First Bite Syndrome Symptoms, Causes, Treatment

First bite syndrome is defined as pain in salivary gland named parotid gland or in the mandibular region i.e. lower jaw region. Parotid gland is located at the back side of mouth and near to the ears. This pain occurs at 1st bite and then gradually its intensity decreases with every bite. Pain may also become intense if patient take a break in eating meal. It is considered a side effect of a surgical treatment which is performed for cancer in head and neck region. Saliva production by parotid gland in mouth triggers pain sensation.

Pain is described as a sharp, intense pain resembling a muscle spasm. It mainly occurs due to nerve damage. Sometimes cancer/ tumor in head or neck region can also lead to first bite syndrome. This syndrome can occur again after treatment with a gap of days, months or years. It is a self-resolving syndrome which recovers on its own. But there are still some treatments which help in resolving its side effects. Sometimes first bite syndrome is accompanied by retrosternal chest pain and esophageal disease. There is no age restriction in first bite syndrome and can occur again and again even after treatment.

First Bite Syndrome Symptoms

       
First bite syndrome have a main symptom of pain occurring at first bite. Pain can be described as intense, sharp, needle like pain resembling muscle spasm. Pain sensation starts decreasing with every bite but pain can occur again if patient takes a break during meal. Patient feels difficulty in eating and chewing food. Pain occurs in the back side of mouth near the ears in parotid gland due to production of saliva before or with every bite. Patient feels pain like toothache in lower jaw line i.e. mandibular region. Sometimes pain spread to ears and brain.

First Bite Syndrome Causes

         
The exact cause behind first bite syndrome is unknown but on going research revealed that it can occur due to nerve damage. Nerve damage which occurs during or after surgery. 1st it was considered a side effect which occurred after chemotherapy of head and neck region. Tumor in head and neck region can also lead to first bite syndrome. Pain is triggered by parotid gland upon saliva production. All these can be the possible causes behind first bite syndrome so care along with proper treatment is required.

First Bite Syndrome Treatment

     
There are many treatment options which are beneficial as well.

• Behavioral changes: patient is asked to do some actions like quenching fists, and rubbing cheeks to distract attention from pain. If pain occurs on one side of mouth, then patient should try to take bite with other jaw. Patients are also asked to take healthy food.
• Medications: pain relievers are of no use in reducing pain but an anticonvulsant drug named carbamazepine and amitriptyline help in reducing pain.
• Radiations therapy: radiation therapy is not common but is considered beneficial.
• Botulinum toxin injection: this injection blocks production of pain.