Differential Diagnosis for Jaw Pain during Mastication

Single Most Likely Diagnosis

• Temporomandibular Joint (TMJ) Disorder: This is the most common cause of jaw pain during mastication. TMJ disorders can cause pain in the jaw, face, and temples, and can be exacerbated by activities such as chewing.

Other Likely Diagnoses

• Bruxism: Grinding or clenching of the teeth can lead to jaw pain, especially during mastication. This condition can be related to stress, anxiety, or misalignment of the teeth.
• Dental Problems: Issues such as cavities, abscesses, or gum disease can cause pain in the jaw that worsens during chewing.
• Myofascial Pain Syndrome: This condition involves pain and inflammation in the muscles of the face and jaw, which can be triggered by activities like chewing.

Do Not Miss Diagnoses

• Acute Angle Closure Glaucoma: Although rare, this condition can cause severe eye pain that may radiate to the jaw, and is a medical emergency.
• Myocardial Infarction: In some cases, a heart attack can cause referred pain in the jaw, especially in women. This is a life-threatening condition that requires immediate medical attention.
• Trigeminal Neuralgia: A condition characterized by sudden, severe facial pain that can be triggered by chewing or other facial movements.

Rare Diagnoses

• Eagle Syndrome: A rare condition where an elongated styloid process causes pain in the jaw and face, which can worsen during mastication.
• Sphenoid Sinusitis: Inflammation of the sphenoid sinus can cause deep facial or jaw pain, including pain during chewing, although this is relatively rare.
• Osteonecrosis of the Jaw: A condition characterized by the death of jawbone tissue, often associated with bisphosphonate use or radiation therapy, which can cause jaw pain during mastication.