandibular joints. An in-depth discussion of your symptoms, general health history, and lifestyle habits follows.
This information helps Dr. Keller craft a customized treatment plan. In some cases, modifying behaviors can yield impressive improvements. Finding ways to manage stress, changing your diet, incorporating jaw stretches, or even changing the way you hold your phone can all help.
A therapy called transcutaneous electrical nerve stimulation (TENS) can be a wonderful option for treating TMJ. This approach uses electrodes to deliver electrical current to the muscles in your jaw, stimulating them, and releasing tension that can contribute to TMJ.
Joint injections, ultrasound therapy, and medications can also help. In cases where posture is contributing to the problem, Dr. Keller can collaborate with a chiropractor to help you find lasting relief.
An oral orthotic appliance can also go a long way toward treating temporomandibular joint disorder. These devices are worn in your mouth and prevent you from clenching your jaw or grinding your teeth. Your treatment plan may include a recommendation for you to wear your orthotic device only while asleep, only during waking hours, or a combination of both.
The Dental Sleep Center at Keller Dentistry offers a variety of dental orthotic appliances that are comfortable to wear and allow for a custom fit. These devices may help in reducing grinding and clenching. Together with thermal therapy and jaw exercises, the oral device can help relax the muscles and joint.