Your jaw is throbbing with pain. Or it’s making an irritating clicking sound whenever you eat. Or it doesn’t open properly. What gives?

“There are 101 reasons why your jaw can hurt,” said dentist Anthony Iacopino, an American Dental Association expert spokesperson on geriatric oral health.

“After age 50, the body’s healing responses start to decline and certain areas in the body become more susceptible to pain and inflammation,” Iacopino says. “Things that may have been dormant for years become more of a problem as you age. The jaw joint is a common place for this to happen, especially for people with diets of hard, chewy food, who have a history of clenching or grinding teeth or who have had whiplash-type injuries at an earlier age.”

You probably know the obvious—that jaw pain can be caused by gum disease or cavities. Read on for some of the other reasons.

Temporomandibular Joint Disorders (TMD)

The temporomandibular joint (TMJ), which connects your lower jaw to your skull, is what allows your mouth to move (your upper jaw stays put). Damage to it can cause TMD, problems with the jaw, face and neck area.

People often refer to jaw problems as “having TMJ disorder”, but technically TMJ is the joint and TMD is the disorder.

Symptoms include jaw muscle spasms, headaches, neck aches, jaw or teeth pain, trouble chewing or opening your mouth. Some culprits are:

Myofascial Pain Syndrome (MPS)

Signs and symptoms: Myofascial pain is chronic pain from the muscles or the sheaths that surround the muscle (fascia). Myofascial pain is usually centered in the jaw muscles. The big three symptoms are facial pain, restricted jaw function, and a clicking or popping noise when you use your jaw.

Risk factors: Arthritis, poor posture, or injury can be the cause but many times, there is no known reason.

Dentist or doctor? See a dentist who specializes in TMD or an ear, nose, and throat medical specialist.

Pain can be managed with behavioral techniques (correcting posture), medications and facial massage. A University of California study found that patients found significant relief with acupuncture. Botulin injections also can sometimes be effective.

In severe cases, surgery may be necessary.

Teeth grinding (bruxism)

Signs and symptoms: Teeth are shortened and look very flat on top. Usually occurs during sleep. You may have a constant dull headache or sore jaw, especially upon awakening.

Risk factors: Stress, missing or crooked teeth.

Dentist or doctor? Start with a dentist who can create a mouth guard to protect your teeth when you sleep. You also might want to see a psychotherapist or talk to your doctor about stress reduction exercises like meditation, physical exercise, physical therapy, or possibly anti-anxiety or antidepressant medications.

Malocclusion (improper bite)

Signs and symptoms: Difficulty or dull pain when chewing or speaking can be indicative of malocclusion.

Risk factors: Trauma, heredity, thumb-sucking, impacted wisdom teeth, missing teeth that cause the others to drift.

Dentist or doctor? Start with a dentist for diagnosis. He can build a bridge or crowns to stop the “drift.” He may refer you to an orthodontist if you need braces, or an oral surgeon if you need teeth extracted, or rarely, surgery to fix your jaw shape or repair poorly done previous dental procedures.

What you can do about pain right now

If the cause of your pain is related to Temporomandibular Disorders, there are several things you can do to ease the pain:

If your pain is not TMD-related, it could be caused by something more serious. It’s possible that your jaw pain isn’t related to problems with your temporomandibular joint.

Unfortunately, the cause could be more serious. If you’ve ruled out myofascial pain syndrome, teeth grinding, and improper bite, you may want to explore the following jaw pain causes with your doctor.

Jaw cancer

Symptoms: Cancerous cells begin in the upper or lower jaw, and can then spread to the whole body. Look for numbness or pain in the jaw, and persistent sores, lumps, or other abnormal growths outside the jaw or within the mouth.

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Risk factors: Smoking, chewing tobacco products, family history

Dentist or doctor? See an oral oncologist who will take a biopsy and do other diagnostic tests. Depending on the stage of the cancer, treatment will call for surgery, radiation, and/or chemotherapy.

Tetanus

Symptoms: A bacterial infection, tetanus can cause what is called “lockjaw.” Exactly what it sounds like, it makes it difficult to open your mouth or swallow because your jaw muscles go into painful spasms.

Risk factors: Clostridium tetani bacteria enters the body through a flesh wound. Once inside, it produces a toxin that quickly spread throughout the body. To prevent it, make sure you are up to date with your tetanus shots.

Dentist or doctor? Seek medical attention. Call 911 or go to the emergency room immediately.

Heart attack

Symptoms: Severe jaw pain that comes on suddenly—most commonly in the lower left section—can be a sign of a heart attack.

Risk factors: “The heart itself doesn’t have pain receptors so it sends signals to other places. Two of the most common are up and down the left arm and jaw,” explains Dr. Iacopino.

Dentist or doctor? Seek medical attention. Call 911 or go to the emergency room immediately.

Broken jaw

Symptoms: Trouble breathing, bleeding in the mouth, sudden misalignment of your jaw, difficulty moving your jaw

Risk factors: Whiplash or blunt trauma to the jaw

Dentist or doctor? Seek medical attention. Call 911 or go to the emergency room immediately.

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