Causes of Pain in Cheekbone and Teeth: What to Know

Pain felt in the cheekbone (zygomatic bone) and teeth is a complex condition arising from the anatomical proximity of these areas and the interconnectedness of their nerve networks. The pain often tends to spread from one area to another.

Causes of pain in cheekbone and teeth

Pain originating from dental nerve tissue

Reversible nerve inflammation:

Factors such as tooth decay, deep fillings, or enamel erosion can reach the nerve inside the tooth and temporarily sensitize it but do not cause permanent damage. This condition can be treated by a dentist.

It is a sharp, sudden pain that occurs only when eating or drinking something hot, cold, or sweet. It subsides on its own within 10-15 seconds after the irritant is removed.

The pain is usually felt only in the affected tooth, with mild and short-lived spread to the cheekbone.

Related: Click for tips to relieve your pain at home.

Irreversible nerve inflammation:

The tooth nerve tissue becomes permanently inflamed and cannot heal itself. It usually stems from deep and long-term untreated decay. In this case, the tooth nerve can no longer be saved. Pain characteristics:

Severe throbbing pain that occurs spontaneously without any trigger

It increases significantly, especially at night and when lying down.

Hot food and drinks intensify the pain, while cold stimuli may provide temporary relief.

The pain spreads not only to the tooth but also to neighboring areas such as the ear, temple, cheekbone, and neck.

Nerve death and abscess:

The inflamed nerve tissue dies completely and bacteria spread towards the tip of the tooth root and into the jawbone, causing an infection called a 'periapical abscess.' Pain characteristics:

Even lightly touching the tooth with a finger or tongue causes severe pain; the tooth feels as if it is raised.

Constant, unbearable pain within the bone, described as piercing or gnawing in nature.

As the infection spreads within the bone, swelling, redness, and intense pressure pain develop in the area beneath the cheekbone.

Pain originating from the gums and surrounding tissues

Gum abscess:

An infection occurring in the tissues on the side of the tooth, caused by bacteria accumulating in deep gum pockets in individuals with advanced gum disease (periodontitis).

Localised swelling, redness and sharp, spontaneous pain on the cheek side of the tooth. The tooth becomes loose and painful when biting.

Severe gum infection:

This is a sudden-onset, severe gum infection triggered by factors such as stress, smoking, and a weak immune system.

Sudden onset of severe pain, bleeding, and ulcers (sores) in the gums. The pain is so sharp that eating and brushing teeth become impossible.

Impacted or problematic teeth

Wisdom tooth infection (pericoronitis):

Particularly when lower wisdom teeth are partially impacted, food debris and bacteria accumulate in the gum pocket partially covering the tooth, leading to severe infection.

Pain characteristics: Severe, throbbing pain in the area of the tooth, jaw muscle spasms, difficulty opening the mouth, and pain when swallowing.

Impacted tooth pressure:

Particularly in the upper jaw, impacted wisdom teeth can exert pressure on the adjacent molar and sinus wall, causing deep, aching pain in the cheekbone.

Pain originating from the jaw joint and masticatory muscles

Muscle-related pain syndrome:

Hypersensitive points develop in the main masticatory muscles (masseter muscle) in the cheek area and in the muscles in the temple region. Teeth clenching and grinding (bruxism) are the most important causes.

Pain characteristics: Dull, deep, and persistent pain over the cheekbone and jaw. Morning stiffness in the muscles and limited mouth opening are observed.

Jaw joint disorders:

Jaw joint disc displacement: When the cushion (disc) of the jaw joint shifts forward, a 'click' or 'clicking' sound is heard when opening and closing the mouth. If the disc is completely displaced and causes locking, opening the mouth becomes very difficult.

Joint calcification: As a result of wear and tear on the joint cartilage, pain increases when opening the mouth, chewing, and in cold weather, and a crackling sound is felt in the joint.

Pain caused by sinusitis

The root tips of the upper molars and premolars are very close to the floor of the maxillary sinus cavity. When the mucosa lining the inner surface of the sinuses becomes inflamed and the sinus channels become blocked, the accumulated mucus and pressure inside cause pain.

Pain characteristics:

A feeling of pressure and throbbing pain felt under the cheekbones, around the eyes, and in the upper jaw teeth

The pain suddenly intensifies when the head is bent forward

Usually, more than one upper jaw tooth is sensitive and painful at the same time

Accompanied by nasal congestion, postnasal drip, and decreased sense of smell

Nerve-related facial pain

This occurs when the trigeminal nerve, which carries sensation to the face, is compressed, usually by a blood vessel, or irritated due to conditions such as multiple sclerosis (MS).

Pain characteristics:

Sudden, extremely severe pain attacks described as 'electric shock', “burning” or “stabbing,” which start and end abruptly.

Attacks last for seconds but may occur in rapid succession.

Pain is triggered by light touch to areas such as the lip, cheek, or edge of the nose on one side of the face, as well as by wind, shaving, tooth brushing, eating, or talking

The pain spreads from the trigger area to the cheekbone, jaw, and teeth

Other rare causes

Spread of dental infection:

If a dental abscess is left untreated, the infection can spread within the jawbone (osteomyelitis) or in the soft tissues (cellulitis), causing severe, widespread pain, fever, and general malaise

Unexplained facial pain:

This is a persistent and stubborn pain whose cause is not fully understood and is often associated with psychological factors.

Heart-related pain:

Although very rare, a heart attack (especially in women) can cause pain radiating to the back, jaw, and left cheek area.

When should you see a doctor for cheekbone and tooth pain?

If you experience any of the following symptoms, do not attempt to diagnose or treat yourself. Seeking professional medical help will both relieve your pain quickly and prevent possible serious complications. Early diagnosis and treatment always yield better results.

Emergencies (Requiring same-day treatment):

Severe and persistent pain:

Pain that is unbearable and does not subside even with painkillers

Pain so severe that it prevents sleep

Noticeable swelling in the face or jaw:

Swelling in the cheek area that is progressively increasing

Swelling causing the face to appear asymmetrical

Swelling or a lump in the jaw that can be felt by touch

Fever and fatigue:

Fever of 38°C or higher

Shivering spells

General feeling of malaise and fatigue

Difficulty swallowing or breathing:

Feeling of tightness in the throat

Difficulty breathing

Pain or difficulty when swallowing

Limited mouth opening:

Inability to open your mouth as wide as usual

Feeling of jaw locking

Severe pain when chewing

1-2 Situations requiring a visit to the dentist within 24 hours:

Pain lasting longer than 24 hours:

Persistent pain, even if mild to moderate in intensity

Intermittent but recurring pain attacks

Loose or broken tooth:

Noticeable looseness in teeth

Tooth fracture or crack

The filling has fallen out

Gum bleeding and inflammation:

Frequent and profuse gum bleeding

Pus (abscess) coming from the gums

Bad taste and odour in the mouth

Numbness or tingling in the face:

Loss of sensation in the cheek, lip or jaw

Persistent tingling sensation

Abnormal sounds from the jaw:

A 'clicking' or 'clacking' sound when opening and closing the mouth

Cracking or grinding sounds

Sensation of jaw displacement

Which doctor/department should you visit?

Firstly, a dentist.

Departments you may be referred to if necessary:

Ear, Nose and Throat (ENT): If sinusitis is suspected

Neurology: For nerve-related pain

Physiotherapy: For jaw joint problems

Emergency department: In cases of severe infection or trauma