Having your wisdom teeth taken out is an extremely common procedure – over 5 million wisdom teeth extractions are performed annually in the United States alone!

Although removing your wisdom teeth is generally straightforward for the oral surgeon, recovering from the surgery can sometimes be quite painful and involve more significant swelling and discomfort than many patients expect.

While it’s normal to have some pain at the actual extraction sites once the local anesthesia wears off, many patients are surprised that their entire jaw aches or feels sore and swollen after having their wisdom teeth removed.

Let’s explore some key reasons why you may be dealing with generalized jaw pain and discomfort after your wisdom teeth are taken out.

Jaw anatomy basics

Jaw anatomy basics

First, a quick refresher on jaw anatomy will help explain why wisdom tooth removal often leads to such extensive pain.

  • The jawbone (or mandible) is the U-shaped bone that forms the lower part of your skull and contains the lower teeth.
  • Powerful jaw muscles like the masseter and temporalis attach to the jawbone and allow you to open/close your mouth, chew, bite, and move your jaw from side to side.
  • The temporomandibular joints (TMJs) connect your jawbone to your skull on the left and right sides. These joints enable the jawbone to move and function properly.
  • Nerves and blood vessels run along the jawbone to provide sensation and nourishment to your teeth and gums. Networks of nerves converge in your bottom wisdom teeth.

So in summary, your lower jaw is a complex structure containing your lower teeth, joints, muscles, nerves and vascular supply all packed closely together to control jaw movement and biting/chewing.

Extracting wisdom teeth impacts many of these important anatomical structures which is why pain and dysfunction after surgery is often not just localized but more generalized.

Why might my whole jaw hurt? Key reasons

Why might my whole jaw hurt? Key reasons

There are several key reasons why you may be left with throbbing, radiating jaw pain after your wisdom teeth have been taken out.

Swelling and inflammation

After the trauma of wisdom tooth extraction, your body mounts an inflammatory reaction to begin the healing process.

Blood vessels dilate, fluid rushes to the area bringing immune cells, and localized swelling results. This is all normal and expected immediately after surgery.

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However in some cases, significant swelling can spread beyond the surgical sites into surrounding jaw regions like the cheeks or entire jawbone. Widespread inflammation irritates nerves and makes the whole jaw ache.

Maximum swelling typically occurs 2-3 days post-op, so you may notice increased generalized discomfort during this time frame before it starts improving.

Jaw muscle spasms

Closely related to swelling is the tendency of the powerful jaw muscles to react to trauma by tightening up protectively into spasms.

The masseter muscles which allow you to chew and clench can involuntarily tense up after wisdom tooth removal surgery, even if the surgical sites themselves feel relatively comfortable.

These muscle spasms can provoke referred pain that seems to originate from your whole lower jaw rather than localized extraction sites. Using moist warm compresses can help relax the clenched muscles.

Complex extractions

Surgical wisdom tooth extractions (versus simple extractions) are essential if the teeth are fully or partially impacted against the jawbone or other teeth.

But aggressive extraction techniques like removing bone, sectioning teeth, extensive tissue retraction, and prolonged use of surgical drills can increase trauma to surrounding structures like nerves, vascular supply, and the jawbone itself (alveolar process).

This irritation to adjacent regions during complicated wisdom tooth removal can cause pain that radiates outward into the entire jaw. Difficult impacted extractions often lead to more severe postoperative discomfort.

Infection risk

While not extremely common, bone and tissue infection can sometimes complicate wisdom tooth extraction healing.

Bacteria may be introduced during surgery or get trapped in the bone sockets afterwards, which can then lead to increased inflammation, pus formation, fever, swelling, and escalating pain.

If a bacterial infection takes hold in the jawbone or tissue flaps, pain can become more generalized and spread beyond the surgical areas themselves. Infection requires prompt antibiotic treatment.

Referred TMJ pain

The temporomandibular joints (TMJs) on each side of your jaw are closely interconnected with the nerves serving your back wisdom teeth.

Irritation to these nerves after extraction can travel along the TMJ and provoke increased inflammation and muscular spasms that make your entire jaw ache.

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TMJ irritation due to referred wisdom tooth pain is usually temporary but can cause lingering jaw discomfort if inflammation was significant.

Biting changes

Finally, removing wisdom teeth invariably shifts your “bite” alignment slightly even with only 4 total teeth removed.

These subtle changes in how your upper and lower teeth meet can place strain on muscles and TMJs as your jaw adapts. This malocclusion effect often provokes generalized muscular soreness or pain with chewing.

Your dentist can evaluate any occlusion changes after wisdom tooth removal and determine whether bite adjustment is needed to alleviate discomfort due to a “high” or uneven bite.

Tips to minimize jaw pain after extractions

Tips to minimize jaw pain after extractions

While some residual jaw pain is expected after extraction, here are some tips to help control symptoms:

  • Apply cold compresses to minimize swelling
  • Use pain relievers like ibuprofen to reduce inflammation
  • Eat only soft foods for 7-10 days post-surgery
  • Avoid extrem jaw motions like wide opening or hard chewing
  • Sleep with your head elevated on pillows to decrease swelling
  • Low-level heat may help relax muscles after 48 hours
  • Follow all post-op directions to keep sites clean and prevent infection
  • See your dentist if pain worsens or you have difficulty opening jaw

With proper care following these guidelines, your post-extraction jaw discomfort should gradually improve within 1-2 weeks as the sites heal. But don’t hesitate to follow up with your oral surgeon if symptoms seem excessive.

When to call your dentist about jaw pain

You should call your dentist promptly if:

  • Pain becomes severe and radiates up into your ear or temple region
  • Swelling is excessive or continues increasing 3-4 days after surgery
  • You have a foul odor or taste coming from extraction sites
  • You have difficulty opening your jaw normally
  • You develop fever, chills, nausea or other signs of infection

Wisdom tooth removal is very common, but significant complications can occasionally occur. Contact your oral surgeon if your jaw pain seems excessive or you experience worrisome symptoms that may indicate an issue like dry socket or infection.

With proper monitoring and treatment as needed, your post-op jaw discomfort should steadily improve within about 7-14 days. But don’t hesitate to call your dentist with any concerns after wisdom tooth extraction.

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Frequently Asked Questions

Q: Why does my jaw keep popping after wisdom tooth removal?

A: Jaw popping is common and caused by inflammation and swelling near the TMJ joint structures. As tissues heal over 1-2 weeks, popping and discomfort should diminish. Avoid extreme jaw motions in the meantime.

Q: When should I worry about jaw stiffness after extractions?

A: Mild stiffness is expected, but contact your oral surgeon if you cannot open your jaw more than 2 fingers width after 2 days or have trouble swallowing or speaking. These may be signs of a more serious issue requiring evaluation.

Q: How long will it take for my swollen jaw to go back to normal?

A: Swelling peaks at 48-72 hours, then slowly improves over 5-7 days. Using ice, medication, and rest will help it resolve. Call your dentist if excessive soft tissue swelling lasts longer than 1 week post-op.

Q: Why do I keep biting my cheek after wisdom tooth removal?

A: Numbness and swelling make it hard to sense your cheek. Take care when chewing and the issue should resolve within 7-14 days as sensation returns and swelling decreases.

Q: What’s the difference between normal versus dry socket pain?

A: Normal pain is dull, throbbing, worst at extraction sites. Dry socket is sharp, radiating pain that starts ~3-5 days post-op. Foul odor is also suggestive of dry socket. Promptly notify your dentist.

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