Sharp Pain in Jaw While Eating? You Might Have First Bite Syndrome

About

First bite syndrome is an uncommon condition that presents itself with a sudden pain, cramp, or spasm around the parotid salivary glands in the lower jaw on the left or right side at the initial moment of eating. These are usually transient, more often, after taking a few bites, but in other times they are severe enough to interfere with feeding.

It is commonly connected with some illnesses or operations but can manifest itself in people without any apparent reason(1^✔ ✔Trusted Source
First Bite Syndrome: What Neurologists Need to Know

Go to source).

What Does First Bite Syndrome Feel Like?

The features of first bite syndrome involve the primary symptom characterised as a piercing sort of pain or a spasm in the mouth and specifically the jaw. The discomfort typically:

• Involves only an affected half of the face.
• It was experienced close to the parotid salivary glands below the jaw line.
• Strengthen or vanish right after a few bites of food.

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First bite syndrome is different from other pathologies of the jaw as pain always develops according to a certain pattern, namely, it appears at once and gradually subsides during the meal.

What Causes First Bite Syndrome?

First bite syndrome is primarily due to the injury of sympathetic nerve fibers that control salivary gland secretion. This damage often occurs as a result of:

• Head or neck surgeries: Damage to sympathetic nerves can occur due to procedures around the parotid gland or the neighbouring structures.
• Cancer treatments: Head and neck cancers treated with radiation or surgery are diseases that may predispose a patient to this condition.
• Unknown causes: Nevertheless, first bite syndrome can occur without any surgery or trauma in an individual.

These effects can be latent, and may manifest themselves only after months and even years since the surgery has been performed.

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Diagnosing First Bite Syndrome

In many cases, no special diagnostic approaches are necessary, as the first bite syndrome can be suspected based on the patient’s history and past procedures. It continues, there are no specific tests but it is crucial for the specialists to perform several examinations to exclude other causes of jaw pain(2^✔ ✔Trusted Source
Successful management of an idiopathic first bite syndrome: A case report and review

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Other Conditions That May Cause Jaw Pain

The pain in the jaws is not restricted to first bite syndrome only. Several other conditions may cause similar discomfort, including:

1. Temporomandibular Joint (TMJ) Disorders

TMJ disorders can cause:

• Pain in the jaw joint or any muscles that are used in chewing.
• Stiffness in the jaw.
• Tinnitus: ringing in the ears.

TMJ pain is not relieved by swallowing a few bites of food therefore, differentiating it from FBS.

2. Salivary Gland Issues

Blocked or infected salivary glands can cause:

• Headache
• Earache
• Pain or swelling in the parotid gland

Chronic pain during meals. Pain due to blockage of the salivary gland increases instead as eating progresses making it different from first bite syndrome.

3. Other Causes

Jaw pain may also result from:

• Dental infections
• Sinus infections
• Tongue and facial weakness, and Trigeminal neuralgia

How Is First Bite Syndrome Treated?

Although first bite syndrome cannot be prevented, several treatment options are available to reduce pain:

1. Medications

Anticonvulsants: Pain medications include gabapentin and pregabalin whereby the latter is as effective as gabapentin but stronger. These drugs can be used to minimize the scale and occurrence of symptoms.

2. Botox Injections

Some treatments include injections of botulinum toxin which affects Botox and parotid gland nerves forwarding major symptoms.

3. Specialist Consultation

Consulting an orofacial pain dentist, oral medicine specialist or an otolaryngologist (ENT surgeon) will get you the best treatment approach.

When to See a Doctor

If you notice sudden pain in the jaws whenever you chew food, you should seek medical attention. However, first bite syndrome is a rare condition and other differential diagnoses may include temporomandibular joint disorder or salivary gland infections.

If you want to make sure that you only get the right diagnosis, and the right treatments for your particular case, consultation with a specialist is necessary.

First bite syndrome is a severe but a rare syndrome which manifests itself in sharp pain in the jaws at the beginning of a meal. It is more commonly associated with certain surgery or cancer therapy but other jaw disorders may present similar problems. A doctor specializing in your particular type of problem can strike at the root of the problem and guide you toward an appropriate conclusion.