When we think of wisdom teeth, often the first thing we think of is removing them. That’s because a large portion of the population gets their wisdom teeth, or third molars, removed before they even erupt through the gums. Those who don’t get them removed prior to their eruption will often have them removed later.
Dentists and oral surgeons remove the wisdom teeth for a variety of reasons. Sometimes there is a fear that the person’s jaw is not large enough for these extra molars, which means they could push other teeth out of alignment. There may also be a fear that the wisdom teeth could get stuck underneath the gums, causing infection.
These are valid concerns that can happen in some cases. However, sometimes the third molars or wisdom teeth are removed without infection or a high risk of impaction or tooth displacement.
The question of wisdom teeth removal
When wisdom teeth are removed only as a precaution, this is known as “prophylactic” removal. Although this surgery has been fairly routine for decades, some experts believe that the surgery is unnecessary in many cases and may even be detrimental to health.
If you’ve ever had oral surgery, you know that the recovery can be painful and certainly puts a wrench in your schedule for a few days or even weeks. Operating on the sensitive gums and teeth can be traumatic, interfering with your ability to eat and drink normally, not to mention speak and go to work or school.
Even routine wisdom teeth removal comes with the risk of infection, pain, and addiction to opioid pain relievers, which are often prescribed after oral surgery. Although opioids are effective medications for pain, they are highly addictive. In fact, opioid addiction is becoming a significant public health crisis.
However, some people do legitimately need their wisdom teeth removed. One should not consider avoiding the surgery if they risk impaction or a serious misalignment of their existing teeth. Only an individual and their dentist or oral surgeon can determine whether they need the surgery.
TMD and wisdom teeth extraction
If wisdom teeth extraction on a normal jaw has some risks, the situation becomes even more complicated if the person has a temporomandibular joint disorder (TMD). That’s because an already inflamed, stressed, and irritated jaw joint may be further aggravated by the stress of the surgery itself and the difficult recovery afterward.
Even if you don’t have TMD now, however, simply having this surgery could trigger it. In fact, some evidence suggests that removing the wisdom teeth is a risk factor for TMD. This is why it’s important to pay attention to pain and other symptoms after surgery and be evaluated for TMD if needed.
Why wisdom teeth removal harms the TMJ
During wisdom teeth extraction, the surgeon must have the mouth open wide in order to access the teeth at the very back of the mouth. Often, the third molars are not even visible on the surface of the gums yet if the surgery is being performed on a younger patient. The surgery can take an hour or more to complete, depending on how many teeth are being removed and how complicated it is.
The removal of any teeth obviously causes some trauma to the gums. In many cases, the surgeon uses surgical instruments to cut the gums and remove the teeth below, followed by stitches to close up the area. Sometimes, however, the surgeon may be able to pull the teeth out without surgical cuts and stitches. This can leave a pocket of space in the gum where the tooth used to be, and requires special care as well.
Either way, this surgery results in a prolonged period of time with the patient’s jaw is forced open very far. For people who have TMD, this can be a major trigger for TMJ pain, swelling, and stiffness. Then, the trauma to the jaw can lead to more TMD symptoms in the days and weeks following, including headaches, neck and back pain, trouble sleeping, difficulty with eating, and ringing in the ears (tinnitus).
What to do if you need wisdom teeth removed
Sometimes it can’t be avoided: you may need your wisdom teeth removed even if you have TMD. We encourage our patients to have a discussion with their dentist or oral surgeon about the risks and benefits of this procedure. Obviously, if the wisdom teeth cause impaction or infection, they should be removed. If there is a reason to believe that the wisdom teeth may displace other teeth in the mouth, they should be removed as well.
Having your wisdom teeth removed doesn’t have to cause you weeks or months of pain from TMD, however. Though some discomfort will be normal for the first few days, there are ways to take care of your mouth and jaw to ensure you have a healthy recovery.
At MedCenter TMJ, we work with patients both before and after their wisdom teeth removal. Here’s what we recommend for the best possible outcome:
Make an appointment with a dental professional who specializes in the evaluation and treatment of TMJ problems. Ideally, this appointment should take place before your wisdom teeth extraction. Together, we can come up with a plan that will help your jaw rest and recover after the procedure. However, if you’ve already had your teeth extracted, it’s not too late to see a professional about your TMJ and to start getting your jaw healthy again. Many of our patients have, unfortunately, been dealing with TMD for months or even years before their first visit with us.
Don’t assume that all pain is normal after wisdom teeth removal. Talk with your dentist or oral surgeon about what you should expect after the surgery. Chances are, the areas where the teeth were removed will be quite tender and you may find eating difficult for at least a few days. However, extreme pain, ongoing headaches, or signs of infection like ongoing swelling or redness are not normal. Call your dentist or oral surgeon right away if these things occur.
Follow your oral surgeon’s post-op instructions carefully. You may be advised to avoid strenuous exercise, smoking, and drinking from a straw. This is because all of these things can make healing more difficult after oral surgery.
Even after you’ve been given the go-ahead to resume a normal diet, consider adopting a TMJ friendly diet for a few weeks or months. The jaw will still be healing after the strain of surgery and could use some TLC to help it recover completely. Avoid crusty breads, crunchy or hard to chew vegetables, and chewy meats. Instead, opt for smoothies, naturally soft foods, and cooking methods that allow healthy foods like fruits and vegetables to soften.
Be mindful of potentially damaging jaw habits. Things like chewing on a pen, chewing gum, and grinding or clenching teeth cause more stress to the TMJ. Try your best to stop these habits or talk to us at Medcenter TMJ about how we can help you manage your TMD with a comprehensive plan.
Get plenty of rest after the procedure. Although you may be tempted to go back to work quickly and get back into the swing of things, this isn’t always the best choice. If you can, take at least a few days to rest at home and eat a soft diet as you are able. The tissue in the mouth, as well as the muscles and tendons in the jaw, need plenty of time to heal after this type of surgery.
If you have symptoms of TMD or are considering wisdom teeth removal, we invite you to make an appointment with us at MedCenter TMJ. Our patients receive comprehensive care to help address the painful symptoms of TMD as well as ways to prevent future flares. Contact us today!