New Jaw Pain After Dental Injection

  • New Jaw Pain After Dental Injection
    New Jaw Pain After Dental Injection
    • Ann C McCulloch
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    New jaw pain after dental injection may be from nerve damage, but it’s more likely to be a warning sign of an underlying TMJ injury. This is because nerve damage from an injection is extremely rare, and if it occurs, the presenting symptoms are numbness and tingling, rather than jaw pain. A more common cause of new jaw pain after a dental procedure is sprain/strain to the jaw joint and muscles.

    Here we explore why new jaw pain after dental injection might occur and what you can do about it.

    Jaw Pain After Dental Injection

    If a trip to the dentist leaves you with lingering jaw pain, you might conclude that the jaw pain and dental injection are related. However, direct nerve injury after a dental injection is exceedingly rare, estimated to occur in the range of 1 in 26,000-160,000 injections. Please note that persistent pain after a dental procedure should be brought to the attention of your dentist.

    When there is nerve damage after an injection, the symptoms are typically prolonged anesthesia (lack of sensation, numbness) or paresthesia (“pins and needles”, tingling, burning) along the distribution of the traumatized nerve.

    A possible indicator of direct nerve injury is a “shock” sensation at the time of injection. However, this sensation is relatively common, occurring in roughly 5% of injections. Thankfully, this unpleasant shock rarely results in lasting symptoms.

    Depending on the site of injection, disturbances in taste can also occur with direct nerve injury.

    The mechanisms of nerve damage after dental injection include bleeding around the covering of the nerve (a hematoma), neurotoxicity of the local anesthetic, and direct injury from the needle. The prognosis for full recovery is good, with roughly 85% recovering within 8 weeks of the time of injury. If symptoms are present two weeks after an injury, an orofacial pain specialist can be helpful..

    TMJ Pain After Dental Work

    Jaw sprain/strain after dental work may be coincident with a dental injection. If the pain is more in the teeth and gums, the primary culprits are gum inflammation, pulpitis (inflammation of the dental pulp), and soft tissue injury. However, true jaw pain after a dental injection is more likely to be from muscle injury combined with strain to the temporomandibular joint (TMJ) and surrounding structures.  The sustained jaw opening after a dental procedure can cause muscle strain and fatigue, resulting in jaw pain.

    Here’s what happens with jaw strain from dental procedures:

    • When the dentist asks you to “open wide”, your jaw moves to its maximal voluntary opening distance.
    • When the dental instruments are in the mouth or when a bite block is placed, the opening pressure forces your jaw to move beyond its voluntary range of motion.
    • This hyperextension triggers muscle guarding and nerve excitability which can last for hours after the procedure is finished.
    • Increased muscle guarding and jaw tension can lead to a self-activating and self-perpetuating cycle that can result in jaw pain and/or dysfunction such as difficulty opening your jaw or chewing.

    Lingering TMJ pain after dental work should be taken seriously because it can convert into a chronic pain condition and result in risk of re-injury with subsequent dental procedures. “Not only is jaw sprain/strain after lengthy dental procedures common, it’s also cited as the initiating factor by more than 50% of patients with chronic TMJ pain”, explains Bradley Eli, DMD, MS, who specialized in the treatment of orofacial pain.

    How can you tell if your TMJ pain is from nerve injury or jaw strain?  The key factor will be the symptoms you feel. Nerve injuries will present with numbness and tingling, whereas jaw strain will be felt as soreness with chewing, limited range of motion, and jaw muscle tenderness.  The symptoms can last as little as a few days or as long as several weeks.

    If you have these symptoms, speak to your dentist right away so that he/she can help you manage a jaw sprain/strain before it gets worse.

    How To Treat TMJ Strain From Dental Work

    The optimal protocol for TMJ strain follows an orthopedic model of joint pain.  This includes the following measures:

    • Jaw Rest: Soft diet and avoidance of hard foods and gum chewing.
    • Stretching exercises: Specialized jaw exercises designed to gradually restore healthy joint mobility.
    • Analgesics: Use of acetaminophen, anti-inflammatories or topical medication to reduce pain and facilitate normal jaw movement.
    • Hot/cold therapy: Alternating heat and cold are an important part of TMJ injury healing.
    • Oral Splint Therapy: An anterior bite guard (like the Quicksplint) helps rest the joint and relieve TMJ muscle hyperactivity.  An anterior bite guard is worn on a short-term basis only.

    All of these components of TMJ injury care are included in the Speed2Treat Home Healing Kit offered by Orofacial Therapeutics. Don’t let an acute injury develop into a chronic condition. Start your journey towards TMJ pain relief with the Home Healing Kit today!


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