Why the jaw and ear hurt together
The jaw joint lies a few millimetres in front of the ear canal, and the muscles that close the jaw attach around the temple and the angle of the jaw. The trigeminal nerve supplies the jaw, chewing muscles, teeth and part of the ear, while other nerves supplying the ear also supply the throat. The brain cannot always tell exactly where pain comes from, so irritation in one area is felt in another. This is called referred pain.
Because of this overlap, ENT specialists always examine the jaw, teeth and throat when a patient has earache with a normal-looking ear.
Common causes of jaw and ear pain
- Temporomandibular disorder (TMD): pain in the jaw joint and chewing muscles, often with clicking, limited opening, headaches and a feeling of ear fullness. See TMJ symptoms.
- Teeth grinding and clenching (bruxism): overloads the muscles and joint, typically causing morning jaw ache and earache.
- Ear infections: middle ear infection causes deep earache, blocked hearing and sometimes fever; outer ear infection (swimmer's ear) makes the ear canal tender, especially when moving the ear or chewing. See swimmer's ear.
- Dental problems: tooth decay, an abscess, a cracked tooth or an impacted wisdom tooth can spread pain to the ear and jaw.
- Salivary gland problems: a stone or infection in the parotid (in front of the ear) or submandibular gland (under the jaw) causes swelling and pain, often worse at mealtimes.
- Throat conditions: tonsillitis or a throat abscess can cause ear pain, especially when swallowing; see ear pain when swallowing.
- Sinusitis: pressure in the upper jaw and cheek with blocked nose.
- Nerve pain: trigeminal neuralgia causes brief, electric-shock pains in the face and jaw.
- Neck problems: muscle tension or joint problems in the upper neck can refer pain around the ear and jaw angle.
Clues that point to each cause
- Worse with chewing, yawning or clenching; clicking; tender in front of the ear: jaw joint or muscles. Compare with jaw clicking when chewing.
- Muffled hearing, discharge, fever or recent cold: ear infection.
- Pain with hot, cold or sweet food, or when biting: a tooth.
- Swelling in front of the ear or under the jaw at mealtimes: salivary gland.
- Pain behind the ear or in the neck: see pain behind the ear and neck muscle strain.
- Sudden stabbing pains triggered by touch, talking or brushing teeth: trigeminal neuralgia.
Pain on one side of the jaw and ear
Pain on one side is very common in TMD, because people often chew on one side or clench asymmetrically. A one-sided ear infection, a tooth problem or a salivary stone also cause one-sided pain. Pain in the neck and ear on one side together often comes from muscle tension in the neck and jaw.
Left-sided jaw pain deserves a mention: occasionally, heart pain spreads to the jaw, usually with chest discomfort, breathlessness, sweating or nausea, often brought on by exertion. This needs emergency assessment. Persistent one-sided earache with a normal ear, especially in smokers, should also be examined by an ENT specialist to check the throat.
What you can do at home
- Eat soft foods for a few days and cut food into small pieces; avoid chewing gum, tough meat and hard bread.
- Apply a warm compress to the jaw and side of the face for 10 to 15 minutes; some people prefer ice.
- Keep the jaw relaxed: lips together, teeth apart, tongue resting on the roof of the mouth.
- Avoid wide yawning, nail biting and resting your chin on your hand.
- Take simple painkillers such as paracetamol or ibuprofen if suitable for you.
- Reduce stress and notice daytime clenching; set reminders to relax the jaw.
For earache from a cold or a mild ear infection, see natural remedies for earache.
How doctors treat jaw and ear pain
Treatment depends on the cause. TMD is usually managed with education, jaw exercises and physiotherapy, sometimes a night splint made by a dentist for grinding, and treatment of stress and sleep problems. Most people improve within weeks to a few months.
Ear infections may need antibiotic drops (outer ear) or, in some cases, antibiotic tablets (middle ear). Dental problems need a dentist. Salivary gland stones are often helped by fluids, sour sweets to stimulate saliva, massage and warmth, and sometimes need removal. Trigeminal neuralgia is treated with specific medicines prescribed by a doctor.
When to see a doctor
- Fever, swelling of the face or jaw, or a hot, red swelling in front of the ear.
- Discharge from the ear or sudden hearing loss.
- Difficulty opening the mouth, swallowing or breathing.
- Jaw pain with chest pain, breathlessness, sweating or nausea: call emergency services.
- Numbness of the face or weakness of the facial muscles.
- Pain lasting more than two weeks, or a lump in the neck, ulcer in the mouth or hoarse voice for more than three weeks.
- In people over 50, new jaw pain when chewing with headache and scalp tenderness, which can be giant cell arteritis.
Key points to remember
- The jaw joint and ear are neighbours and share nerves, so pain is often felt in both.
- TMD is the most common cause, especially with chewing pain and clicking.
- Ear infections, teeth and salivary glands are other frequent causes.
- Soft food, warmth, jaw relaxation and painkillers help most jaw-related pain.
- Fever, swelling, ear discharge or chest symptoms need medical help.
Questions about jaw and ear pain
These answers are general information and do not replace an examination or individual medical advice.
Why do my jaw and ear hurt at the same time?
The jaw joint sits next to the ear and they share nerves. TMJ problems are the most common cause, followed by ear and dental problems.
Can TMJ cause ear pain without an ear infection?
Yes. Many people with earache and a normal ear examination have pain coming from the jaw joint or chewing muscles.
Can an ear infection cause jaw pain?
Yes, especially an outer ear infection, which makes chewing and moving the ear painful.
What causes pain under the ear behind the jaw?
The most common causes are the jaw joint and chewing muscles, a swollen lymph node, the parotid salivary gland (infection or a salivary stone, which hurts more when eating) and wisdom teeth. Pain that lasts more than 2 to 3 weeks, a lump that keeps growing, or swelling with fever should be checked.
Can a tooth cause ear and jaw pain?
Yes. Problems with back teeth and wisdom teeth commonly spread pain to the ear and jaw.
How do I relieve jaw and ear pain at night?
Use warmth, keep the jaw relaxed, avoid sleeping on the painful side and ask a dentist about a night splint if you grind your teeth.
Who should I see for jaw and ear pain?
A family doctor or ENT specialist to check the ear and throat, and a dentist or physiotherapist for jaw and teeth problems.
Sources
- NHS · Temporomandibular disorder (TMD)
- NIDCR (NIH) · TMD (temporomandibular disorders)
- NHS · Earache
- NHS · Toothache
- NHS · Salivary gland stones
- NHS · Trigeminal neuralgia
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.