Will the pain and stiffness in my jaw after implant surgery ever go away?

[Sue10191]

I had my first dental implant surgery three weeks ago.  The area where the tooth was pulled and post implanted feels okay except for some minor aching from time to time and slight numb feeling where the gum tissue was cut.  I am not chewing on that side at all and had not been for several months before the surgery due to discomfort at that site.  My problem is that there is pain, not throbbing or acute, on the side of the jaw when I open my mouth up wide.  The most disturbing part is the stiffness and total lack of mobility of the lower jaw when I try to move it to one side or stick it out as if creating an underbite.  It just stops.  I mean it will not budge beyond a certain point.  I can move it perfectly normal to one side but not the other. This morning when I first woke up, I was laying on my non surgical side.  I opened and closed my mouth and felt a pop on the non surgical side each time I opened and closed my mouth.  This went away after I got up.  The dentist has said that this is all do to a strain on the muscles in the jaw during surgery.  My mouth is rather small and it was open for an hour and a half for the surgery.  I was on gas so couldn't really tell how wide it was open etc.  This situation has gotten no better.  Do you think this will get better when I am chewing on both sides of my mouth?  Could this be due to a nerve in my jaw which is irritated?  The main nerve under the implant was not touched as I had a ct scan to see its exact location.  I remember having slight discomfort in the jaw from novacaine needles in the past which lasted quite awhile.  Could this be a combination of causes for my frozen jaw?  HELP?

[Jerome Tsang, DDS]

Judging by your description, I would tend to agree with your dentist that its more of a muscular problem than a nerve problem.  If you had damage to the nerve, there would be more of a constant numb or tingling sensation of the jaw rather than tightness or stiffness.  Your muscles are probably sore from being open too long.  Any swelling in the cheek area though?  Its possible you may have gotten an infection in your cheek from an injection although its fairly rare.  If there isn't any swelling, then I would say that a soft diet, some stretching exercises and a warm towel to help alleviate the muscles are needed.  Also, I'm fairly certain you're taking some anti-inflammatories which should help as well.  Hope you feel better.

[Jerome Tsang, DDS]

Actually you might want to go see the dentist and have it checked out.  It should be better after a month or so.  Try some stretching exercises, chew on some gum (sugarfree) to sort of move the muscles a bit (don't over do it), apply warm towels still, take some anti-inflammatories such as ibuprofen (if its safe for you) and massage the muscles out.  I'm a little concerned about the "crackling" though.  Muscle injuries don't "crackle" as far as I know.  That's why I think its a good idea to check it out.

[Sue10191]

I think I have a slight bit more mobility moving the lower jaw forward(as if to create an underbite) and to the right. Although it is still quite stiff and there is a "crackling" sound/sensation in my ear, on the affected side, when I do so. Certain movements cause an ache where the jaws meet in the side of my face.  The ache is generally in the morning.

Am hoping this will not become a chronic condition, flaring up each time I have dental work done.

Am having my teeth cleaned this month so will have to explain the situation to the hygienist........actually I think I will call and see if I can postpone the cleaning.

Thank you again.

[Jerome Tsang, DDS]

Has it improved any?  Its been roughly 5 weeks I think.  It should be back to normal or close to it by now.

[Sue10191]

Thank you.

[Jerome Tsang, DDS]

It may take up to a month to improve or go back to normal.  I would be patient and monitor the situation but it should be a gradual improvement over time.  If it doesn't get better or worsens suddenly, I'd go let your dentist know.

[Sue10191]

I still am chewing on one side.  I think this may be contributing to my problem and once the crown is on and I am chewing normally, the jaw function will return to normal. I hope. However, while I am prepared to be patient, at what point after the crown is on should I seek medical attention for this problem?  I have at least a minimum of two or three months to go before the bone is healed and crown is on.  Thank you Dr.

[Jerome Tsang, DDS]

Sounds good.  Ya, treat it like a muscle injury or a sprained ankle.  Just by babying it and stretching it out every so often, it should gradually get better.  If you ever go through that again, make sure you remind the doc to let you stretch out once in awhile even if you're out cold.  I do it even if my patient is out whenever I get a chance.

[Sue10191]

Thank you for your opinion.  I don't think there is any swelling and I was on antibiotics after the surgery.  I think I will finally try the warm towel as my dentist made this suggestion as well.  I will be seeing him again for a check of the implant on Friday.  
Thanks again