Expert: Benjamin Schwartz, DDS FAGD - 11/25/2008

Question
I am 41 years old and recently (2 weeks ago) had one of my lower wisdom teeth extracted.  It was deeply impacted in the jaw bone and also had a cyst over it.  After my extraction, I developed dry socket which I am still getting treatment for today (medicated gauze and antibiotics).  I have grinded my teeth at night for years and do have a hard nightguard which I do not wear much.  About a week after the extraction I was chewing a soft bagel on the opposite side of my mouth from where I had the extraction and I heard and felt a very loud pop in my jaw on the side where I had the wisdom tooth out.  Immediately the side of my face got very sore and I am now experiencing intense pain up near my ear that radiates down into my jaw.  My oral surgeon gave me Naproxen as well as Hydrocodone (Vicodin).  When I wake up in the morning the pain is minimal but as I use my jaw throughout the day to talk and eat (all soft foods with minimal chewing) the pain intensifies to the point where at night I need to take the Vicodin to sleep.  My oral surgeon has suggested that I start wearing my mouthguard every night and apply moist heat to the area to get relief.

My question is how long do you think I need to keep up with this treatment before we can say it is not working and try something different?  Based upon some of the other postings I have read on this site, I feel that I did something to the TMJ joint/disk/muscle (hence the popping sound) and feel my current course of treatment will not work.  I am unsure as to how long the recovery time is for wisdom tooth extraction on the jaw or for trauma to my TMJ joint (the painful pop I heard).

Thanks…also I have severe pain in the front of my shoulder (same side as the wisdom tooth extraction).  Not sure if it is related to the TMJ joint pain I am feeling


Answer
Hi Mark,

I am sorry to hear about this.

As you described, you most likely caused some sort of inflammation in your TMJ area. A muscle was likely stretched, and this is what is causing the majority of the pain. The anti-inflammatories, soft diet, and warm compresses are all important steps in allowing the area to heal and recover.

You should hopefully start feeling better within a week's time. It still may be sore, and you might not be able to chew hard foods, but it should be improving. Within another week, you should almost be back to normal.

Unfortunately, accidents happen. Hopefully, you will recover and have no further issues.

Please let me know if you need more help.