Facial pain caused by craniomandibular dysfunction
Craniomandibular Dysfunction (CMD) is another possible cause of facial pain, especially when it is described as originating from the jaw or temporomandibular joint. CMD is often referred to as myoarthria of the masticatory system and refers to the following anatomical structures: the temporomandibular joint, the masticatory muscles and also the temporal muscle are involved. The cause of the pain lies in the temporomandibular joint itself.
This consists of the skull bone and the jaw bone, connected by a small cartilage disc between them. When the lower jaw is moved, this cartilage glides along between the two bones and reduces the resulting friction. This can sometimes cause crunching noises, but these are completely normal.If you notice that these noises occur more frequently or if the patient complains of long-lasting pain, there is a need for medical action.
Frequently, this is caused by tension in the masticatory muscles or wear and tear of the cartilage disc. Nocturnal teeth grinding is often an expression of tension in the temporomandibular joint and during the day can lead to severe radiating of the jaw pain, especially into the temples. Teeth grinding can be treated relatively easily.
A bite splint is made, which on the one hand relieves the joint and on the other hand tries to improve the unfavorable learned movement patterns in the jaw by changing the position. In addition, physiotherapy with progressive muscle relaxation is recommended. If necessary, the use of medication can also be discussed, primarily tricyclic antidepressants are used, which may cause fatigue as a side effect. If the cause of craniomandibular dysfunction is wear and tear of the cartilaginous parts of the temporomandibular joint, surgical removal of the cartilage disc can bring improvement to the patient. If, however, the symptoms are more likely to be caused by inflammation of the temporomandibular joint, anti-inflammatory medications can help.
Thyroid gland diseases
In rare cases, facial pain can also be caused by a thyroid gland disease. This is especially the case with a certain form of inflammation known as Hashimoto’s thyroiditis. In this form of thyroiditis, the body produces (auto)antibodies against its own thyroid gland; it is therefore an autoimmune disease. The result is an inflammation, which usually leads to hypothyroidism, but also to pain that can spread to the neck and face.