Cheek Pain When Closing Mouth: Causes, TMJ Dysfunction, and Self-Care Strategies

Why Does My Cheek Hurt When I Close My Mouth?

When you experience pain in your cheek upon closing your mouth, it often points to issues with the temporomandibular joint (TMJ), the powerful muscles of mastication, or underlying dental concerns that impact the mechanics of your jaw.

Understanding the Anatomy of Mastication

To understand why your cheek might hurt, it's essential to briefly review the key structures involved in jaw movement:

• Temporomandibular Joint (TMJ): This is the hinge joint connecting your jawbone (mandible) to your skull (temporal bone). It's one of the most complex joints in the body, allowing for various movements like opening, closing, side-to-side, and forward/backward motions. A small disc of cartilage cushions the joint.
• Muscles of Mastication: These are the primary muscles responsible for chewing and jaw movement. The most prominent ones affecting the cheek area include:
  • Masseter: A large, powerful muscle on the side of your face, primarily responsible for elevating the mandible (closing the mouth) and clenching the teeth.
  • Temporalis: A fan-shaped muscle on the side of the head, also involved in elevating the mandible and retracting it.
  • Pterygoids (Medial and Lateral): Deeper muscles involved in jaw protrusion, side-to-side movement, and opening/closing.

Pain in the cheek when closing the mouth suggests that one or more of these structures, or their associated nerves, are being stressed or irritated during this specific action.

Common Causes of Cheek Pain When Closing the Mouth

Several factors can contribute to pain in your cheek during jaw closure, ranging from muscular strain to dental issues.

• Temporomandibular Joint (TMJ) Dysfunction (TMD):

  • Description: This is a broad term for conditions affecting the TMJ and the muscles of mastication. It's one of the most frequent causes of jaw and facial pain.
  • Mechanism: Misalignment of the disc within the joint, inflammation, or degenerative changes can lead to pain, clicking, popping, limited jaw movement, and referred pain into the cheek muscles. When you close your mouth, the joint structures are compressed, potentially exacerbating the pain.
  • Symptoms: Pain or tenderness around the jaw, ear, face, or neck; clicking, popping, or grating sounds when opening or closing the mouth; difficulty chewing; locking of the jaw.

• Muscle Strain or Spasm (Myofascial Pain):

  • Description: The masseter and temporalis muscles are particularly susceptible to overuse and tension.
  • Causes:
    • Bruxism (Teeth Grinding/Clenching): Often subconscious, especially during sleep or stressful periods, leading to chronic muscle overuse and fatigue.
    • Excessive Chewing: Chewing gum frequently, hard foods, or biting nails.
    • Stress and Anxiety: Can manifest as increased muscle tension in the jaw.
    • Poor Posture: Forward head posture can strain neck and jaw muscles.
  • Mechanism: Overworked muscles can develop trigger points, leading to localized pain and stiffness that worsens with movement, such as closing the mouth.

• Dental Issues:

  • Malocclusion (Misaligned Bite): When your upper and lower teeth don't fit together properly, it can create uneven pressure on the TMJ and surrounding muscles, leading to strain and pain.
  • Cavities or Abscesses: While typically causing tooth pain, severe dental infections can sometimes refer pain to the surrounding facial structures, including the cheek.
  • Wisdom Teeth Eruption: An erupting or impacted wisdom tooth can put pressure on nearby structures, causing inflammation and pain that radiates to the cheek.
  • Ill-fitting Dental Appliances: Braces, retainers, or dentures that don't fit correctly can irritate soft tissues or create an uneven bite, leading to muscle strain.

• Trauma or Injury:

  • Direct Impact: A blow to the jaw or face can cause bruising, muscle strain, or even fracture, leading to pain with movement.
  • Dental Procedures: Prolonged mouth opening during dental work can strain the TMJ and jaw muscles, causing temporary soreness.

• Salivary Gland Issues:

  • Sialolithiasis (Salivary Stones): A stone blocking a salivary duct can cause swelling and pain in the cheek area (parotid gland) that may worsen with jaw movement or before meals.
  • Sialadenitis (Salivary Gland Infection): Bacterial or viral infection of a salivary gland can cause pain, swelling, and tenderness in the cheek.

Less Common, More Serious Causes

While less frequent, some other conditions can cause cheek pain upon closing the mouth.

• Trigeminal Neuralgia: A chronic pain condition affecting the trigeminal nerve, which carries sensation from your face to your brain. It causes sudden, severe, shock-like facial pain, often triggered by simple actions like chewing, talking, or touching the face.
• Oral Infections or Abscesses (Beyond Simple Cavities): Deeper infections in the jawbone or soft tissues can cause significant pain and swelling.
• Nerve Compression: Rarely, a compressed nerve in the neck or jaw area could refer pain to the cheek.
• Tumors: Although rare, growths in the jaw, salivary glands, or surrounding tissues can cause pain as they put pressure on adjacent structures.
• Systemic Conditions: Certain autoimmune diseases (e.g., rheumatoid arthritis, lupus) can affect the TMJ, leading to inflammation and pain.

When to Seek Professional Medical Advice

While many cases of cheek pain are temporary and resolve with self-care, it's important to consult a healthcare professional if:

• The pain is persistent or worsening.
• You experience limited jaw movement or your jaw locks.
• You hear loud clicking, popping, or grinding sounds in your jaw.
• The pain is accompanied by swelling, fever, or difficulty swallowing.
• You have trouble eating, speaking, or opening your mouth wide.
• The pain significantly impacts your quality of life.

Depending on the suspected cause, you might need to consult a dentist, oral surgeon, TMJ specialist, ENT (ear, nose, and throat) specialist, neurologist, or a physical therapist specializing in craniomandibular disorders.

Self-Care Strategies and Prevention

For mild to moderate cheek pain, especially if related to muscle tension or overuse, these strategies may provide relief:

• Soft Diet: Avoid hard, chewy, or crunchy foods to give your jaw muscles a rest.
• Warm or Cold Compresses: Apply a warm compress to the cheek to relax muscles, or a cold pack to reduce inflammation and numb the area.
• Over-the-Counter Pain Relievers: NSAIDs like ibuprofen can help manage pain and inflammation.
• Stress Management: Practice relaxation techniques (meditation, deep breathing) to reduce overall muscle tension.
• Avoid Clenching/Grinding: Be mindful of jaw habits during the day. If you suspect nighttime bruxism, discuss a night guard with your dentist.
• Gentle Jaw Exercises: Your dentist or physical therapist may recommend specific exercises to improve jaw mobility and strengthen muscles.
• Good Posture: Maintain proper head and neck alignment to reduce strain on jaw muscles.
• Limit Excessive Jaw Movement: Avoid wide yawning, shouting, or prolonged chewing.

Conclusion

Cheek pain when closing your mouth is a common symptom with a diverse range of potential causes, primarily involving the intricate mechanics of your temporomandibular joint and the powerful muscles of mastication. While often stemming from muscular overuse or dental misalignments, it's crucial to pay attention to persistent or severe pain. A comprehensive evaluation by a qualified healthcare professional is the most effective way to accurately diagnose the underlying issue and implement an appropriate, evidence-based treatment plan, ensuring the long-term health and function of your jaw.