Temporomandibular joint (TMJ) disorder surgery can reduce pain and improve jaw functioning. However, doctors use this treatment as a last resort because there is a lack of research on its safety and effectiveness.
TMJ disorders are a group of conditions that cause pain in the joints and muscles that control the jaw. The TMJ connects the jaw to the skull and allows it to open and close. Surgery can repair or replace parts of the jaw to treat TMJ disorders.
Researchers have not yet confirmed the long-term safety and effectiveness of surgery on the muscles and joints in the jaw. Therefore, doctors may first recommend conservative, noninvasive treatments, such as pain relievers or jaw exercises.
This article discusses different types of TMJ disorder surgery and some of the other treatment options.
Before undergoing surgery, the National Institute of Dental and Craniofacial Research (NIDCR) recommends trying more conservative treatments first.
It makes this recommendation because there have been no long-term clinical trials to evaluate the long-term effectiveness and safety of TMJ-related surgical procedures, which are often irreversible. It is possible that they may cause more damage and pain to the jaw.
Anyone interested in undergoing surgery should discuss the best options with their doctor, who can provide personalized advice.
According to the American Society of TMJ Surgeons, the surgical options available include:
- TMJ arthroscopy: People who undergo this minimally invasive procedure can usually return home the same day. Surgeons use a micro-incision to perform the operation, which may involve repairing the TMJ disk or removing a bone spur.
- Arthrocentesis: During this minimally invasive procedure, surgeons insert needles into the jaw to rinse the joint with sterile fluid. This process cleans the joint and removes any inflammatory triggers.
- Modified condylotomy: This form of mouth surgery increases joint space to prevent the jaw from locking up.
- Open joint surgery (arthrotomy or arthroplasty): This is a more invasive procedure in which the surgeon attempts to fix the joint or the disk inside it. The operation requires general anesthesia, and the person may need to spend a night in the hospital afterward.
- Joint replacement: During this invasive procedure, doctors replace parts of the TMJ or the whole joint with a prosthetic to improve its function. This surgery also requires general anesthesia and an overnight hospital stay.
The duration of recovery will depend on the severity of the condition and the procedure that a person undergoes.
According to the American Society of TMJ Surgeons, typical recovery times for the procedures are as follows:
- Arthrocentesis: A person will likely require 1–2 days of rest at home following the operation.
- TMJ arthroscopy: As another minimally invasive option, the healing time will be similar to that for arthrocentesis.
- Modified condylotomy: This requires at least
2–3 weeksof recovery time, during which a person may have wires, bands, or splints holding their jaw in place.
- Open joint surgery: A full recovery can take 2–6 weeks.
- Joint replacement: As another invasive option, the healing time will be similar to that for open joint surgery.
However, these recovery times are estimates, and the actual time may vary from person to person.
The TMJ Association recommends not rushing the recovery process, as doing so can cause further damage to the jaw. For example, a person should follow all postoperative instructions and not introduce hard, solid foods until their healthcare team gives the go-ahead.
Prior to any procedure, a person can talk with a doctor about their likely recovery time. Knowing this information before the procedure can help the person plan for the recovery process, such as by booking time off work or organizing child care.
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- damage to adjacent structures
- bleeding problems
The NIDCR also warns that joint replacement surgery, specifically, can cause pain or permanent damage to the jaw. In addition, it notes that the artificial implant may break down over time or not function properly.
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- prescription medications, such as muscle relaxants or pain relievers
- stabilization splints or bite guards
- exercises to improve jaw functioning
They also state that invasive surgery may not correct the issue if the more conservative treatments do not work.
The TMJ Association also recommends a person with a TMJ disorder follow some basic self-care steps to help ease symptoms. These include:
- wrapping ice in a cloth and applying it to painful areas of the joint
- eating soft foods
- using moist heat
- avoiding chewing gum or yawning widely to prevent excessive jaw movement
TMJ disorders are a group of conditions that cause joint and muscle pain around the jaw. There are three main categories of TMJ disorders, which affect different parts of the joint:
- internal derangement of the joint, which involves a dislocated disk or joint or an injury to the joint
- arthritis that affects the TMJ
- myofascial pain, which affects the muscles that control the jaw
A 2015 article in American Family Physician explains that there are many possible causes of TMJ disorders. In some cases, these disorders are the result of trauma to the jaw.
Other common causes include:
- clenching or grinding the teeth
- tooth and jaw misalignment
- autoimmune disease
In some cases, the cause may be unclear.
Surgical procedures for TMJ disorders range from minimally invasive options to full joint replacement. As researchers are still establishing the safety and effectiveness of these surgeries, doctors typically only use them as a last resort.
People should first try less invasive treatments, such as pain relievers, ice packs, and protective dental guards.
Anyone experiencing the symptoms of a TMJ disorder should speak with a doctor for advice on the best treatments for them.