In most women, jaw pain in pregnancy may indicate temporomandibular joint dysfunction (TMD). Temporomandibular joints (TMJ) are located on each side of the face, and it connects the lower jaw to the skull. Various musculoskeletal and neuromuscular disorders can affect the TMJ and lead to severe pain (1). Pregnancy-induced jaw pain and dental pain can be due to hormonal changes. This may also cause headaches when pregnant. Swelling and stress with hormonal alterations can worsen jaw pain in pregnant women. However, simple care measures and some medications may help relieve this pain in most people. Keep reading this post to learn about the causes, risk factors, symptoms, tests, and treatments of jaw pain in expectant mothers.
Causes Of Jaw Pain In Pregnancy
The following are the common causes of jaw pain in pregnancy.
1. Hormonal changes
Estrogen and relaxin hormones rise in pregnancy. These hormones increase the laxity of all the joints in the body to help in childbirth. However, it might lead to joint stretching and pain, including in the temporomandibular joints (2). According to Dr. Jordan Weber, DDS, Burlington Dental Center, Kansas, United States, “The science on the relationship between estrogen levels and jaw pain (“TMD pain”) is inconclusive, although many researchers have suggested that there is a link of some kind. Due to the substantial hormonal changes that occur during pregnancy, it is nearly certain that hormones modify and potentially increase the incidence of jaw pain during pregnancy.”
2. Grinding of the teeth
The involuntary grinding of teeth is known as bruxism, which is often associated with anxiety or stress. Women prone to bruxism could experience an increase in teeth grinding due to stress during pregnancy. Chronic bruxism is one of the causes for jaw pain and temporomandibular joint dysfunction (3). “Any life event that increases stress levels is likely to cause teeth clenching. So, the increased stress (combined with a reduction of sleep quality) during pregnancy will significantly increase a woman’s risk of teeth clenching and associated jaw pain,” notes Dr. Weber.
3. Morning sickness
Vomiting may put excess pressure on the shoulder and neck muscles. The jaw needs to be thrust forward vigorously to expel the contents of the stomach. Frequent vomiting can strain or even sprain the jaw muscles. It can lead to pain in the TMJ (4).
4. Lack of calcium
The baby in the womb needs calcium to develop its skeleton. Calcium is needed the most in the second and third trimester of pregnancy. If there is insufficient calcium in the mother’s blood, then the body draws it from the bones to supply to the fetus (5).This might cause bone weakness and jaw pain in expecting mothers.
5. Sleeping on one side
Pregnant women find it comfortable to sleep on one side throughout the night. Sleeping on one side might cause pressure on the muscles of the jaw and cause jaw pain.
6. TMJ disorders
Women with a history of TMJ pain and problems might display an increase in the severity of jaw pain due to hormonal changes. “Bi et al. hypothesized that increased estrogen may reduce jaw muscle nociception (pain response to a stimulus) in the TMJ area, and if there is inflammation present in the TMJ, there is resulting hyperalgesia (more severe pain) in the TMJ area. Additionally, a study by LeResche suggested that while estrogen tends to reduce TMJ pain, significant changes in estrogen level are associated with more pain because our body likes harmony, and changes (mechanical, chemical or emotional) can arouse our fight or flight response which in turn causes more TMJ pain,” says Dr. Brijesh Chandwani, BDS, DMD Attending dentist, St. Barnabas Hospital, New York City Metropolitan Area.
7. Abscessed tooth
An infection, which causes pus collection at the base of the root of the tooth is known as an abscess. It causes tooth pain and might cause radiating pain in the entire jaw, intraoral or extraoral swelling, fever, tooth mobility, etc. (6).
8. ENT infection
An infection in the ear, nose, or throat might cause pain that radiates to the jaws.
9. Wisdom teeth
When the wisdom teeth begin to erupt, they might push against other teeth, and make them move. This could cause stiffness and discomfort in the jaw. The pain from wisdom teeth radiates to the entire jaw or the TMJ (7).
10. Cardiovascular condition
Some individuals with cardiac diseases have pain in jaws and TMJ. It is generic for both pregnant and non-pregnant patients (8).
11. Injury
Any injury on the muscles of the jaw, neck, or the head, due to an accident, such as a blow or a fall, might also cause pain in the jaw.
Symptoms Of TMJ Disorder And Jaw Pain In Pregnancy
The following are the commonly associated symptoms seen in TMJ disorders and jaw pain (4).
Difficulty in chewing Difficulty in opening the mouth Limitation on the range of motion of the jaw TM joint clicking TM joint locking Tension in the face Swelling on one side of the face Frequent headaches in the temple region Morning headaches on waking up Sore jaw muscles Neck tension
Tips To Manage Jaw Pain During Pregnancy
The following precautions at home might help you manage TMJ pain during pregnancy.
Diagnosis Of TMJ Disorder And Jaw Pain During Pregnancy
If you experience jaw pain during your pregnancy, then visit a dentist or your gynecologist at the birth center. There is no specific diagnostic test to evaluate TMJ disorders. The dentist might do the following to diagnose the cause and plan treatment accordingly.
They will take note of all the symptoms and medical history, do a thorough clinical evaluation, and check all probable problem areas, including the head, neck, face, and jaw.
They will palpate and check for tenderness, popping, clicking, or difficulty in moving the joint.
Although radiographs (x-rays) are contraindicated in pregnancy, if you are in severe pain and if necessary, then the dentist might suggest a panoramic x-ray known as an orthopantomogram (OPG) (9). It shows the upper jaw, lower jaw, and all the teeth.
If the dentist suspects the pain is coming from one tooth due to a localized infection, then he/she might shoot a small intra-oral x-ray that would focus only on one tooth and that is safe in pregnancy.
The doctor will check for the presence of an abscess, broken teeth, infections, or fractured jaws in these scans and plan your dental care
If any radiographic scans need to be performed for proper diagnosis, then the doctor will take all the precautions, like covering you in a lead apron and a lead thyroid collar to protect the baby from the harmful effects of dental x-rays.
What Is The Treatment For TMJ Disorder And Pain In Pregnancy?
The doctor will evaluate your condition and suggest a treatment that is safe and efficient for pain management during pregnancy. The following are the commonly deployed treatment protocols (4).
