Twin Block, Pain Medications and Third Molar Extractions

Inclusion Criteria: * All patients requiring extraction/s of at least 1 lower wisdom (third) molar that is partially/fully 'impacted', under intravenous sedation, are eligible to participate in this study so long as they 1. are older than 18 years of age, 2. are healthy, 3. have no cognitive/intellectual disability, 4. have no past/recent pain or reduced range of motion in their jaw joint/ muscle complex, no trauma or surgery in their jaw region. 5. have an electronic device such as a smart phone or a tablet/ computer with internet connection. 6. are willing to participate in the study and not be excluded by the following criteria below. Exclusion Criteria: * Any patients, even if satisfying the criteria above, may not take part if they have any of the following: 1. Compromised ability to guard their self-interest, for e.g., prisoners, children, pregnant women, patients with intellectual/cognitive disability are not enrolled in the study. 2. Those patients who present with infection/inflammation involving the third molars slated for extractions, on the day of their procedure, may not take part in the study. 3. In addition, those who have had opioid pain medication/s in the past to address short-term or long-standing pain, or those who are on long term prescription of anti-inflammatory pain medication, are unable to participate. 4. Those with long standing pain of the jaw joint or muscles. 5. Finally, those patients who are allergic to/unable to tolerate either the dental local anesthetic or its components, opioids, acetaminophen ('Tylenol') or ibuprofen ('Motrin' or 'Advil') also may not take part in the study.