Hi Friends! I’m Priya Mistry the TMJ doc and today I’m going to talk to you about
wisdom teeth and TMJ Disorders. I’m part of multiple TMJD Support Groups online, and
I have seen many people asking questions about wisdom teeth and TMJD - if wisdom teeth can
cause TMJD, if you should get your wisdom teeth out while suffering from TMJD, and more.
These questions, these comments - they inspired me to make this video in hopes of providing some
answers for you guys. That being said, if you’re looking for more information on TMJ Disorders for
yourself or a loved one, then this is the YouTube channel for you. Be sure to hit that Subscribe
button as I post a new video every Friday for people who are suffering from TMJ Disorders!
For those of you who don’t who I am, I’m a General Dentist with a practice in Portland, Oregon where we are dedicated
to taking care of patients with TMJ disorders. I practice here with
my wonderful mentor, Dr. Arthur L. Parker. If you haven't already, be sure to check out our website. Please be sure to follow me on Instagram as
I post about TMJD frequently - at least 3-4 times a week! My Instagram handle is "the_tmj_doc". Also follow me on Twitter!
Tweet tweet. My handle there is "@ PriyaTMJ". I post lots of useful
information about TMJ disorders, tips, trivia, etc.. for all of you who like to nerd out
on TMJ knowledge like I do!
So let’s get right into it! Wisdom teeth - also commonly called third molars -
start erupting into the mouths usually around the age of seventeen. For many of us, these
teeth are actually impacted - which means that they are stuck in the bone or in the gums. If this
is the case and there’s a chance that the wisdom teeth can cause damage to the adjacent
bone or the teeth in front of them, the second molars, then many dentists will recommend
extracting the wisdom teeth. Another reason wisdom teeth are commonly extracted is due
to infection.
Many people who are suffering acutely from TMJ Disorders are very hesitant to get their
wisdom teeth out because they are afraid that the pain will get worse. And I will say,
this is a valid concern. If there’s no infection or pain being caused specifically by the wisdom
teeth, then I would recommend treating the TMJD first - this means eliminating pain and stabilizing
the Temporomandibular Joints - the TMJs. We treat with orthotics, myofascial release, and osteopathic manual jaw manipulation.
With this treatment modality, we can typically get our patients relief and release them
from active treatment within 4-6 months. Sometimes we can do this faster; sometimes it takes
longer, depending on the severity of the problem.
Fully erupted wisdom teeth - teeth that are in the mouth and used for chewing - can potentially
cause occlusal interferences which then exacerbate TMJ symptoms. What that means, in plain English,
is that the way the wisdom teeth bite against each other can put too much strain or stress
on the temporomandibular joints (the TMJs) and the muscles that surround and support
the jaw. This can then lead to TMJ problems - clicking, popping, crackling noises, episodes
of the jaw locking, headaches, neck pain, jaw pain, ear pain, and more! So what to do?
Do we extract the wisdom teeth because of this? Do we adjust the bite on the wisdom
teeth - remove enough enamel so that those occlusal interferences are eliminated? Well actually, you might be surprised to find out that
at my practice we do neither. If these wisdom teeth that are fully erupted, are healthy, and are infection-free,
we don't recommend extracting them. We recommend holding on to them! We eliminate the negative influence of the bite
by making a TMJ orthotic. A TMJ orthotic, if made correctly, will take the occlusion - or the
bite - out of the equation and treat the muscles and joints effectively. Once an orthotic is
worn for a significant amount of time and our patients have followed through with our weekly treatments of
myofascial release and osteopathic manual jaw manipulation, we find that the muscles and TMJs are
brought back to health, we can then release our patients from active treatment. Most patients
will continue to wear the orthotic at nighttime only to keep them out of trouble. We've found that 7-8 consecutive
hours wearing it at night will set our patients up for success the next day. And then same
thing - when they go to bed the next night, they wear it for 7-8 hours - it sets them up for success the next day. And so on, and so forth.
Lastly, I wanted to address TMJ problems that begin AFTER wisdom teeth are extracted. Unfortunately
I’ve seen this many times. What happens with wisdom teeth extractions is that the
mouth is held or propped open with a very large bite block. It has to be held open this much for
the dentist to actually reach the wisdom teeth because of how far back they are. Along with
that, some wisdom teeth are very difficult to extract - they may have big cavities, they may be
situated at awkward angles, or the roots may be wrapped around a nerve. If any of these are the
case, then the extractions may take a long time. The mouth being held open very wide for a
long period of time is not great for the Temporomandibular Joints or the muscles that surround and support the jaw.
One thing that can happed in is that the cartilaginous disk within the joint can become completely displaced, causing the law to lock closed. Another thing that can happen is that the ligaments
holding the disk in place can become loose or stretched. This then causes that cartilaginous disk to become slightly displaced
- causing clicking and popping noises. The muscles can also get strained from staying
open for such a long period of time, leading to muscle inflammation and pain. I've seen
all of these situations at my private practice. If this occurs, the best thing to do is to get
the patient into treatment as soon as possible with the orthotics, the myofascial release, and the jaw manipulation.
I want to be very clear that I am NOT blaming oral surgeons, dentists, or anybody else that might be out there
extracting wisdom teeth. These things happen and this video is purely informative.
So that’s really it my friends. If you like what you heard, if you've learned something new, click
“Like” below, Subscribe to my channel, do all the things. As always, questions and comments are welcome.
And remember, my friends, you can never have TMI about TMJ!