Zygomaticus and Buccinator: Pain Pattern and Treatment
The zygomaticus runs from the cheekbone to the corner of the mouth and lifts it in a smile. The buccinator is the flat muscle of the cheek wall that keeps food between the teeth and lets you blow. Their documented patterns share the cheek: the zygomaticus sends pain in an arc from beside the nose up to the middle of the forehead, the pattern behind a sinus headache with normal scans; the buccinator gives deep cheek and jaw pain that is worst chewing, with a cheek that traps food. This page covers both, with each zone attributed. They relate to the masseter and temporalis pages.
Attachments and action
Origin: Zygomaticus major: the zygomatic bone. Buccinator: the outer surfaces of the upper and lower jaws opposite the molars, and the pterygomandibular raphe.
Insertion: Zygomaticus major: the skin and muscle at the corner of the mouth. Buccinator: the orbicularis oris at the corner of the mouth.
Action: Zygomaticus major draws the corner of the mouth up and back in smiling. Buccinator presses the cheek against the teeth in chewing and in blowing, and draws the corner of the mouth back.
Where the pain is felt: Zygomaticus: beside the nose, up the side of the nose to the middle of the forehead. Buccinator: deep in the cheek and at the jaw on that side, worst chewing and swallowing, with a cheek that feels stiff and traps food.
Common causes: Clenching and grinding; a wind instrument or a long day of speaking; chewing gum; a cheek held against the teeth in concentration; smiling for hours at work; a dental bite that has shifted; sinus congestion that changes the breathing and the bite.
Patients say: "Sinus pain, but the scan was clear." A line of pain from beside my nose up my forehead. "My cheek aches when I chew." "Food gets stuck in my cheek."
When to get evaluated: Face pain with fever, thick nasal discharge, or swelling around the eye needs medical evaluation for sinus infection first. A cheek that droops, a smile that is uneven, or a new weakness of the face needs medical assessment the same day. Jaw pain with swelling, heat, or a bad taste needs a dentist for an abscess.
How this muscle is examined and treated
Examination has you smile hard and then puff the cheeks against resistance, then presses the cheek between a gloved finger inside the mouth and a thumb outside for the points that reproduce the forehead arc and the deep cheek pain. Needling here addresses the muscles of the cheek from the outside, shallow, with fine needles. Assessment and treatment happen in the same visit.
Related conditions
Headaches & MigrainesChronic Pain PatternsNeck & Cervical Pain
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600