TMJ Troubles

The temporomandibular joint (TMJ) is a crucial hinge-like joint that connects the jawbone to the skull, enabling essential functions like talking and chewing. When a TMJ disorder occurs, it can cause debilitating pain, stiffness, and limited jaw mobility. While conservative treatments like oral splints and mouthguards are often recommended, surgery may be necessary for some individuals to restore full use of their TMJ.


Signs indicating the need for surgery

A doctor may recommend TMJ surgery if experiencing consistent, intense pain or tenderness when opening or closing the mouth, inability to fully open or close the mouth, difficulty in eating or drinking due to jaw pain or immobility, progressive worsening of pain or immobility even with rest or nonsurgical treatments, or structural problems or diseases in the jaw joint confirmed through imaging tests like an MRI.

However, TMJ surgery may not be recommended if symptoms are not severe, such as clicking or popping sounds without associated pain, symptoms are inconsistent, with severe pain that disappears quickly, or if one can fully open and close the jaw, albeit with some pain or tenderness.

Decoding surgical options

Several types of TMJ surgery are available, each catering to the severity and nature of symptoms. Arthrocentesis is a minimally invasive procedure, considered a first-line treatment, involving the injection of fluid into the joint to wash out inflammation byproducts and enhance jaw motion. Arthroscopy, less invasive than open-joint surgery, employs small incisions and a cannula to visualize the joint with an arthroscope. Surgeons then use small tools through the cannula for procedures like scar tissue removal, joint reshaping, and pain relief. Open-joint surgery is reserved for severe cases, requiring an incision over the joint to directly operate on structures, such as removing growths, repairing or repositioning the disc, or using artificial replacements.

From clicks to comfort

The recovery period after TMJ surgery varies, and most TMJ surgeries are outpatient procedures. After surgery, a bandage may be on the jaw, and additional bandages might be recommended to secure the wound dressing. During the initial days following surgery, it is crucial to take prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, avoid solid and crunchy foods, apply a cold compress to reduce swelling, use warm heat on the jaw muscles, follow bandage care instructions, wear a splint or device on the jaw, and attend follow-up appointments for TMJ care instructions.

Biting into the details

Considering potential complications and the long-term outlook after TMJ surgery is crucial. TMJ pain may reoccur, especially with procedures like arthrocentesis. Additionally, persistent TMJ pain due to habits like teeth clenching or grinding (bruxism) and recurring pain in individuals with underlying immune conditions causing joint inflammation should be anticipated.

Before opting for TMJ surgery, essential discussions should include the threshold of pain or severity that justifies surgery, exploring alternative treatments or lifestyle changes if surgery is not recommended, understanding the recommended type of surgery, contemplating the role of physical therapy, evaluating the necessity of dietary changes, and acknowledging potential complications if surgery is not

Jaw-dropping decisions

TMJ disorders can cause persistent pain, limited jaw mobility, and difficulty with everyday activities. While surgery is not always the first course of action, it can be effective for those who have not found relief through conservative treatments. Consult with a dental or oral surgeon experienced in TMJ disorders to determine if oral surgery is the right solution for your TMJ disorder.

Great resources for oral surgery patients