young adult woman holding her mouth in painFacial pain can be disruptive to your ability to live life on a daily basis. It can make simple tasks like eating, talking, or even smiling impossible. It’s hard to interact with anyone in a business or personal situation if you’re constantly wincing through your day. You want relief, but treatment depends on finding the true cause of your pain, which isn’t always easy.
Three common sources of facial pain are temporomandibular joint disorders (called TMJ or TMD), trigeminal neuralgia, and toothache. The best way to tell the difference is to schedule an appointment with Columbia TMJ dentist Dr. Adam Hahn, who can distinguish these three conditions. However, some basic information can help you make that appointment with more confidence.

Which Is Most Common?

While these three conditions could all be behind your facial pain, they’re not equally common. Trigeminal neuralgia is the least common. About 150,000 cases a year are diagnosed, with new cases affecting about 12 out of every 100,000 people (0.012%). In contrast, both TMJ and toothache are far more common. TMJ might affect as much as 3% of people, though most of these cases don’t require professional treatment. About 26% of adults have untreated tooth decay (cavities), although not all of these will cause pain, and it’s not the only source of toothache.

What Is Toothache?

Toothache is pain in your tooth. It might be related to tooth decay, but it could also be caused by irritation or trauma to the tooth. Toothache can also be linked to gum disease.

How to Identify Toothache

Usually, a toothache is felt in the tooth. However, thanks to the phenomenon of referred pain, you might feel a toothache as facial pain. To identify toothache, look for these other signs and symptoms:

  • Visible damage to a tooth: black spots, cracks, or discoloration
  • Sensitivity to heat or cold
  • Sensitivity to acidic or sweet foods and drinks
  • Pressure sensitivity
  • Foul taste in your mouth
  • Chronic bad breath
  • Lack of TMJ or trigeminal neuralgia symptoms

Inspect your teeth as best you can. If you see one with discoloration, black spots, or cracks, you should suspect a toothache. Also, try sucking in cool air or drink a mouthful of ice water. If this causes an immediate pain response, you likely have a toothache.

What Is TMJ?

TMJ is an umbrella term for many different types of joint dysfunction affecting one or both jaw joints. It can be related to the muscles, nerves, and joint structures, which means it can cause a wide range of symptoms that can affect much of the body, from the top of your head to the tips of your fingers. It’s also linked to other chronic pain conditions, so people with TMJ might experience pain almost anywhere in the body, though much of the pain centers in the face, head, and jaw.

How to Identify TMJ

TMJ facial pain can affect the entire face, from the forehead to the jaw. It can occur on one or both sides of the face. It can have many different characteristics, from dull muscle ache to sharp nerve pain. Headaches are common, but not everyone gets them.
In addition to pain, watch for these common TMJ symptoms:

  • Limited jaw movement
  • Irregular jaw movement (the jaw might seem to jump suddenly at one point)
  • Clicking, popping, or grinding noise in the joint
  • Worn teeth and damaged restorations
  • Tinnitus (ringing or roaring in the ears)
  • Vertigo and dizziness
  • Ear fullness

TMJ symptoms are likely to flare with jaw activity. This might mean actively moving your jaw when talking or eating. However, it might also be linked to less obvious jaw activity, such as clenching your teeth or swallowing.
Since TMJ can cause damage to your teeth, some people don’t notice TMJ until they experience a related toothache.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia results from damage, irritation, or pressure on the trigeminal nerve. The trigeminal nerve is a large cranial nerve that divides into three branches to control facial muscles and relay pain signals back to the brain. Usually, trigeminal neuralgia starts after an accident or injury to the face. However, it can sometimes occur for no discernible reason.

How to Identify Trigeminal Neuralgia

Trigeminal neuralgia is almost entirely characterized by pain. The pain may start mild but worsens over time. It often comes in attacks, where you experience bouts of pain that’s common for a while, then it subsides, sometimes for months or even years. Over time, pain attacks become more frequent and severe.
Symptoms of trigeminal neuralgia include:

  • Pain on one side of the face
  • Sharp, electric pain in the cheek, jaw, eye, or forehead
  • Numbness or tingling in the face
  • Pain in response to minor triggers like:
    • Touching skin lightly (even the wind might do it)
    • Shaving
    • Brushing teeth
    • Jaw activity
  • Absence of ear and joint TMJ symptoms

Trigeminal neuralgia affects only the trigeminal nerve, so its symptoms all relate to excessive sensation (pain), sensitivity to touch, or minimal nerve sensation (numbness or tingling). While jaw activity can trigger both trigeminal neuralgia and TMJ, TMJ will have more symptoms related to the jaw (limited motion, noises, etc.) and ear (tinnitus, vertigo, etc.).

Identify the Source of Facial Pain in Columbia, SC

You don’t have to track down the source of your pain alone. Columbia TMJ dentist Dr. Adam Hahn has decades of experience helping people with facial pain. He can distinguish between toothache, TMJ, and trigeminal neuralgia. Once he identifies the source of your pain, he will either treat it or refer you to someone who can.

Please call (803) 781-9090 or use our online form today to request an appointment at Smile Columbia Dentistry, located near the intersection of I-26 and Murray.