Differential Diagnosis for Jaw Pain

The following is a comprehensive differential diagnosis for jaw pain, categorized for clarity and emphasis on critical conditions.

• Single Most Likely Diagnosis

  • Temporomandibular Joint (TMJ) Disorder: This is often the most common cause of jaw pain due to its prevalence and the frequent use of the TMJ in daily activities like eating and speaking. TMJ disorders can result from jaw injury, arthritis, or habits like teeth grinding and clenching.

• Other Likely Diagnoses

  • Dental Problems (e.g., tooth abscess, impacted teeth): Dental issues are a common source of jaw pain, often due to infection or pressure on the jawbone and surrounding tissues.
  • Bruxism: Teeth grinding, either during sleep or as a stress habit, can lead to jaw pain and fatigue.
  • Sinusitis: Inflammation of the sinuses can cause referred pain to the jaw area, especially in the upper jaw.
  • Tension Headache: Muscle tension in the face and neck can radiate pain to the jaw.

• Do Not Miss Diagnoses

  • Acute Angle Closure Glaucoma: Although rare, this condition can cause severe eye pain that may radiate to the jaw. It's an emergency requiring immediate medical attention.
  • Myocardial Infarction (Heart Attack): Jaw pain can be a symptom of a heart attack, especially in women, and is critical not to miss due to its high mortality rate if untreated.
  • Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause intense shock-like or stabbing pain in parts of the face, including the jaw.
  • Osteonecrosis of the Jaw: A rare condition often associated with long-term bisphosphonate use, characterized by the death of jawbone tissue.

• Rare Diagnoses

  • Jaw Tumors (benign or malignant): Although uncommon, tumors in the jaw can cause pain and should be considered in the differential diagnosis, especially if there are other symptoms like swelling or unexplained weight loss.
  • Sialadenitis (inflammation of the salivary glands): Can cause jaw pain, especially if the parotid gland is involved.
  • Eagle Syndrome (elongated styloid process): A rare condition where an abnormally long styloid process can cause pain in the jaw and face.
  • Fibromyalgia: A chronic condition characterized by widespread musculoskeletal pain, including jaw pain, fatigue, and tenderness in localized areas.

Each of these diagnoses has distinct characteristics and requires a thorough medical history, physical examination, and sometimes additional diagnostic tests to accurately diagnose the cause of jaw pain.