Many conditions may cause orofacial pain. Orofacial pain may be the result of problems in the:

• Mouth or teeth (odontogenic pain)
  
  
• • Dental disease. Dental diseases are one of the most common causes of orofacial and dental pain. Among common types of dental disease are tooth decay, gingivitis (inflammation of the gums, the early form of periodontal disease), pulpitis (inflammation of the dental pulp), chipped teeth and pericoronitis (a soft tissue infection around the crown of an erupting tooth).
    
    
  • Facial trauma. The orofacial area, especially the mouth and teeth, is susceptible to injuries from automobile, motorcycle and bicycle accidents; sports injuries; and other types of blunt trauma.
    
    
  • Mouth sores. Infections such as thrush and injuries such as biting the inner cheek are frequent causes of oral sores. Common types of mouth sores include cold sores and canker sores.  Infections from HIV or fungal diseases may also lead to oral sores.
    
    
  • Burning mouth syndrome. Condition characterized by a burning sensation of the tongue or lips. It can be caused by chronic infections, reflux of stomach acid, blood diseases or hormone imbalances.
    
    
  • Bruxism. Medical term for grinding, gnashing or clenching the teeth. In most cases, it is mild but it can be frequent and lead to jaw disorders, headaches and damaged teeth.
    
    
  • Oral cancer. Cancer of the mouth can cause orofacial pain. Treatments for oral cancers such as radiation therapy can also result in orofacial pain by causing mucositis (mouth inflammation and sores).
    
    
• Blood vessels (vascular pain)
  
  
• • Facial headaches. Migraines, cluster headaches, tension headaches and other types of headaches can lead to pain in the face as well as the head.

• • Carotodynia. Characterized by pain caused by pressure on the carotid arteries, which supply blood to the head and neck. The carotid arteries can also be tender during a migraine.
    
    
  • Temporal arteritis. Inflammation of the temporal arteries, which are located along the side of the head. This can lead to headaches, difficulty chewing and may lead to visual impairment if left untreated.
    
    
• Muscles, joints or bones (musculoskeletal pain)
  
  
• • TMJ disorder. Acute or chronic inflammation of one or both of the temporomandibular joints connecting the jaw to the skull. The potential causes include wear and tear, arthritic inflammation, injury, stress, some dental appliances or grinding of the teeth.
    
    
  • Sinusitis. Inflammation of the air–filled cavities (sinuses) in the dense portions of the bones of the skull.
    
    
  • Injuries to the cervical spine or other parts of the neck or skull, such as whiplash or fractures. These can cause referred pain to the orofacial region if the cervical nerves are damaged.
    
    
  • Osteomyelitis. Acute or chronic bone infection. Risk factors for osteomyelitis include diabetes and intravenous (I.V.) drug abuse.
    
    
  • Osteonecrosis. Death of bone tissue. Deterioration of the jawbone has in rare cases resulted from use of bisphosphonates, medications commonly used to treat osteoporosis.

• Nerves (neurogenic pain)
  
  
• • Postherpetic neuralgia. Painful condition affecting the nerve fibers and skin. It is caused by herpes zoster (shingles). The pain is often described as burning or a sharp shooting sensation, and can be associated with severe itching due to a rash.
    
    
  • Trigeminal neuralgia (also known as tic douloureux). A disorder of the fifth cranial nerve (trigeminal) that causes episodes of intense, stabbing, electric-shock–like pain in the lips, eyes, nose, scalp, forehead, and upper and lower jaw. This is the most common type of cranial neuralgia.
    
    
  • Glossopharyngeal neuralgia. A cranial neuralgia marked by repeated episodes of severe pain in the tongue, throat, ear and tonsils. The pain can last from a few seconds to a few minutes.
    
    
  • Superior laryngeal neuralgia. A cranial neuralgia marked by pain radiating from the throat to the ear or eye. Episodes last seconds or minutes and may occur spontaneously or as the result of coughing, swallowing or speaking.
    
    
  • Cluster–tic syndrome. A combination of trigeminal neuralgia and cluster headache.
    
    
  • Bell’s palsy. A temporary paralysis of one side of the face, caused by injury to either of the facial nerves. Pain near the ear or neck sometimes precedes Bell’s palsy.
    
    
  • Jabs and jolts syndrome. There are several names for this condition, including idiopathic stabbing headache. It results in pain that can last up to 10 seconds but usually lasts less than two seconds. It can occur on its own or in combination with other types of headaches, such as migraines and cluster headaches.
    
    
  • Short–lasting neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome. Condition characterized by brief pain, typically near the eye, but can occur in the temple or face. It is a rare syndrome that predominantly affects men.
    
    
  • Ramsay Hunt syndrome. Infection of a portion of the facial nerve with the herpes zoster virus, which causes shingles. It causes paralysis of the facial muscles on the same side of the face as the infection.
    
    
• Emotions (psychogenic pain). Sometimes psychological factors or emotional disorders, such as depression or anxiety, result in orofacial pain.
  

In some cases the source of orofacial pain remains unknown (idiopathic).