If you feel a sharp pain in your jaw after taking a bite of food—especially something sweet or sour—you might have a rare condition known as “first bite syndrome."

People may experience first bite syndrome without any known causes. But, those with head or neck tumors and those who have undergone certain cancer treatments or surgeries face a much higher risk of developing this condition.

“Over the last six to eight years, I’ve seen and treated maybe five people [with first bite syndrome]. It’s characterized as a rare condition, and I think that’s appropriate,” saidMark Drangsholt, DDS, MPH, PhD, a professor and chair of the Department of Oral Medicine and attending clinician at the University of Washington Center for Pain Relief.

There was a “history of some surgery” in four out of the five cases he has seen, he added.

The Potential Causes of Jaw Pain and How It’s Treated

What Does First Bite Syndrome Feel Like?

When someone with first bite syndrome takes the first bite of a meal, they might feel a sharp pain, cramp, or spasm close to the parotid salivary glands along the lower jaw. The pain—which typically occurs on one side of the face—often goes away after the next few bites.

In most cases, this occurs because “sympathetic fibers to your salivary parotid glands are damaged or injured with surgical operations,” said Drangsholt.

Healthcare providers can diagnose first bite syndrome without running any tests, especially since this usually occurs in people who have had a recent surgery. Some people don’t develop these symptoms until months or years after a procedure.

The Anatomy of Salivary Glands

What Else Could Cause Jaw Pain?

Recently, some social media users have taken toTikTokandRedditto share their experiences with jaw pain and discuss if the discomfort is from first bite syndrome. While it is possible to have first bite syndrome without a history of oral surgery or cancer, experts say this is very rare.

“I think the confusing thing that may happen in the community is that other conditions can cause pain when you’re eating, like problems of the temporomandibular joint, which is not far away from that area,”Ileana Showalter, MD, a board-certified otolaryngologist who sees patients at Mercy Medical Center in Baltimore, told Verywell.

Temporomandibular disorders, also called TMJ, can lead to pain in the jaw and chewing muscles, jaw stiffness, and ringing in the ears. There is often no known cause for TMJ.

If you have a salivary gland infection or the parotid gland becomes blocked due to salivary gland stones or scar tissue, you could also experience jaw pain or swelling.

“The way they describe [first bite] syndrome is that you have acute pain, but then as you go on eating your meal, it gets better. Someone that has a blockage in the gland, that’s not the case. As long as you’re eating, it’s going to hurt,” said Showalter.

While these conditions are all uncomfortable and painful, it is important to talk to a healthcare provider about your symptoms to get the correct diagnosis and treatment plan.

Treatments for TMJ

How Is First Bite Syndrome Treated?

While you can’t prevent first bite syndrome, you can treat the pain with certain medications.

“I’ve used primarily anticonvulsants, which are medications like gabapentin and pregabalin,” said Drangsholt. Not only does it work really well, but it “will typically reduce the severity of the pain, and oftentimes, it may decrease the number of attacks,” he added.

Speaking with a specialist in orofacial pain, oral medicine, neurology, or an ear, nose, and throat doctor can help you find the right treatment plan for your symptoms, Drangsholt said.

“I think all those providers across medicine and dentistry are going to have knowledge of what it is, and they could differentiate and make sure it’s not a more common condition,” he added.

What Is Associated Sjögren’s Disease?

What This Means For YouFirst bite syndrome occurs when you eat something that makes your salivary glands hurt. Doctors agree that it typically occurs after someone has face or neck surgery, but in some cases has no known cause. Talk to your doctor if this type of pain is interfering with your daily life.

What This Means For You

First bite syndrome occurs when you eat something that makes your salivary glands hurt. Doctors agree that it typically occurs after someone has face or neck surgery, but in some cases has no known cause. Talk to your doctor if this type of pain is interfering with your daily life.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.First bite syndrome.Handa S, Shafik AA, Intini R, Keith DA.First bite syndrome - an underrecognized and underdiagnosed pain complication after temporomandibular joint surgery.J Oral Maxillofac Surg. 2022;80(3):437-442. doi:10.1016/j.joms.2021.10.012National Library of Medicine: MedlinePlus.Temporomandibular disorders.Cedars Sinai.Parotid duct obstruction.Johns Hopkins Medicine.Salivary gland infection (sialadenitis).Steel SJ, Robertson CE.First bite syndrome: what neurologists need to know.Curr Pain Headache Rep. 2021;25(5):31. doi:10.1007/s11916-021-00950-7

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.First bite syndrome.Handa S, Shafik AA, Intini R, Keith DA.First bite syndrome - an underrecognized and underdiagnosed pain complication after temporomandibular joint surgery.J Oral Maxillofac Surg. 2022;80(3):437-442. doi:10.1016/j.joms.2021.10.012National Library of Medicine: MedlinePlus.Temporomandibular disorders.Cedars Sinai.Parotid duct obstruction.Johns Hopkins Medicine.Salivary gland infection (sialadenitis).Steel SJ, Robertson CE.First bite syndrome: what neurologists need to know.Curr Pain Headache Rep. 2021;25(5):31. doi:10.1007/s11916-021-00950-7

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Cleveland Clinic.First bite syndrome.Handa S, Shafik AA, Intini R, Keith DA.First bite syndrome - an underrecognized and underdiagnosed pain complication after temporomandibular joint surgery.J Oral Maxillofac Surg. 2022;80(3):437-442. doi:10.1016/j.joms.2021.10.012National Library of Medicine: MedlinePlus.Temporomandibular disorders.Cedars Sinai.Parotid duct obstruction.Johns Hopkins Medicine.Salivary gland infection (sialadenitis).Steel SJ, Robertson CE.First bite syndrome: what neurologists need to know.Curr Pain Headache Rep. 2021;25(5):31. doi:10.1007/s11916-021-00950-7

Cleveland Clinic.First bite syndrome.

Handa S, Shafik AA, Intini R, Keith DA.First bite syndrome - an underrecognized and underdiagnosed pain complication after temporomandibular joint surgery.J Oral Maxillofac Surg. 2022;80(3):437-442. doi:10.1016/j.joms.2021.10.012

National Library of Medicine: MedlinePlus.Temporomandibular disorders.

Cedars Sinai.Parotid duct obstruction.

Johns Hopkins Medicine.Salivary gland infection (sialadenitis).

Steel SJ, Robertson CE.First bite syndrome: what neurologists need to know.Curr Pain Headache Rep. 2021;25(5):31. doi:10.1007/s11916-021-00950-7

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