Limited Mouth Opening After Wisdom Tooth Extraction: Is It Normal?

Limited mouth opening after extraction of the lower left horizontal wisdom tooth?

Before the tooth extraction, I could open my mouth about 48mm.
After the extraction, I could only open it about one finger's width.
A week later, I was able to open it two fingers' width.
Initially, I was taking pain medication, and during those days, I could yawn and even open my mouth normally to 48mm.
However, after stopping the pain medication a week post-extraction, I started to experience pain in the masseter muscle extending to the front of my ear when I opened my mouth beyond two fingers.
When biting down, I felt soreness and a burning sensation in the masseter muscle.
Resting after eating helps alleviate the discomfort.
I initially thought it was related to the wisdom tooth extraction site, but it seems more like a temporomandibular joint (TMJ) issue.
Is this considered a normal condition? Should I apply heat and rest more? Thank you.

Mei Yu, 20~29 year old female. Ask Date: 2022/03/12

Dr. Zeng Guanghui reply Dentistry

If there is an infection or inflammation at the extraction site after wisdom tooth removal, it can affect the ability to open the mouth.
However, if there is soreness when biting down, particularly in the area in front of the ear, it may indicate a temporomandibular joint (TMJ) issue.
It is recommended to return to the dentist for an examination if the pain persists for more than a week.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/03/12

More Info

After wisdom tooth extraction, it is not uncommon to experience limited mouth opening, also known as trismus. This condition can arise due to several factors, including muscle spasms, inflammation, or trauma to the muscles and tissues surrounding the jaw during the extraction process. In your case, it seems that you initially had a good range of motion with your mouth opening, but after a week, you began to experience pain when trying to open your mouth wider than two fingers. This discomfort, especially if it radiates to the area around your ear, may indicate involvement of the temporomandibular joint (TMJ) or the muscles associated with jaw movement.

It is important to note that limited mouth opening can be a normal part of the healing process following wisdom tooth extraction. The muscles may become tense or inflamed, leading to discomfort when attempting to open your mouth wider. The fact that you experienced relief after resting suggests that your muscles may be fatigued or strained from overuse.
Here are some recommendations to help manage your symptoms:
1. Rest and Avoid Overexertion: Give your jaw a break. Avoid wide mouth movements, such as yawning or eating large bites, until the discomfort subsides.

2. Heat Therapy: Applying a warm compress to the affected area can help relax the muscles and improve blood flow, which may alleviate pain and stiffness. You can use a warm towel or a heating pad for about 15-20 minutes several times a day.

3. Gentle Stretching Exercises: Once the acute pain decreases, gentle stretching exercises can help improve your range of motion. For example, you can try slowly opening your mouth as wide as comfortable and holding it for a few seconds before closing it again. Repeat this several times a day.

4. Pain Management: If you are experiencing significant discomfort, over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage your symptoms. Always follow the dosage instructions on the label or those provided by your healthcare provider.

5. Consult Your Dentist or Oral Surgeon: If your symptoms persist or worsen, it is crucial to follow up with your dentist or oral surgeon. They can assess your condition, check for any complications, and provide further treatment options if necessary. They may also evaluate your TMJ to rule out any underlying issues.

6. Physical Therapy: In some cases, if the limited mouth opening and pain persist, your dentist may refer you to a physical therapist who specializes in TMJ disorders. They can provide targeted exercises and treatments to help restore function and alleviate pain.

In summary, while some degree of limited mouth opening and discomfort is normal after wisdom tooth extraction, it is essential to monitor your symptoms. If you notice any significant changes, such as increased pain, swelling, or difficulty in opening your mouth, do not hesitate to seek professional advice. Your oral health is paramount, and timely intervention can prevent further complications.

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