Tooth and facial pain - explanation and treatment
A number of patients present with quite severe tooth and or facial pain without realising that Osteopaths can help with these symptoms. Many have experienced pain for some time and have already seen a dentist, often with little relief despite appropriate dental care.
In a proportion of cases, symptoms persist because the source of the pain is not dental but musculoskeletal. Tooth pain can be referred from muscles, producing a very specific pattern of pain felt in one or more teeth even though the tooth itself is healthy. In a similar way, headaches, earache, tinnitus, jaw joint pain (TMJ-related pain) and facial pain can originate from tight or overactive muscles in the face or neck.
These tight areas, known as trigger points, may be located some distance away from where the pain is felt. Jaw clenching or grinding (bruxism) can increase muscle tension and sensitivity, and is a common contributing factor in both facial and tooth pain.
Three muscles frequently involved in dental and facial pain patterns are the masseter, temporalis and digastric. In the images below, the crosses indicate the most sensitive areas of the muscle (trigger points), while the shaded areas and dots show where pain is commonly referred. This helps illustrate how pain can be experienced some distance from the original source of muscle tension.
Masseter – is the strongest muscle in the body (pound for pound) and is your primary chewing muscle which covers the sides of the jaw just behind the cheek. It’s responsible for clenching your jaw and grinding your teeth (bruxism) and tempero-mandibular (TMJ) syndrome or jaw joint pain. It is one of the most common locations for trigger points in the human body. It refers pain to the back top and bottom teeth.
Temporalis – refers pain to the whole set of upper teeth (moving back tooth by tooth according to the location of the trigger point)
Digastric – refers pain only to the front bottom teeth.
(Images from Dr. Janet Travell & Dr David Simons – Myofascial Pain & Dysfunction: The Trigger Point Manual)
Test 1 – Jaw opening – Face a mirror and place your first two fingers over your tempero-mandibular joint (TMJ) on either side and slowly open and close your jaw. You should see smooth straight opening and closing and should not feel or hear any clicks or grinding.
Test 2 – Two-knuckle jaw opening – Try to place two knuckles of your non-dominant hand in between your top and bottom incisors (front teeth). If your jaw cannot open wide enough to fit both knuckles, one of the 3 toothache muscles may be the culprit.
Test 3 – Palpation – for temporalis and masseter, you can gently press into the black cross areas noted in the pictures above to see if these muscles are particularly tight and/or sore.
Osteopaths can treat trigger point–related muscle tension effectively and help ease tooth pain, jaw pain, facial pain and associated headaches. Treatment may involve a combination of soft tissue techniques, deep inhibition, gentle stretching and articulation of the jaw, neck and upper back, and dry needling (modern acupuncture) where appropriate.
In the meantime, gentle heat can be helpful. This can be applied using a towel soaked in hot water and wrung out, or a microwaveable heat pack, taking care not to overheat or irritate the sensitive tissues of the face.
Some patients find it helpful to read about others with similar symptoms. You can scroll down to Arlene Allan’s testimonial (8 Jan 2019) on my Reviews page to read how I helped her with facial and tooth pain.
Appointments can be booked via my online diary.
