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Oral Surgery/Double Jaw Surgery complications

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Screw
Screw  
Hi Joel,

I had DJS on 3/30/16 for severe TMJ pain/overbite. My first question to you is, is it normal to still be in as much pain as I am now? My surgeon seems to think Botox every month or so will help the pain. Had it twice already, hasn't done a thing.  Second, do you usually suggest jaw excersises or any stretching after a certain amount of time post op? I haven't done any at all because he said not to. Also, is it normal for surgical hardware to come out at all? I have had this very uncomfortable spot behind my bottom right molar, making it difficult to eat, and I discovered a screw poking through (see attached image). Apparently it has to get surgically removed at some point this week.

Thank you for your time,
Caitlin

Answer
Caitlin -  I am sorry to tell you this, but your surgeon is way off base.  First of all the screw poking through can accentuate any residual inflammation from the surgery.  This can potentially produce a bone infection.  

Secondly, postoperative exercises and or physical therapy to accentuate normal function, along with making the area feel better is important.  If your surgeon does not want physical therapy for you he is not promoting a healing.  If nothing else, the exercises allow the muscles, that were not working well before surgery and affected from the surgery to regain normal functioning.

So have that screw removed and the surgeon should refer you to a physical therapist.  If he refuses, speak to your physician and ask him to refer you to a physical therapist.  You can also ask your dentist to refer you, but it is important.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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