Wisdom teeth removal is a very common surgical procedure that often results in temporary side effects. One of the most frequently experienced issues after the operation is jaw stiffness, a condition medically known as trismus. This restricted ability to open the mouth is a normal and expected part of the healing process. Understanding the causes and the expected recovery timeline can help manage this temporary discomfort.
Why Jaw Stiffness Occurs and the Standard Timeline
Jaw stiffness (trismus) is a protective reflex caused by trauma to the surrounding tissues and the muscles used for chewing (muscles of mastication). Surgical manipulation required to extract wisdom teeth, especially in the lower jaw, causes inflammation and swelling in these muscle groups, such as the masseter and temporalis. Holding the mouth wide open during the procedure also contributes to muscle fatigue and soreness.
The local anesthetic injection itself can sometimes cause minor bruising or irritation to the medial pterygoid muscle, further limiting the jaw’s range of motion. This localized inflammation causes the muscles to involuntarily spasm or contract, leading to restricted opening.
Stiffness is typically most noticeable in the first 24 to 72 hours following surgery, coinciding with the peak of post-operative swelling. Patients usually notice significant improvement in jaw mobility by the fourth or fifth day of recovery. Most people find that the stiffness is largely resolved within seven to ten days, allowing for near-normal function. While minor tightness can linger for up to two weeks, the most restrictive period is short-lived.
Safe Techniques to Improve Jaw Mobility
Managing the initial post-operative period with cold therapy and anti-inflammatory medication helps limit the extent of stiffness. Applying an ice pack to the face for the first one to two days minimizes swelling, which reduces pressure on the jaw muscles. Over-the-counter anti-inflammatory drugs, such as ibuprofen, reduce the inflammation causing muscle contraction.
Once the initial acute swelling phase has passed (around 48 to 72 hours post-surgery), switching to moist heat therapy is beneficial. A warm compress or heating pad applied to the cheek helps relax tense muscles and increase blood circulation to the area. This transition from cold to heat promotes muscle recovery.
Gentle, controlled jaw exercises should begin after the initial acute pain and swelling subside, generally starting on the third or fourth day. Exercises involve slowly and slightly opening the mouth without forcing the movement or causing sharp pain, along with subtle side-to-side motions. Massaging the masseter muscle, located on the cheek, can also help release tension. The goal is to gradually restore the full range of motion and prevent chronic stiffness.
When Stiffness Indicates a Serious Complication
While some degree of stiffness is normal, certain signs indicate the condition requires immediate attention from an oral surgeon. A primary warning sign is stiffness that worsens after the first week, especially if accompanied by increasing difficulty in opening the mouth. If you cannot open your mouth at all, prompt evaluation is necessary.
Other indicators of a potential complication include stiffness accompanied by a high fever or severe pain that does not respond to prescribed medication. Worsening swelling, a foul odor or taste, or a noticeable discharge from the extraction site are red flags for a possible infection. Stiffness that persists without any improvement past the 10-day mark should also be reviewed.
These symptoms may point toward complications such as a post-operative infection or, in rare cases, nerve irritation contributing to muscle restriction. Another possibility is a dry socket, where the protective blood clot has dislodged, causing severe pain that can radiate to the ear and jaw.