TMJ Surgery

When Is It the Right Choice?

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Surgery for TMJ

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Temporomandibular joint disorder (TMJ) is a painful jaw condition that can be difficult to treat. While many cases respond respond to non-invasive treatments and lifestyle management, severe cases can require surgery.

What Is TMJ?

TMJ is a disorder that causes pain in the jaw. The joint that causes the problem is the one that joins your jaw bone to your skull—in other words, the one that's crucial for things like talking and eating.

Pain in such an important and high-use joint can have a major impact on your life.

TMJ is characterized by pain while chewing that often involves popping or clicking in the jaw. It also can lead to headaches, pain in the ear, a locked jaw, and tinnitus (a ringing of the ears).

Surgery may not be something you want to consider, and the good news is that you probably won't have to. If, however, you don't get enough help from other kinds of treatments, it just might be necessary. It's important for you and your doctor to look at all the options and come up with what the best treatments are based on your individual symptoms and circumstances.

TMJ Treatments

We have a lot of different options for treating TMJ. Your healthcare provider will usually make recommendations based on the severity of your symptoms.

Most of the time, some combination of non-surgical treatments and lifestyle changes will provide substantial relief of TMJ symptoms.

Some standard treatments include:

  • Ice
  • Rest
  • Physical therapy
  • Massage
  • Ultrasound
  • Relaxation techniques, used for at least 30 minutes per day
  • Orthodontic bite correction (i.e., braces, retainer) if the TMJ is cause or exacerbated by bite problems

Medications your doctor may recommend include:

  • Over-the-counter pain relievers or anti-inflammatories (such as ibuprofen, naproxen, or acetaminophen)
  • Muscle relaxants
  • Steroidal injections
  • Antidepressants

You may be able to find some relief through changing your habits, as well. It's recommended that you:

  • Don't chew gum
  • Eat soft foods
  • Cut food into smaller pieces
  • Learn to manage your stress, so it doesn't cause you to clench or grind teeth
  • Stretch your jaw regularly
  • Be aware of activities that may strain your head or neck muscles

If those treatments aren't successful, your healthcare provider may recommend something called occlusal therapy. That involves a custom-fitted splint, or "night guard," that is most often made by a dentist. It prevents you from clenching or grinding your teeth at night, which can help alleviate TMJ symptoms caused by those things.

However, those treatments don't work well for everyone.

Surgery

When other treatments fail, or don't provide enough relief, TMJ surgery may become an option. Surgery is considered a last resort because it involves not only a painful recovery, but risks, as well. Surgery doesn't always work, and in some cases, it can even make things worse.

For those reasons, it's important that you first give other treatments serious consideration and stick to your treatment regimen to give it the best chance of helping you get better.

Several types of surgery are available, including:

  • Arthrocentesis: This is the least invasive  type of TMJ surgery and it is an outpatient procedure, meaning you can go home the same day. It involves a doctor inserting a small needle into the joint to add fluid that lubricates the joint and reduces friction. It may also be used get rid of anything inside the joint that may be causing inflammation.
  • Modified condylotomy: This surgery is performed on the mandible (jaw bone) and can help stop the jaw from locking up.
  • Disc repositioning: This more complex procedure is used in cases when the TMJ's cushioning disc is out of place. The doctor puts the disc back where it goes and secures it in place with a stitch. Expect a hospital stay with this one.
  • Discectomy: In this surgery, the doctor removes the cushioning disc from the joint. The jaw may need to be wired shut. This procedure requires a hospital stay and involves a long recovery period because the body has to replace the cushioning.
  • Joint replacement: This extensive and invasive surgery can involve reshaping the ball inside the joint, removing diseased bone, or using prosthetics to replace portions of the jaw. The jaw has to be wired shut to allow for healing. Recovery time can be a month or even longer, and you will likely face food restrictions for the rest of your life.

Other types of surgery are sometimes used for treating TMJ. Your TMJ specialist can help you decide which one is right for you. Your doctor may also recommend that you have physical therapy both before and after your surgery to help ensure its success.

Complications of Surgery

No surgery is without risk of complications, and these are something you and your doctor should consider before making the decision to have TMJ surgery.

Possible risks include:

  • Problems with general anesthesia
  • Infection
  • Bleeding problems
  • Surgical failure, which may mean multiple attempts need to be made
  • Damage to the nerves in the face or ear
  • Damage to other structures in the area

According to The TMJ Association, often when surgery fails, it is because the underlying cause of the TMJ hasn't been addressed. For example, in someone who has a degenerative form of arthritis, the disease may continue attacking the joint after surgery, so that the pain comes back. Surgery may also be unsuccessful in cases of misdiagnosis.

A Word From Verywell

Having surgery to alleviate your TMJ pain and other symptoms is a last-resort action for a reason—all surgery comes with risks, recovery is unpleasant, it's disruptive to your life, and it may not be effective. In fact, it can even leave you in worse shape.

However, sometimes it may be your best option. You may want to include your TMJ specialist, regular doctor, and dentist in your decision-making process. Educate yourself about the different methods, their risks, and what you need to know about recovery. Then, you can make an informed decision about what's best for you.

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Article Sources
  • Hoffman D, Puig L. Complications of TMJ surgery. Oral and maxillofacial surgery clinics of North America.2015 Feb;27(1):109-24. doi: 10.1016/j.coms.2014.09.008.
  • Renaparkar SK. Surgical versus nonsurgical management of degenerative joint disease. Oral and maxillofacial surgery clinics of North America. 2018 Aug;30(3):291-297. doi: 10.1016/j.coms.2018.04.005.
  • Singh RK, Pal US, Goyal P, et al. TMJ arthrocentesis alone and in combination with duloexetine in temporomandibular joint pain.Journal of maxillofacial and oral surgery. 2018 Sep;17(3):270-275. doi: 10.1007/s12663-017-1037-4.
  • Vega LG, Gutta R. Louis P. Reoperative temporomandibular joint surgery. Oral and maxillofacial surgery clinics of North America. 2011 Feb;23(1):119-32, vii. doi: 10.1016/j.coms.2010.12.001.