If you have experienced pain when chewing or simply opening your mouth, you may have blamed it on your teeth. However, the pain may actually be coming from your jaw instead.
Temporomandibular joint (TMJ) and muscle disorders are common and can contribute to significant pain, loss of function, and movement in the jaw. In minor cases of TMJ disorders, mouth guards can provide relief. However, in many cases, TMJ surgery may be necessary.
At Soundview Family Dental, we understand that the idea of surgery can be intimidating. So here we explain the types of TMJ surgery and what you can expect during recovery.
What are temporomandibular joints (TMJs)?
The temporomandibular joints (TMJs) are the joints that connect your mandible (lower jaw) to the base of your skull. You have one of these joints on each side of your face, just in front of your ears. These joints are bimodal, allowing for both a hinged rotation and a sliding movement to open your mouth and chew your food. Numerous muscles within your face help guide and control the movement of the lower jaw and these joints.
What is a TMJ disorder?
TMJ disorders are a group of conditions that can cause pain in temporomandibular joints and the muscles that control their movement. These conditions can be caused by a number of different things, including damage to the disc within the jaw, bruxism (teeth grinding), connective tissue disorders, damage to the joint from arthritic conditions, injury to the jaw, or a malformation of the joint from birth.
Common symptoms of TMJ disorders can include:
- Persistent pain around the ears, often worsening with jaw movement
- Inability to open the mouth to a full range of movement
- Clicking or popping sound when you open your mouth
- Problems or pain when chewing food
- Jaw stiffness and discomfort after a lack of use
Types of TMJ surgery
In most cases of TMJ disorders, lifestyle changes and non-invasive TMJ treatment options are considered first. These can include resting the joint, applying heat or cold packs, a soft-food diet, specialized physiotherapy, and wearing an occlusal splint or mouthguard.
Surgery may be necessary when TMJ disorders do not respond to these treatment options, and you experience severe pain, jaw locking, or joint destruction due to disease or trauma. There are various surgical options available, and your dental professional will discuss which treatment options are best for you.
Prior to any surgical intervention, your surgeon may opt to try corticosteroid or botulinum type A (Botox) injections into your jaw to help reduce pain and inflammation. These can often provide relief for a few months.
Arthrocentesis is a procedure that bridges the gap between non-invasive treatment options and surgical procedures. This is often the first TMJ surgical treatment offered for TMJ disorders. It uses small needles injected directly into the joint to flush out the inflammation and debris that contribute to pain and affect your joint function. They can also administer medications into the joint to reduce inflammation in some cases.
Similar to arthrocentesis, TMJ arthroscopy uses two needles and an arthroscope to go directly into the joint. In addition to flushing out the joint, your oral surgeon can look inside the joint and identify potential damage, such as scar tissue, bone spurs, and incorrect disc position. In many cases, they can remove scar tissue, smooth out bone spurs, and reposition the disc with the arthroscope.
A modified condylotomy procedure can help address pain and locking of the jaw associated with TMJ disorders. This surgery focuses on the mandible bone and not directly on the joint, increasing the space in which the joint has to move.
Arthroplasty, also known as arthrotomy, is an open joint procedure done under general anesthesia and involves an incision made along the ear so that the surgeon can work on the affected joint. This procedure allows the surgeon to address any necessary bone reshaping, repair discs, remove discs, and any other necessary treatments. It is done in the hospital and may require an overnight stay.
Total joint replacement
This invasive surgical procedure allows the oral surgeon to replace parts of the joint or the entire joint with a prosthetic in order to eliminate pain and restore function. It requires general anesthesia and an overnight stay in the hospital.
Recovering from TMJ surgery
What to expect with your recovery depends on the type of procedure and the extent of the damage within your joint. After the procedure, you will receive aftercare instructions that will include things like dietary guidelines, oral hygiene guidelines, exercises to help with the healing, and medication recommendations or prescriptions.
The American Society of TMJ Surgeons provides a baseline for each type of procedure and what you can expect for recovery. These include:
- Arthrocentesis: Recovery is quick with this procedure, allowing most people to return to normal activity within 1-2 days.
- TMJ arthroscopy: This in-patient procedure has little recovery time, with most people able to return to normal activities within 1-2 days.
- Modified condylotomy: This surgery addresses the jawbone and, because of this, may require the use of wires or splints to hold the jaw in place for recovery. In most cases, you can expect recovery to last 2-3 weeks.
- Arthroplasty: This open surgery requires more extensive recovery based on the extent of the damage. Recovery can last anywhere from 2-6 weeks.
- Total joint replacement: Similar to arthroplasty, you can expect a recovery time of between 2-6 weeks for total joint replacement.
When is surgery not recommended?
Surgery is not recommended for everyone. If your TMJ responds to non-invasive treatment options, you are best to stick with these. If despite pain and discomfort, you still have a full range of motion in your jaw joint, surgery will not likely improve your condition.
If you have any underlying medical condition that could hinder recovery or put you at a greater risk of undergoing general anesthesia, surgery is not likely a good option for you. Your dental professional will continue to work with you to find non-invasive options that can help reduce your discomfort.
Don’t let TMJ reduce your quality of life
At Soundview Family Dental, we understand that TMJ disorders can be frustrating, painful, and greatly affect your quality of life. Our team of professionals will work with you to create a treatment plan that starts conservatively, with the hope of reducing symptoms while avoiding the need for surgical intervention. If, however, these options do not resolve your issues, our team will discuss your surgical options and determine a plan that works best for you.
To learn more about how we can help you say goodbye to jaw pain, contact us online or call the office at (425) 563-6360 today to schedule an appointment.