Although it happens infrequently, TMJ disorders sometimes occur after wisdom teeth extractions. Here’s what you need to know about the reasons for this, along with information on how we can help patients who experience these disorders.

How frequently do wisdom teeth extractions lead to TMJ disorders?

It is sometimes the case that patients will experience TMJ disorders after they have undergone wisdom teeth extractions. We have seen that this occurs when patients have pre-existing jaw joint issues that escalate following their wisdom teeth extractions. For patients with healthy jaw joints, TMJ disorders usually do not follow or result from oral surgery.

Generally speaking, what might cause these conditions to escalate?

Various factors can contribute to this. Jaw joint ligaments may weaken due to gum chewing, teeth grinding, or just through usual wear and tear. Within the jaw joint, a disc (condyle) that is already weakened may weaken to the point of a problem if a patient undergoes oral surgery and must open his or her mouth widely for an extended period.

What might indicate that a patient has a potential TMJ disorder?

It is sometimes the case that patients experience clicking, popping, or grating sounds in their jaws for long periods of time—weeks or sometime months—without any pain or difficulty in regular jaw function. These seemingly harmless symptoms may be easy to overlook, but when a TMJ disorder surfaces, it may quickly become painful.

At Winchester Dental, you provide various options for TMJ pain management.

We do. It is crucial that we reduce a patient’s pain level and control his or her inflammation during the first six weeks after a TMJ disorder surfaces. Depending on the individual case, we may offer prolotherapy (injections containing dextrose and Prilocaine or lidocaine), or cold laser treatments. Cold laser treatments use a low-level laser, are painless (some patients even report that they are relaxing) and help the affected cells to absorb light energy and begin healing. In addition to reducing inflammation and pain, both of these methods help to create motion in the joint.

Can you explain more about prolotherapy? How does it work?

Prolotherapy is so named because it brings about proliferation of new tissues. A prolotherapy injection strengthens the jaw joint ligaments. Ligament looseness is frequently a condition of a TMJ disorder, and this what causes the ligaments to pop. The mixture of lidocaine and dextrose in a prolotherapy injection actually functions as an irritant that creates inflammation in the affected area. The inflammation causes the body to produce new keratin cells, which form around ligament tissue and help the ligaments to tighten. The jaw joint can work more efficiently after this process. Each patient and each case is different—some patients may need a series of these injections, and some may need only one.

Are there side effects associated with prolotherapy?

There may be some soreness from the injection itself, but no significant side effects. We recommend that patients take Excedrin or Tylenol as needed for the first 72 hours after a prolotherapy injection to relieve any soreness. But because prolotherapy uses inflammation to begin the healing process in the area of the ligaments, it is vital not to use anti-inflammatory medications that would counteract that process. We therefore caution patients against using Advil, ibuprofen, or naproxen (NSAIDs), which are anti-inflammatories.

We thank Victor D. Woodlief, DMD for kindly sharing this information.