Oral health is one of the areas that might get affected during pregnancy. There are several pregnancy-induced jaw and dental problems, and jaw pain is one such condition.
Temporomandibular joint dysfunction (TMD) could be one of the reasons for jaw pain during pregnancy. The temporomandibular joints (TMJ) are the two joints present on each side of the face. These joints connect the lower jaw to the skull. TMD is an umbrella term for musculoskeletal and neuromuscular conditions involving the temporomandibular joints (TMJ) (1).
In this MomJunction post, we tell you about the causes, symptoms, diagnosis, and treatment of TMJ disorders and jaw pain in pregnancy.
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).
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).
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.
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).
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.
- Soft diet: Eating soft, easy-to-chew food might help reduce jaw pain.
- Ice application: External application of ice over the jaw might help reduce localized swelling and muscle spasm.
- Restricted mouth opening: Try not to yawn, laugh, or yell too loudly. Avoid certain food items that are served whole. Chop food into smaller pieces so that you do not have to open your mouth wide open.
- Alteration in sleeping position:Try and avoid sleeping only on one side. Use a soft pillow.
- Posture changes: Avoid slouching in front of a laptop or a TV as it can strain your neck muscles and lead to jaw pain. Always sit with your back well-supported.
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).
- Jaw exercises and physical therapy: The doctor might recommend physical therapy for relief from pain.
- Massage: A physical therapist can teach you gentle self-massage techniques. You can do it yourself several times a day.
- Acupuncture: Acupuncture might help in managing the symptoms of TMJ pain (10).
- Medications: Oral medications like paracetamol may be prescribed for pain. The topical application of pain relief and anti-spasm gels might also be recommended. In case of severe pain, the doctor might recommend pain relief injection at the site of pain. You should never self-medicate and only stick to prescription medicines.
- Breathing techniques: The doctor might recommend breathing techniques to ease out the stress and to relax the tensed muscles.
- Root canal treatment: If the cause of jaw pain is due to a severe dental abscess, then you will require root canal treatment. This treatment is not contraindicated in pregnancy, but if not an emergency, then the doctor might postpone it until after the delivery. If jaw pain emerges early in pregnancy, then the second trimester is the safest time to get dental procedures done along with antibiotic coverage (11).
- Extraction: If the tooth infection is severe or the tooth is fractured, then the doctor might advise removal. Although elective extractions must be avoided in pregnancy, emergency extractions can be done in pregnancy (11).
- Mouthguard: A mouthguard is a habit-breaking appliance for habits like bruxism. It does not let the upper and lower teeth come in contact and could help relieve TMJ pain.
- Oral bite plates: Bite plates are similar to mouthguards and work as a cushion between the teeth. These plates could help reduce jaw muscle tightness and pain.
Frequently Asked Questions
1. Can pregnancy cause my jaw to hurt?
Pregnancy does not cause jaw pain in all women. Women prone to jaw pain might find it aggravated during pregnancy. Jaw pain can happen due to more than one reason.
2. Is jaw pain a sign of labor?
Jaw pain is not a usual sign of labor. It can be associated with pneumomediastinum (presence of air between the two lungs), a rare condition that could occur due to the onset of labor pain (12).
Jaw pain during pregnancy can occur for various reasons. Follow good oral hygiene habits to avoid dental issues and make sure to visit a dentist as a part of your prenatal care. Avoid taking non-prescription medicines. Lifestyle and dietary modifications often help in getting relief from jaw pain.
2. Temporomandibular disorders and pregnancy;Federal University of Parana
3. Teeth grinding (bruxism); National Health Service
4. Afa Bayramova, TMD and pregnancy?; Clinical Journal of Obstetrics and Gynecology
5. Pregnancy, Breastfeeding and Bone Health; Arthritis and Musculoskeletal and Skin Diseases
6. Tooth Decay; US National Library of Medicine
7. Symptoms that may Indicate you need your Wisdom Teeth Removed; St John Health
8. Dalband M, Mortazavi H, and Hashem-Zehi H; Bilateral temporomandibular joint pain as the first and only symptom of ischemic cardiac disease: a case report.; US National Library of Medicine
9. Habets LL et al., The OPG: an aid in TMJ diagnostics. III. A comparison between lateral tomography and dental rotational panoramic radiography (Orthopantomography); US National Library of Medicine
10. Jun-Yi Wu et al., Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders; US National Library of Medicine
11. Pregnancy and Dental Work; American Pregnancy Association
12. Janice C.Raley and Janet I.Andrews, Spontaneous pneumomediastinum presenting as jaw pain during labor; The Journal of Obstetrics and Gynecology
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