Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 11/21/2006

Question

Thanks for reply.  You mentioned "opening of the mouth and keeping it open by yourself can fatigue the muscles and stimulate spasms" -- I was wondering if having the procedure done while under general anesthesia would help with this since I would not be actively holding my mouth open, rather it would passively be open while I was out?-------------------------------------------
The text above is a follow-up to ...

-----Question-----
I have mild TMJ- more muscle related than joint.  My jaw does lock open if I open too wide.  After any dental procedure I get a flare-up w/ spasms.  These flare-ups last from 1-4 months.  I need to have an impacted wisdom tooth extracted and I'm very fearful about how this will effect my TMJ.  Can you tell me anything that will ease my mind about this procedure?
Thanks!
-----Answer-----
Monica -  Ease your mind--I'm not sure I can do that.  It is always possible to stimulate the muscles that help open and close your mouth when dental work is done.  The opening of the mouth and keeping it open by yourself can fatigue the muscles and stimulate spasms.  Removing wisdom teeth by themselves can stimulate muscular problems because of the position of the teeth relative to the attachment of the muscles to bone.  

To reduce the chances of problems, the surgeon should have you bite on a device that keeps you open without excess effort.  This can reduce the chances, but it may still occur.  Warm salt water rinses beginning a couple of days after the extraction can soothe the muscles.  Be sure not to place heat on the outside of your face after the extraction.  This could actually increase the fluid in muscles and stimulate discomfort.

So ask the surgeon for something to bite on.  I wish you the best, but if you have any further questions feel free to contact me again.

Answer
Monica - Having the teeth removed under anesthesia would definitely help.  Your mouth would be propped open with a device and the muscles that open and close your mouth would be relaxed.  So yes that would be a good choice.

Again, any questions please feel free to contact me again.