Symptom Finder - Jaw Pain
JAW PAIN
The key to formulating a list of causes of jaw pain is anatomy. Visualizing the area, one notes the skin, arteries, veins, nerves, salivary glands, teeth, bone, and joints. These structures should prompt the recall of the various causes of jaw pain as follows:
1. Skin: Cellulitis, herpes zoster, and so forth.
2. Arteries: Histamine cephalgia, migraine, and so forth.
3. Veins: Not usually a cause of jaw pain.
4. Nerves: Trigeminal neuralgia, glossopharyngeal neuralgia.
5. Teeth: Dental caries, alveolar abscess, impacted wisdom teeth,
gingivitis, and so forth.
6. Bone: Osteomyelitis, fracture, bone tumors.
7. Salivary glands: Mumps, calculi, neoplasms.
8. Joints: Temporomandibular joint (TMJ) syndrome, rheumatoid arthritis (RA).
Approach to the Diagnosis
Obviously, the history and physical examination will help to diagnose many causes of jaw pain. If trigger points can be found, suspect trigeminal neuralgia. A significant swelling would prompt the suspicion of cellulitis, mumps, or an alveolar abscess. Swollen gums should raise the question of gingivitis, periodontitis, or alveolar abscess. Malocclusion would suggest TMJ syndrome.
ACBC; arthritis panel; and x-rays of the teeth, jaw, and TMJ may disclose abnormalities. Referral to a dentist or oral surgeon is indicated if the diagnosis is obscure after these studies are done. A magnetic resonance imaging (MRI) of the TMJ may need to be done to exclude the TMJ syndrome. If all tests are negative, a psychiatric consult may be in order.
The key to formulating a list of causes of jaw pain is anatomy. Visualizing the area, one notes the skin, arteries, veins, nerves, salivary glands, teeth, bone, and joints. These structures should prompt the recall of the various causes of jaw pain as follows:
1. Skin: Cellulitis, herpes zoster, and so forth.
2. Arteries: Histamine cephalgia, migraine, and so forth.
3. Veins: Not usually a cause of jaw pain.
4. Nerves: Trigeminal neuralgia, glossopharyngeal neuralgia.
5. Teeth: Dental caries, alveolar abscess, impacted wisdom teeth,
gingivitis, and so forth.
6. Bone: Osteomyelitis, fracture, bone tumors.
7. Salivary glands: Mumps, calculi, neoplasms.
8. Joints: Temporomandibular joint (TMJ) syndrome, rheumatoid arthritis (RA).
Approach to the Diagnosis
Obviously, the history and physical examination will help to diagnose many causes of jaw pain. If trigger points can be found, suspect trigeminal neuralgia. A significant swelling would prompt the suspicion of cellulitis, mumps, or an alveolar abscess. Swollen gums should raise the question of gingivitis, periodontitis, or alveolar abscess. Malocclusion would suggest TMJ syndrome.
ACBC; arthritis panel; and x-rays of the teeth, jaw, and TMJ may disclose abnormalities. Referral to a dentist or oral surgeon is indicated if the diagnosis is obscure after these studies are done. A magnetic resonance imaging (MRI) of the TMJ may need to be done to exclude the TMJ syndrome. If all tests are negative, a psychiatric consult may be in order.
