Facial pain localized to the cheek area is a common and often confusing symptom due to the complex network of bones, air cavities, nerves, and muscles in the face. Aching in this region, distinct from simple tooth or neck soreness, frequently indicates an issue originating from a structure that shares nerve pathways with the cheek. Pinpointing the exact cause is complicated because pain can be “referred,” meaning the source of the problem is located elsewhere but the brain interprets the signal as originating in the cheek.
Pain Stemming from Sinus Pressure
One of the most frequent origins of cheek discomfort is inflammation within the paranasal sinuses, specifically the maxillary sinuses. These air-filled cavities are situated directly behind the cheekbones. Inflammation, caused by viral infections, bacterial sinusitis, or allergies, blocks the natural drainage pathways, leading to mucus buildup and increased internal pressure. This pressure causes a characteristic dull, constant ache across the cheekbone area.
The discomfort often intensifies when the head is positioned lower than the heart, such as when bending over. Because the roots of the upper back teeth are close to the maxillary sinus floor, sinus pressure can also be perceived as a generalized ache in the upper teeth. Acute sinusitis symptoms, such as thick nasal discharge and congestion, usually accompany this facial pressure.
Jaw and Dental Structure Issues
Pain in the cheek can be a direct result of problems with the underlying dental structures or the jaw joint itself. An infection in an upper molar, known as a dental abscess, creates inflammation that can radiate throbbing pain upward into the cheek. This infectious pain is often localized and may be accompanied by swelling in the gum or face.
Temporomandibular Joint Dysfunction
The temporomandibular joint (TMJ), which connects the jawbone to the skull, is another common source of cheek pain. Dysfunction of this joint (TMD) often involves the shock-absorbing disc moving out of alignment or the surrounding muscles becoming strained. Habits like nocturnal teeth grinding or clenching (bruxism) stress the jaw muscles, leading to fatigue and aching facial pain felt in the cheek or near the ear. TMD-related discomfort is often mechanical, worsening with chewing or talking, and may include a clicking or popping sound when the jaw moves.
Nerve and Muscle Related Causes
The sensation of cheek pain can originate from the nervous system or from simple muscular tension. Stress and anxiety frequently cause people to unconsciously tense their facial muscles, particularly the masseter muscle used for chewing. This tension can lead to a generalized, dull ache or soreness in the cheek area. This myofascial pain is purely muscular and often responds to massage or relaxation techniques.
Trigeminal Neuralgia
A more distinct and severe cause is a condition affecting the trigeminal nerve, the fifth cranial nerve responsible for sensation in the face. Trigeminal neuralgia (TN) causes sudden, unpredictable attacks of intense, electric shock-like, shooting pain in the face, which can be felt in the cheek. These brief episodes are typically triggered by light stimulation, such as a cool breeze, chewing, or touching the face. The unique severity and sharp, shooting quality of TN pain clearly differentiate it from the dull pressure or throbbing ache of other conditions.
Determining When to See a Doctor
While minor cheek pain often resolves on its own, certain symptoms require professional medical or dental attention. Pain accompanied by a persistent fever, visible swelling of the cheek or face, or a foul-tasting discharge suggests a spreading infection, such as an abscess or severe sinusitis, requiring prompt treatment. An evaluation is warranted if the pain limits your ability to open your mouth fully or makes swallowing difficult.
Seek medical advice for any pain that is sudden, severe, and recurrent, especially if it presents as the sharp, electric shock sensations characteristic of nerve pain. If the discomfort seems related to the upper teeth, consult a dentist first to rule out a dental infection. For generalized facial pain accompanied by cold symptoms or congestion, a primary care physician can assess for a sinus infection or other systemic causes.