With the high-profile cases of a young woman who slipped into a coma and a teen who died of infection following wisdom tooth removal, the issue of whether we should routinely have wisdom teeth removed has become more controversial. Adding to that controversy is new findings that TMJ may be a complication of wisdom tooth extraction.
No Benefits of Wisdom Tooth Extraction
Researchers of the new study, published in the American Journal of Public Health, a significant number of people who undergo wisdom tooth extraction experience TMJ jaw pain. Although 801 patients participated in the study, follow-up data was only available for 517 participants. Among these participants, 201 had one or more wisdom teeth removed during the study (720 wisdom teeth were removed in total).
Although the ostensible reasons for removing wisdom teeth were to protect periodontal health and reduce cavity risk on the second molar, these outcomes were not achieved by the process. People with wisdom tooth removal actually tended to have deeper periodontal pockets by their second molar than those who had not had them removed. In addition, the rate of cavities on the second molar was essentially the same between the two groups.
What was different was the complications related to removal of wisdom teeth. People with wisdom tooth removal were much more likely to experience a loss of sensation in the lips or jaw (paresthesia), which occurred in 6% of those who had their wisdom teeth removed, but only in 0.7% of those who hadn’t had their wisdom teeth removed. This is likely because wisdom teeth removal can damage nerves related to the jaw, which may also be responsible for the TMJ risk.
Jaw Complications of Wisdom Tooth Extraction
Researchers looked at several possible symptoms of TMJ when identifying the complication. First, they considered jaw joint noise, but found that self-reported popping and clicking was higher for those who had wisdom teeth extracted, but not significantly so.
However, jaw pain was significantly higher for people who had wisdom teeth extracted. About 34% of people who had their wisdom teeth extracted experienced jaw pain, either muscular pain or joint pain, compared to about 8.8% of those who had not had their wisdom teeth extracted.
Based on the paresthesia comparison and the lack of difference in jaw joint noise, it’s likely the pain is related not to the joint itself, but to nerves that are damaged or disturbed during the wisdom tooth procedure.
The findings of this study give us a better picture of the risk/benefit profile of wisdom tooth removal and can help us decide whether or not this is the right decision for any patient.