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. 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.
Common salivary gland disorders that are accompanied by pain include sialoadenitis, sialolithiasis, epidemic parotitis, and tumors.
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 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. Saliva aids in chewing, swallowing, talking, and eating. Formation of stones can occur from infections, viruses, or crystallization of saliva chemicals that block the salivary ducts.
SALIVARY DUCT STONES
Can occur in all salivary glands but are most common in the submandibular glands. Stones in the parotid glands are possible but 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 2 and 12 are most commonly infected. The virus spreads person-to-person via respiratory droplets or contaminated articles.
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 dry mouth. It often accompanies other immune disorders such as rheumatoid arthritis and lupus. The mucous membranes and moisture-secreting glands of the eyes and mouth are usually affected first.
SYMPTOMS
- Dry eyes — burning, itching, or gritty sensation.
- Dry mouth — feeling like cotton in the mouth, making swallowing or speaking difficult.
- Other symptoms may include joint pain, swollen salivary glands, dry skin, vaginal dryness, persistent dry cough, and fatigue.
DENTAL ABSCESS WITH FACIAL CELLULITIS
A dental abscess is an infection at the base of a tooth forming a pocket of pus. Untreated, it can cause facial swelling (cellulitis). The infection can spread quickly and requires urgent care.
Pain often worsens with hot/cold beverages or biting hard foods. It may radiate to the ear or jaw on the same side.
I hope you have found this blog helpful and informative. Over the years, as you treat more TMJ/TMD patients, you will inevitably encounter cases that are more medical in nature and require referrals to your team of specialists.
All the best!
Mike
