Like any dental surgery, wisdom tooth removal involves some risks. Some, such as dry socket, are very well known; others, not so much.
One often overlooked risk is cavitations forming at the extraction sites. These are areas of dead and decaying tissue, often hidden under healthy looking gum tissue. They’re also incubators of harmful bacteria and the many potent toxins they generate, which can migrate through the body, generating illness or dysfunction far from the source.
One of the most common causes of cavitations is failure to fully remove the periodontal ligament along with the tooth or properly clean the supporting bone before closing up the surgical site. The bone doesn’t fill in properly, setting the stage for hidden infection.
While cavitations can occur anywhere in the mouth, they are especially common at wisdom tooth sites. According to research by Drs. Hal Huggins and Thomas Levy, nearly 90% of such sites present these lesions.
Another complication that may arise from wisdom tooth extraction? According to a new casual review in the journal Cranio, “the literature appears to suggest that third molar extractions are a risk factor for the development of TMD.” (“Third molar” is the clinical term for a wisdom tooth, while “TMD” is shorthand for temporomandibular disorders.)
A TMD is characterized by pain and dysfunction in the jaw joints and muscles used for chewing. Common symptoms include facial pain or tenderness, headaches, jaw clicking or locking, and limited jaw movement. It’s a condition that Dr. Parsi has successfully treated here in his San Diego office for many years now through his neuromuscular approach that ranges from oral appliance therapy to bite balancing to comprehensive postural and nutritional therapies.
Always, his focus is on identifying the root cause of each patient’s TMJ troubles so he can develop a custom treatment plan to bring them long term relief.
Sometimes that root cause can be an oral surgery such as wisdom tooth removal, which can either trigger new TMD symptoms or aggravate a mild TMJ problem so it becomes a more significant one.
Interestingly, notes the review author, most patients who are recommended for wisdom tooth extraction are also in the group most likely to be diagnosed with a TMD: young, middle-aged adults, especially women.
In an article by DeAngelis et al., they report that signs of TM joint disorders are common in patients referred for third molar extractions. In this study, approximately 40% of all patients referred for third molar extraction had one or more clinical signs of a potential TM joint disorder.
Yet others claim that they experienced no jaw troubles until after the surgery. So what might be going on there?
One likely culprit it simple trauma, such as “the use of excessive force during the extraction of third molars.” (That’s the clinical term for wisdom teeth: third molars.)
A paper by Dolatabadi and Esshagh reviewed the incidence of TMJ injuries and derangement due to trauma by dental students. The prevalence of TMJ injuries after student extractions of third molars was 50–63%. In a paper by Raustia and Oikarinen, oral surgeons performed all the surgeries, and even though the sample size was small, only 16% of the patients reported severe TMD pain post-surgery (no patients reported severe joint pain pre-surgery).
This suggests that extractions may best be handled by surgical specialists rather than general dentists.
It also highlights the importance of TMD screening before any surgical procedures (or lengthy dental procedures, for that matter, since very long ones can likewise stress the jaw joints). That way, extra precautions can be taken as needed, so you get the full benefit of any dental work you need without creating the need for additional procedures or therapy.
And if TMD does emerge? Whatever the cause, Dr. Parsi is here, a highly trained, skilled, and gentle clinician, ready to help you on your way to TMJ pain relief.