Facial Pain Due to Other Causes

Facial Pain Due to Other Causes

Facial pain may be caused by temporomandibular joint dysfunction in patients with malocclusion, abnormal bite, or faulty dentures. There may be tenderness of the masticatory muscles, and an association between pain onset and jaw movement is sometimes noted. This pattern differs from that of jaw (masticatory) claudication, a symptom of giant cell arteritis, in which pain develops progressively with mastication. Treatment of the underlying joint dysfunction relieves symptoms.

A relationship of facial pain to chewing or temperature changes may suggest a dental disturbance. The cause is sometimes not obvious, and diagnosis requires careful dental examination and radiographs. Sinusitis and ear infections causing facial pain are usually recognized by the history of respiratory tract infection, fever, and, in some instances, aural discharge. There may be localized tenderness. Radiologic evidence of sinus infection or mastoiditis is confirmatory.

Glaucoma is an important ocular cause of facial pain, usually localized to the periorbital region.

On occasion, pain in the jaw may be the principal manifestation of angina pectoris. Precipitation by exertion and radiation to more typical areas establish the cardiac origin.

When to Refer

• Worsening pain unresponsive to simple measures.
• Continuing pain of uncertain cause.
• For consideration of surgical treatment (trigeminal or glossopharyngeal neuralgia).

Posted in: Facial Pain