I recently received two inquiries in one week requesting explanations for facial swelling and as it might relate to TMJ issues. One request was from a visitor of my TreatingTMJ.com website, suffering some facial swelling after dry needling to their masseter muscle and the other was from another PT colleague who has a young teen presenting with intermittent facial swelling, so I took this as a sign that maybe I need to put a blog together to highlight some of the more common causes, but not all-inclusive, causes of facial swelling.

Pain originating in the salivary glands is typical of inflammatory, infectious, traumatic, or neoplastic origin. Common salivary gland disorders that are accompanied by pain include sialoadenitis, sialolithiasis, epidemic parotitis, and tumors. Usually, diagnosis of salivary gland pain is not difficult, due to the accompanying signs and symptoms, such as pain occurring on eating, or swelling, firmness, or tenderness of the affected gland. I will describe below a few of these.

Sialadenitis

Is an infection of the salivary glands. It is usually caused by a virus or bacteria. The parotid (in front of the ear) and submandibular (under the chin) glands are most commonly affected. Sialadenitis may be associated with pain, tenderness, redness, and gradual, localized swelling of the affected area.

Sialolithiasis

Is the medical term for the formation of salivary duct stones in a patient’s salivary glands. The main function area of the salivary glands is to produce saliva in the mouth, which aids in our everyday lives by making chewing, swallowing, talking, and even eating possible. The formation of salivary gland stones can occur as a result of an infection, virus, and in certain cases, chemicals in our saliva that can become crystallized and block the salivary ducts.

Salivary Duct Stones

Can occur in all salivary glands, but are most commonly found in the submandibular glands, which are located in the back of the mouth and on both sides of the jaw. Stones in the parotid glands are also possible but are much rarer.

Epidemic Parotitis (mumps)  

Mumps is an acute, contagious, viral disease that causes painful enlargement of the salivary or parotid glands. Unvaccinated children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. The mumps are caused by a virus which is spread from person-to-person by respiratory droplets or direct contact with articles that have been contaminated with infected saliva. Avoiding this contact would subsequently greatly reduce the chance for the infection to take hold.

Tumors

We will hold off on that for now and proceed with 2 more thoughts:

Sjogrens syndrome

Sjogren’s (SHOW-grins) syndrome is a disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouth.

The condition often accompanies other immune system disorders, such as rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first — resulting in decreased tears and saliva.

Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women. Treatment focuses on relieving symptoms.

Symptoms

The two main symptoms of Sjogren’s syndrome are:

• Dry eyes. Your eyes might burn, itch or feel gritty — as if there’s sand in them.
• Dry mouth. Your mouth might feel like it’s full of cotton, making it difficult to swallow or speak.

Some people with Sjogren’s syndrome also have one or more of the following:

• Joint pain, swelling, and stiffness
• Swollen salivary glands — particularly the set located behind your jaw and in front of your ears
• Skin rashes or dry skin
• Vaginal dryness
• Persistent dry cough
• Prolonged fatigue

Dental Abscess with Facial Cellulitis

A dental abscess is an infection at the base of a tooth. It means a pocket of pus has formed at the tip of a tooth root in your jaw bone. If the infection isn’t treated, it can appear as a swelling on the gum near the tooth. More serious infections spread to the face. This causes your face to swell (cellulitis). This is a very serious condition. Once the swelling begins, it can spread quickly.

A dental abscess usually starts with a crack or cavity in a tooth. The pain is often made worse by drinking hot or cold beverages or biting on hard foods. The pain may spread from the tooth to your ear or the area of your jaw on the same side.

I hope you have found this blog helpful and informative. I have found over the years as you continue to treat more TMJ/TMD patients, you will inevitably run into those cases that are more medical in nature and require your referral expertise to the team of specialists you have built relations with.

All the best!

Mike