Pain and/or swelling of the jaw results most commonly from dental conditions. In the upper jaw, pain may also result from infection of the paranasal sinuses. The latter condition is considered under Facial swellings (p. 134). History of trauma, e.g. fights, road traffic accidents. Fracture of the mandible is the most common. Dental abscess presents with a dull ache in the jaw, becoming throbbing and severe. There is often accompanying malaise and loss of appetite. Previous history of dental caries. Acute osteomyelitis of the mandible is rare. It may follow dental infection or tooth extraction. There may be a history of fractures, irradiation, leukaemia, diabetes, malnutrition, alcoholism or immunosuppression. There is a severe, throbbing deep-seated pain. The patient has difficulty opening the mouth and swallowing due to muscle oedema. Actinomycosis presents with swelling of the jaw with persistent low-grade infection. Temporomandibular joint pain dysfunction syndrome results from grinding and clenching the teeth. The patient may have had a stress-related illness. Pain arises in the region of the temporomandibular joint or ear, which may be associated with a clicking noise and is aggravated by wide opening of the mouth, as with yawning and chewing. Rheumatoid arthritis of the temporomandibular joint is rare. Other signs and symptoms of rheumatoid arthritis are usually apparent. Osteoarthritis usually causes pain, swelling and limitation of jaw movement. Temporomandibular joint dislocation may be recurrent, habitual or isolated. The condyle is displaced forwards and upwards into the temporal fossa. The patient’s mouth remains open and cannot be closed following yawning, tooth extraction or general anaesthesia. The condition may be unilateral or bilateral. The patient presents with an open mouth, which he or she cannot close, and pain due to muscle spasm.
Jaw Pain and Swellings
Causes
History
Traumatic
Infective
Temporomandibular joint
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