When to Have TMJ Surgery

A potentially debilitating condition affecting the jaw joint, temporomandibular joint disorder or TMD can seriously diminish the quality of a person’s life. In some instances, patients with TMD may need surgery to restore normal function and provide relief from painful symptoms.

When is TMJ Surgery Needed?

There are a variety of available treatments designed to relieve common symptoms of TMD, including pain medications, muscle relaxers, steroid injections, oral splints and physical therapy. When these treatments fail to provide relief, patients sometimes turn to surgery. If your TMD symptoms seriously disrupt your life and well-being, you should talk to your dentist or oral surgeon about surgery. You should also strongly consider surgery if your jaw joint has begun to degenerate due to trauma, osteoarthritis or a genetic disorder.

Types of TMJ Surgery

There are three surgical options used to treat temporomandibular joint disorder (TMD): arthroplasty, arthroscopy and complete joint replacement. Each type of surgery is performed by an oral and maxillofacial surgeon. The first two treatment options are minimally or moderately invasive, same-day procedures, which are performed under general anesthesia. On the other hand, complete joint replacement requires patients to recuperate in a hospital for a few days.

Arthroscopy: The least invasive and most common type of TMJ surgery, arthroscopy involves a small incision near the ear, which allows the surgeon to insert a small instrument with a scope affixed to the end. Using the scope, the surgeon is able to explore for signs of damage and potential causes of pain. He or she can also extract inflamed tissue and prepare for potential realignment. Recovery typically involves swelling and stiffness, which subsides after a few days.

Arthroplasty: Also known as open joint surgery, arthroplasty involves a larger incision which exposes the jaw joint. This allows the surgeon to replace or repair the disc that allows a patient to open and close his or her jaw. Arthroplasty may also involve realignment and the removal of bone spurs and scar tissue. Recovery times are often more painful and lengthier than those following an arthroscopy procedure.

Total joint replacement: When the temporomandibular joint has degenerated due to osteoarthritis, trauma or other type of irreparable damage, total joint replacement may become necessary. Because the surgery is extensive, patients are required to stay in the hospital for three to five days. Surgeons sometimes also recommend that patients have their jaws wired shut for a short period. According to research from the International Journal of Oral and Maxillofacial Surgery, the average patient experiences significant improvements in speech, range of motion and diet after receiving a total joint prosthesis.

Things to Consider

Like every other type of surgery, TMJ surgery involves some amount of risk and does not guarantee a cure. Before deciding if TMJ surgery is right for you, discuss the goals and risks with your dentist and doctor in advance. If you choose to get surgery, make sure you understand the length of your recovery time, so you can take enough time off work. You should also make sure your surgeon has the training and experience to treat your specific issue.