TMJ Facial Pain

Why Does My Whole Face Hurt?

Pain in the side of your face, above the eyes, and the tops and sides of your head, can all be related to TMJ Disorders signs and symptoms. Facial pain can also come from infected teeth or gum tissue. Dr. Bramanti will perform a thorough evaluation of all the possible factors associated with your pain.

Facial pain can also come from injuries or nerve damage. Barring an infection in your mouth or nerve damage, Facial Pain often is caused by teeth hitting unevenly and/or the muscles of the head and neck. This has all to do with how your mouth functions.

What can make this really tough is that Facial Pain from muscles can refer pain signals to a single tooth or to multiple teeth in an area. Patients end up having multiple root canals to attempt to remove pain that is actually jaw muscle in origin. Pain is a poor diagnostic tool simply because it refers to other areas of the body. Sometimes pain is hard to pin down. Dr. Bramanti will perform a sensory analysis to determine the origins and epicenter of your pain.

What does TMJ Facial pain feel like?

Facial pain associated with TMJ Disorders can be sharp and instant, or dull and constant. It is like a “charlie horse” leg pain in your jaw. It can often come from neck muscles as well. Pain does not just show us where the problem is but is often referred to a totally different area.

Did you know that a muscle on the side of your neck (Sternocliedomastoid muscle or SCM) will often refer pain to your forehead? A chewing muscle (Masseter Muscle) will often refer pain to a back tooth on that side.

Pain is real. Pain is debilitating. The origin of pain can be confusing and requires a comprehensive diagnostic examination. Dr. Bramanti is a TMJ Specialist who applies his expert knowledge and scholarship to your diagnostic examination to determine the origin of your pain.

Are facial muscles affected?

Muscle strain is the most common symptom of TMJ Facial Pain. That muscle pain can be sharp and excruciating. It can mimic a toothache, it can mimic a migraine, and it can create pain far from its source.

TMJ disorders, a misaligned bite, daytime/nighttime airway issues, body posture and even foot problems can all affect the muscles of the head and neck and thus cause pain.

Many times Facial Pain will show up on the opposite side of your bite problem. Your pain on the right is caused by a bite problem on the left or vise-versa.

The pain typically comes from overworked muscles or muscle linings (called the fascia) constricting the function and motion of muscles. Chronic, long term strain to muscles will create various kinds of damage to the muscles and the bones that they are attached to. Often the bone of the lower jaw will change shape to accommodate years of muscle strain.

Can stress cause facial pain?

References

Chaves, Paulo de Jesus, Franceane Esther Moreira de Oliveira, and Laila Cristina Moreira Damázio. 2017. “INCIDENCE OF POSTURAL CHANGES AND TEMPOROMANDIBULAR DISORDERS IN STUDENTS.” Acta Ortopedica Brasileira 25 (4): 162–64.
D’Attilio, Michele, Maria R. Filippi, Beatrice Femminella, Felice Festa, and Simona Tecco. 2005. “The Influence of an Experimentally-Induced Malocclusion on Vertebral Alignment in Rats: A Controlled Pilot Study.” Cranio: The Journal of Craniomandibular Practice 23 (2): 119–29.
Kerstein, Robert B., and John Radke. 2012. “Masseter and Temporalis Excursive Hyperactivity Decreased by Measured Anterior Guidance Development.” Cranio: The Journal of Craniomandibular Practice 30 (4): 243–54.
Westersund, Curtis D., Jeffrey Scholten, and Raymond J. Turner. 2017. “Relationship between Craniocervical Orientation and Center of Force of Occlusion in Adults.” Cranio: The Journal of Craniomandibular Practice 35 (5): 283–89.
Sutter BA, Girouard P. Posture Stability and Forward Head Posture Before and After Disclusion Time Reduction (DTR). A Five-Year Cohort Study. Adv Dent Tech. 2021 Jul;3(2):23-35. Epub.

Thomas E. Bramanti, D.D.S., Ph.D.

Board-Certified Diplomate American Board of Periodontology/Implant Dentistry

Board-Certified Diplomate American Board of Oral Implantology/Implant Dentistry

Certified TMJ Expert, The Pankey Institute

Fellow American Academy of Implant Dentistry
Clinical Assistant Professor at UCSF in the Department of Oral and Maxillofacial Surgery

Clinical Assistant Professor UCSF-Fresno Medical Education Program, School of Medicine

Stress or Strain. These are two different problems. Stress happens when we are either physically or mentally consumed. Stress is usually our body tightening up and collapsing inwards similar to a fetal position where the body would just like to curl up on itself. The main feature of stress is tightness of muscles, stress hormone release, and perhaps a feeling of being overwhelmed.

Stress is something we all have. You cannot easily avoid it. It is natural and our bodies have ways we try to cope with it.

Strain is different. When your body is functioning or doing things, many body systems are working together to allow you to do the things in your day that you need to do. Often that strain causes muscles, tendons, and ligaments to be overused. If the body needs to overcome stress it will tighten up and create an unbalanced and uncoordinated function. If that creates strain in the body, pain may be the result. Over time, the strain in your body creates a loss of function, a loss of freedom of movement , and pain.

Can my bite create strain or stress?

How you bite, how your jaw has to function, are major causes of strain. With that strain, comes pain and with that pain comes stress. How you bite has global effects on your body. Studies show that changes in the bite can create changes in the way you stand. That strain, or the release of it, can go from teeth to toes.

How do you relax your jaw with TMJ treatments?

TMJ Treatment goals are to provide structural balance to the jaw, teeth, head, neck, and body. This helps relax strained muscles and provide relief to facial pain.

A small dental contact interference altering the way teeth meet or function has been shown to create jaw muscle strain. The task for Dr. Bramanti is to find the interference in the unevenness of the bite. Often that interference is on the opposite side of the mouth from the facial pain.

Sometimes the strain comes from unfortunate jaw growth. Sometimes tooth loss, dental fillings, prolonged cleaning appointments, and traumatic injuries will create strain in the jaw. Whatever the cause, there are treatments and therapies that can help relieve strain in the bite and how the bite functions. These can reduce muscle strain and reduce facial pain due to this problem.

Since muscles are all connected in your body, Dr. Bramanti will assess more than just your jaw, but body muscle strain and imbalance to help bring other appropriate healthcare providers into your care, if needed.

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