Post-Wisdom Tooth Extraction: Why Can't I Open My Mouth?

After the extraction of the lower right impacted wisdom tooth, I am unable to open my mouth?

Hello, Doctor.
I had my wisdom teeth extracted on November 13, and it has been two weeks since then.
I can only open my mouth about one finger's width, and if I try to open it wider, I feel a locking sensation.
The wound is still inflamed, and I have been taking anti-inflammatory medication (although the wound itself no longer hurts).
My face was very swollen, but after acupuncture and massage, the swelling has significantly reduced; however, there is still one area that feels hard and is painful when pressed.
The right side of my tongue is still numb and slightly swollen.
When I asked the doctor, he said it was due to the wound.
I would like to ask: 1.
How long will it take for me to be able to open my mouth normally? What treatment should I pursue? Previously, the doctor used a mouth opener to check the wound, and I was in so much pain that I cried.
The second time, I told the doctor not to use it, and he got angry, saying that if I was afraid of pain and didn't open my mouth, it would be even harder to open.
(I genuinely feel like my jaw is locked, and it really hurts to keep it open for a long time.) 2.
Is it normal for my tongue to be numb?

Fanny, 20~29 year old female. Ask Date: 2008/11/27

Dr. Zhuang Suhui reply Dentistry

1.
Given your situation, it would be best to go to a major hospital for further examination and treatment, preferably consulting an oral surgeon (a dental specialty).

2.
The treatment for wisdom teeth varies greatly due to the significant differences in their anatomy, and there are many surgical techniques for extraction.
The surgical method and postoperative recovery can also differ widely.
Without seeing the wound, I cannot make an accurate assessment or provide professional advice.

3.
Difficulty opening your mouth? This can involve individual pain tolerance, the speed of wound healing, or other issues, leading to considerable variability in recovery time.
Treatment must be tailored to the specific problem.

4.
Numbness of the tongue? The causes can be complex, and without observing the actual condition, I cannot make a judgment.
Treatment for tongue numbness varies significantly depending on the underlying cause, so it is best to seek care at a major hospital for more comprehensive treatment.

5.
My recommendation: After two weeks, you may consider applying local heat to increase blood circulation, which might help improve mouth opening and tongue numbness.
If the heat application causes increased pain, stop immediately and seek care at a major hospital.

Note: 1.
Most major hospitals have dental emergency services; if you are experiencing urgent discomfort, you can go to the nearest major hospital.
The on-call dentist in the emergency department can refer you to an appropriate dental specialist based on your condition.
2.
If you have concerns about your current doctor's treatment approach or explanations, seeking a second opinion from another physician is advisable; asking questions online may not effectively resolve your issues.

Reply Date: 2008/11/27

More Info

After wisdom tooth extraction, it is not uncommon to experience limited mouth opening, also known as trismus. This condition can be caused by several factors, including inflammation, muscle spasms, and swelling in the area surrounding the extraction site. Given that you had your wisdom teeth removed two weeks ago and are still experiencing difficulty opening your mouth, it is essential to understand the underlying reasons and how to manage them effectively.

Why Can't I Open My Mouth?
1. Inflammation and Swelling: After surgery, the body responds with inflammation, which is a natural part of the healing process. This inflammation can lead to swelling in the jaw muscles and tissues, restricting movement. Although you mentioned that the swelling has decreased, residual inflammation can still affect your ability to open your mouth fully.

2. Muscle Spasms: The muscles responsible for opening the mouth can become tense or spasm due to pain or discomfort from the extraction site. This muscle tension can further limit your mouth's range of motion.

3. Nerve Involvement: The numbness and tingling sensation in your tongue may indicate that the nerves in the area were affected during the extraction. This can lead to altered sensation and may contribute to the feeling of tightness or restriction in your jaw.

How Long Will It Take to Open My Mouth Normally?
The timeline for recovery varies from person to person. Generally, most individuals can expect to regain normal mouth opening within a few weeks to a couple of months post-surgery. However, if you continue to experience significant limitations, it is crucial to follow up with your dentist or oral surgeon for further evaluation. They may recommend physical therapy or specific exercises to help improve your range of motion.

Treatment and Management Strategies
1. Gentle Stretching Exercises: Once the acute pain has subsided, you can begin gentle stretching exercises to help improve your mouth opening. Start by placing a small object, such as a tongue depressor or a popsicle stick, between your teeth and gradually increase the size as tolerated. Aim for a few minutes of stretching several times a day.

2. Heat Therapy: Applying a warm compress to the jaw area can help relax the muscles and reduce stiffness. Use a warm towel or heating pad for 15-20 minutes several times a day.

3. Pain Management: Continue taking anti-inflammatory medications as prescribed by your doctor. These medications can help reduce inflammation and alleviate pain, making it easier to perform stretching exercises.

4. Physical Therapy: If your symptoms persist, consider consulting a physical therapist who specializes in jaw disorders. They can provide tailored exercises and techniques to help improve your jaw mobility.

5. Follow-Up with Your Dentist: If you experience ongoing pain, swelling, or difficulty opening your mouth, it is essential to return to your dentist for a follow-up appointment. They can assess the healing process and determine if any additional treatment is necessary.

Is Tongue Numbness Normal?
Tongue numbness following wisdom tooth extraction can occur due to nerve irritation or damage during the procedure. While it is often temporary, it is essential to monitor the situation. If the numbness persists or worsens, you should consult your dentist or oral surgeon for further evaluation. They may perform tests to assess nerve function and determine if any additional treatment is needed.

In summary, limited mouth opening after wisdom tooth extraction is a common issue that can be managed with appropriate care and exercises. Be patient with your recovery, and do not hesitate to seek professional help if your symptoms do not improve. Your oral health and comfort are paramount, and addressing these concerns early can lead to a better outcome.

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