This document discusses common causes of jaw pain and their classification. It categorizes the causes as either odontogenic (dental) or non-odontogenic in origin. Odontogenic causes include pulpitits, apical periodontitis, periapical abscess, and osteomyelitis. Non-odontogenic causes involve temporomandibular joint disorders, myofascial pain, sinusitis, and neuropathic pain. Various conditions are described in detail, along with their symptoms, signs, diagnostic methods, and typical treatments. Proper diagnosis and treatment planning tailored to the underlying problem are emphasized.

2. INTRODUCTION
•PAIN OR TENDERNESS IN THE JAW OR THE AREA AROUND THE JAW HAS BECOME A VERY
COMMON PROBLEM NOW A DAYS.
•PAIN IS SEEN IN 20% OF THE POPULATION.
•PAIN CAN BE GENERALIZED TO THE WHOLE JAW OR LOCALIZED TO ONE SIDE OF THE JAW.

3. CLASSIFICATION OF ORIGIN OF JAW PAIN
ODONTOGENIC
ORIGIN
NON
ODONTOGENIC
ORIGIN

4. ODONTOGENIC ORIGIN
•PULPITIS
•APICAL PERIODONTITIS
•PERIAPICAL ABSCESS
•PERIODONTAL ABSCESS
•PERICORONITIS
•ERUPTING IMPACTED
TOOTH PAIN
•OSTEOMYELITIS
•OTHERS

5. NON-ODONTOGENIC ORIGIN
•TEMPRO MANDIBULAR JOINT
DISORDERS
•MYOFACIAL PAIN
•ATTRITION
•SINUSITIS
•NEUROPATHIC PAIN
•VASCULAR PAIN
•NEUROVASCULAR PAIN

6. THE STAGES OF CARIES DEVELOPMENT

7. PULPITIS
• IT IS THE INFLAMMATION OF THE PULP ARISING FROM THE INFECTED PULP WHEN THE CERIES REACHES
THE PULP.
• THE PAIN INCREASES AT NIGHT DUE TO CHANGE IN THE POSTURE.
• IT IS NOT EASY TO LOCATE THE TOOTH WHICH IS THE SOURCE OF THE PAIN IN SOME CASES.
• PROPER DIAGNOSIS IS VERY IMPORTANT WITH NOTING DOWN PROPER CASE HISTORY RECORDING.
• NO CHANGES ARE SEEN IN THE X-RAY.

8. APICAL PERIODONTITIS
•INFECTION FROM THE PULP REACHES THE BONE SURROUNDING THE BONE OF THE
TOOTH.
•THE PAIN CAN BE LOCALIZED TO THE TOOTH.
•TENDERNESS ON PERCUSSION IS POSITIVE .
•X-RAY REVEALS WIDENING OF THE PERIODONTAL LIGAMENT AROUND THE ROOT APEX
WITH CARIES IN THE TEETH INVOLVING THE PULP.

9. PERIAPICAL ABSCESS
•IT IS THE FORMATION OF PUS IN THE AREA AROUND THE ROOT TIPS OF THE TOOTH
WHICH CAUSES PAIN IN THE JAW.
•THE PAIN CAN BE LOCALIZED TO A PARTICULAR TOOTH.
•IT IS SOMETIMES ASSOCIATED WITH A SWELLING IN THE JAW OR THE AREA AROUND
THE TOOTH IN THE GUMS.
•MIGHT BE A PUS DISCHARGE SEEN FROM THE SWELLING WHICH IS CALLED A SINUS
OPENING.

10. PERIODONTAL ABSCESS
•IT IS THE COLLECTION OF PUS IN THE PERIODONTAL LIGAMENT AREA OF THE TOOTH.
•IT OCCURS DUE TO CONVERSION OF THE FOOD LODGED IN A POCKET AROUND THE
TOOTH INTO PUS/ ABSCESS.
•ASSOCIATED WITH SWELLING IN THE GUM AROUND THE INVOLVED TOOTH.
•THE INVOLVED TOOTH SHOWS INCREASED MOBILITY.
•TENDERNESS ON TOUCH FROM THE LATERAL SIDE.

11. PERICORONITIS
•IT IS THE PAIN ASSOCIATED WITH AN ERUPTING WISDOM TOOTH DUE TO
INFLAMMATION OF THE GUM THAT PARTIALLY COVERS THE TOOTH.
• THE PAIN IS DUE TO FOOD LODGEMENT WHICH GETS INFECTED OVER A PERIOD OF TIME,
IF THE ORAL HYGIENE IS NOT MAINTAINED.

12. OSTEOMYELITIS
•IT IS THE SPREAD OF THE INFECTION FROM THE TOOTH INTO THE JAW, LATERAL SPREAD
OF THE INFECTION INTO THE BONE. THE BONE GETS INFECTED WHICH CAUSES THE PAIN.
•ASSOCIATED WITH FORMATION OF SEQUESTRUM ( DEAD BONE )

13. CRACKED TOOTH PAIN
•PAIN IN THE JAW CAN ALSO BE ASSOCIATED WITH A CRACK IN THE TOOTH
(MICROSCOPIC OR MACROSCOPIC) WHICH HAS REACHED THE PULP CHAMBER.
•THE PAIN IS PRESENT ON RELEASING THE BITING PRESSURE ON THE TOOTH.
•CAN BE SEEN CLINICALLY OR THROUGH A CBCT OF THE INVOLVED TOOTH.

14. CRACKED TOOTH

15. TEMPERO-MANDIBULAR JOINT DISORDERS
•ASSOCIATED WITH CONDITIONS LIKE ARTHRITIS AND TMJ DYSFUCTION
WITH REDUCTION OR WITHOUT REDUCTION.
•CLICKING OF THE JOINT ON OPENING OR CLOSING.
•THE PAIN IS MAINLY SEEN IN FRONT OF THE EAR.

16. MYOFACIAL PAIN
•PAIN IN THE JAW AND RELATED AREAS OF THE FACE DUE TO EXCITATORY
RESPONSE OF NERVE IMPULSE BY ONE OR THE OTHER NERVE SUPPLYING
THE AREAS OF THE JAW.
•SEEN IN MYOFACIAL PAIN DYSFUCTION SYNDROME.
•PAIN IS SEEN AROUND THE MANDIBULAR JAW AROUND THE MUSCLES OF
THE TMJ.

17. ATTRITION
•IT IS SUBCONSCIOUS GRINDING OF THE TEETH EITHER DUE TO STRESS OR
OTHER ENVIRONMENTAL FACTORS
•LEADS TO REDUCTION IN THE HEIGHT OF THE TEETH.
•THIS EXCESSIVE GRINDING OF THE TEETH OVER THE LONG RUN CAUSES
PAIN IN THE JAW DUE TO OVERSTRESSED MUSCLES OF THE JAW.

18. SINUSITIS
•IT IS THE INFLAMMATION OF THE SINUSES OF THE SKULL.
•THE PAIN IN THE JAW IS MAINLY ASSOCIATED WITH THE MAXILLARY SINUSES.
•CONGESTED SINUSES CAUSES PAIN IN THE JAW SPECIALLY POST NASAL INFECTIONS OR
COLD.
•THE PAIN INCREASES ON BENDING OVER.
•DIAGNOSED WITH A WATER’S VIEW X-RAY.

19. NEUROPATHIC PAIN
•PAIN IN THE JAW ARISING FROM THE NERVE
THAT SUPPLIES THAT AREA.
•SEEN IN CASES OF TRIGEMINAL NEURALGIA.
•IT IS A SEVERE CUTTING KIND OF A PAIN ON
ONE SIDE OF THE FACE RADIATING TO THE
LOWER JAW ( RELATED TO THE TRIGEMINAL
NERVE THAT SUPPLIES THAT AREA).

20. VASCULAR PAIN
•PAIN ASSOCIATED WITH SPECIFIC BLOOD
VESSEL THAT SUPPLIES THE AREA.
•EXAMPLE BEING THE TEMPORAL ARTERITIS.
•ASSOCIATED WITH PAIN IN THE JAW AFTER
CHEWING.

21. DIAGNOSIS
•PROPER CASE HISTORY RECORDING
•OPTIMUM DIAGNOSTIC TESTS LIKE OPG, CBCT ETC.
•METICULOUS STUDY ABOUT THE CASE
•PROPER AND SCHEDULES TREATMENT PLANNING

22. TREATMENT PLAN
•VARIES ACCORDING TO THE MAIN PROBLEM.
•ODONTOGENIC ORIGIN OF THE PAIN MAINLY INCLUDES TREATMENT AS
• ROOT CANAL TREATMENT
• CURETTAGE AND ROOT PLANNING
• EXTRACTION
• APICECTOMY
•NON ODONTOGENIC ORIGIN OF PAIN MAINLY INCLUDES
• LASER THERAPY
• SYMPTOMATIC RELIEF
• EXERCISES

24. To book an appointment contact :
Dr.Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental
Aesthetic And Implant
Institute
I 101, Ashok Vihar Phase 1, Delhi-
110052

25. IMAGE COURTESY
• HTTPS://DENTAGAMA.COM/NEWS/WHAT-IS-THE-DIFFERENCE-BETWEEN-DENTAL-ATTRITION-
ABFRACTION-EROSION-AND-ABRASION
• HTTPS://WWW.ROCKYVIEWDENTAL.CA/CALGARY-CRACKED-TOOTH.HTML
• HTTPS://POCKETDENTISTRY.COM/DISEASE-ENTITIES-AND-DIAGNOSIS/