Hello All,

I am referring to these forums because I have been under a lot of stress and hoped that I could find some advice. Before anything, I want to say that I have TMJ (hypermobility of my left joint) but never had any pain in my joints. My right side has been fine with some minor clicking. Never had any jaw pain.

Everything went downhill at the beginning of the month (September 2015). I came back from vacation and started developing major pain in my left upper wisdom tooth (erupted for almost 3-4 years) area and that alternated with my right upper wisdom tooth (erupted for a year). The bottom right had not erupted yet. I only had 3 wisdom teeth at that point because I had my bottom left removed a couple years ago.

I figured that I needed to remove them ASAP I got them removed through an oral surgeon. He mentioned that the top two were easy to remove and the bottom one had to be removed surgically, but will probably give me the most problems in terms of healing (also had stitches at that site). After the surgery, of course the first week was spent in pain and swelling (mostly on the right side that had 2 wisdom teeth removed). Jaw stiffness lasted for 4-5 days and I could open my mouth with ease after that. For the first 1.5 weeks I was having liquids and soft foods (e.g. eggs, yogurt, protein shakes, pasta, etc.) just in case. Maybe one or two times I had chewier foods like chicken. When I hit the 2 week mark, I decided to eat more solid foods (burgers, chicken). This is when my nightmare has restarted.

The right side is fine, but my left top extraction site is hurting like crazy. I went in to the same clinic and had to see a different (much younger) oral surgeon who said all the sites were healing well, but it is actually the muscles in the left side of my jaw are giving me pain. I have been put on a soft diet for 2 weeks.

I do not understand his logic as I feel the pain literally radiating from the extraction site (or so it feels). My jaw joints don’t hurt. I felt that for 2 weeks that site was giving me no issues, even when I was opening my wide really to eat. How can all of a sudden this extraction site give me pain? Or the muscles behind it? I was rinsing my mouth religiously with salt water for 2 weeks, but for the past few days I noticed that particular hole had food stuck in it and the sensitivity went up (they did not give me a syringe to clean out the holes).

I am so scared because I can’t tell at this point whether it is my TMJ muscles or if the extraction site has been irritated majorly after eating those foods or maybe because I have been using the left side more to chew. If it is TMJ muscles, how long does this last usually?

What if the pain that I thought was my wisdom teeth was actually my TMJ muscles?

My question is it normal for the pain to go away and then suddenly come back 2 weeks after? I don’t know what to think because I have reading horror stories online and I feel that maybe this is the beginning of my TMJ disorder.

Please please help. I have been crying for the past two days because I am under so much stress.

Hi fathm,

You could be experiencing TMJ problems from chewing too soon after the extractions along with severe irritation in the one extraction site. If food debris becomes impacted in an extraction site it is going to cause pain in that site and possibly referred pain into the muscle area also.

The fact that you already had TMJ abnormalities, with or without pain, makes you at a higher risk for further TMJ issues after dental work. Especially if you over use your jaw muscles too soon afterwards. Which it sounds like you did that.

The TMJ musculature can be asymptomatic until the muscle spasms. If it wasn't in spasm prior to the extractions or until you chewed food, then it would make sense for the delayed musculature pain as it hit due to a spasm. Backing off from chewing and opening your mouth wide may be just enough to relax the muscle. But that is not something you can rush. It could takes weeks or more to truly relax because it is a muscle that is used for talking and opening the mouth to drink, eat soft foods, brush teeth, etc.

It is important that the extraction site be evaluated properly to make sure there is not a food impaction. If the oral surgeon did not look thoroughly at the extraction sites... then go back and see him or someone else again.

Bryanna

Hi Bryanna,

Thank-you for responding. I really appreciate it. Since last night, I have been having pain in the same general area and I have been drinking liquids only to give my muscles a rest. The pain has just gotten worse. I actually had to take my leftover T3s today because the pain was just so frustrating. I have two additional questions if you could please, please address them any way possible:

Is it possible that if food was stuck in there for a few days, that the site was irritated and can cause pain after for a few days? Or would the pain subside the next day or so? The oral surgeon yesterday (or dentist, I dont even know what he was) cleaned out my sockets, so nothing should be in there since yesterday. Could it be that the hard food like the burger I had actually hit my healing site hard and irritated/damaged it?

If it is my TMJ, I have no clue what to eat. I'm upset because at my 1 week followup, my oral surgeon said that I could start eating normally, but I still kept it on the soft side. The oral surgeon that I met yesterday said that I should stick to "soft foods" like eggs, fish, yogurt, etc for 2 weeks. I have become so paranoid that I have been having only liquids. Should I really start chewing or just stick to drinking? Should I stick to soft diet for 3 weeks instead of 2?

fathm,

One day of less chewing is not enough time to relax the jaw muscles. It can take weeks for the muscles to recover from spasm.


If the pain in the socket in getting worse, then you could have a dry socket or have some food debris deep inside. I am confused as to when you had the sockets cleaned out by the dentist as you said it's been hurting for a few days and then said you just had them done. It is also in your best interest to be sure to see an oral surgeon not a general dentist and specifically express your concerns about food debris being impacted in the socket.

Generally when impacted food is removed from the surgical socket, there is relief from the intense pain so long as the site is not infected and the clot had formed properly. The site may be sore for a few days but should feel better, not worse.

It is advisable to eat a nutritious soft food diet for a few weeks post op until the mouth feels pain free and comfortable. Only you can gauge how your mouth feels. Soft foods are those that do not require a lot of chewing. There is no reason to be on a liquid diet only.

Bryanna

Hi Bryanna,

I wanted to provide you an update.

Thank-you for your response. I saw the other dentist/oral surgeon on Wednesday (2 days ago). He cleaned my sockets and said that the issue was TMJ muscles. He asked me to eat soft foods and keep putting heating pads, which I did for 2 whole days.

I was in so much pain today even after putting heating pads (which actually made my pain worse) that I called in the clinic AGAIN and asked to see my original oral surgeon (who did my extractions). I just saw him and his diagnosis was completely different.

He says it is not my TMJ muscles but the tooth adjacent to the wisdom tooth extraction site. When he pushed, I immediately felt the soreness. Moreover, this tooth also has quite a bit of filling. He has put me on anti-inflammatory for now and I see him next week. Worst comes to worst, he says I will have to do a root canal on this tooth (joy). I'm beginning to think that maybe my source of pain wasn't the wisdom teeth trying to squeeze in, but rather this dang tooth!!!!

My question is that, is it likely for the adjacent teeth to experience nerve pain and other sorts of pain after extractions? BTW, I still plan on sticking to a soft diet regardless of what the real issue is!! I still want to give my TMJ muscles time to heal.

Thanks for all your help!