TMJ Sounds After Wisdom Tooth Extraction: Rehabilitation Options

Temporomandibular joint (TMJ) noise rehabilitation issues?

Hello, doctor.
I would like to ask if there are any rehabilitation treatments that can help with sounds in the temporomandibular joint (TMJ).
Currently, there is no pain, and both opening and closing of the mouth are normal without any sounds; the only issue is that there are abnormal noises when chewing food.
This problem with the TMJ sounds began a few months after I had my wisdom teeth extracted, and I also noticed a deviation in my dental midline after the extraction.
A few days ago, I returned for an adjustment of my occlusal splint, and the dentist reviewed the X-rays taken before the extraction, which did not indicate any midline deviation.
However, after the onset of the sounds, new X-rays were taken, and the dentist mentioned that there is a developmental issue with the condyle of the TMJ.
I have been undergoing occlusal splint therapy at the dental clinic for about two months.
My attending physician has suggested that I consider rehabilitation treatments that may be beneficial.
Could you please provide some recommendations? Thank you.

Che, 20~29 year old female. Ask Date: 2016/08/11

Dr. Yin Xinbei reply Rehabilitation

Generally, when experiencing temporomandibular joint pain, localized treatments such as laser therapy or ultrasound can be used.
These methods help alleviate inflammation of the temporomandibular joint; however, they are symptomatic treatments rather than addressing the root cause.
The use of an occlusal splint should be considered the appropriate treatment approach.
As for the sound issues, it may be advisable to wait and see the effects of the occlusal splint treatment, as it is uncertain whether laser or ultrasound therapy will be effective for the noises.

Reply Date: 2016/08/11

More Info

After wisdom tooth extraction, it is not uncommon for patients to experience various issues, including sounds from the temporomandibular joint (TMJ). Your situation, where you notice sounds during chewing but do not experience pain or functional limitations, suggests that while there may be some changes in the joint mechanics, it is not currently causing significant discomfort or dysfunction.

The TMJ is a complex joint that connects the jawbone to the skull, and it can be affected by various factors, including dental procedures like wisdom tooth extraction. The sounds you are hearing could be due to changes in the alignment of the jaw or the way the joint moves after the extraction. It is also possible that the extraction has altered your bite, leading to compensatory movements in the jaw that result in these sounds.

Regarding rehabilitation options, there are several approaches that may help alleviate the sounds and improve the overall function of your TMJ:
1. Physical Therapy: A physical therapist specializing in TMJ disorders can provide exercises to strengthen the muscles around the jaw and improve joint function. These exercises may include stretching, strengthening, and relaxation techniques to help reduce tension in the jaw muscles.

2. Jaw Exercises: Gentle jaw exercises can help improve mobility and reduce any stiffness in the joint. These may include opening and closing the mouth slowly, moving the jaw side to side, and gently massaging the jaw muscles.

3. Heat and Cold Therapy: Applying heat to the jaw area can help relax the muscles, while cold therapy can reduce inflammation if there is any swelling. Alternating between heat and cold can provide relief and improve comfort.

4. Occlusal Splints or Bite Guards: Since you are already using a bite plate, it is essential to ensure that it is correctly adjusted. These devices can help stabilize the jaw and prevent grinding or clenching, which can exacerbate TMJ issues.

5. Stress Management: Stress can lead to muscle tension and exacerbate TMJ symptoms. Techniques such as mindfulness, meditation, or yoga can help manage stress levels and reduce muscle tension.

6. Consultation with a Specialist: If the sounds persist or worsen, it may be beneficial to consult with a specialist in TMJ disorders or an oral and maxillofacial surgeon. They can provide a more in-depth evaluation and recommend further treatment options, such as imaging studies to assess the joint's condition.

7. Medication: Over-the-counter anti-inflammatory medications may help reduce any inflammation in the joint if needed. However, it is essential to consult with your healthcare provider before starting any medication.

In terms of the alignment issue you mentioned, it is crucial to monitor any changes in your bite and ensure that your dental care team is aware of your concerns. Sometimes, adjustments to your bite plate or further orthodontic treatment may be necessary to correct any misalignments that could be contributing to the sounds.

In summary, while TMJ sounds after wisdom tooth extraction can be concerning, there are various rehabilitation options available that can help improve your situation. It is essential to work closely with your dental care team and any specialists involved in your treatment to ensure a comprehensive approach to your recovery. Regular follow-ups and open communication about your symptoms will be key to achieving the best outcome.

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