Effective management of conditions relating to the temporomandibular joint

The temporomandibular joint (TMJ) is located where the lower jaw meets the base of the skull on each side of your head. Due to its ability to allow your jaw to move up and down, side to side and back to front, it is one of the most complex joints in the human body and can often be the cause of a range of symptoms within the jaw and facial structure.

About four out of every ten people experience signs of TMJ disorder at some point in their lives, with one out of those four people being aware that these symptoms relate to TMJ disorder. Only five per cent of people who have symptoms of TMJ disorder will require surgery.

Causes of TMJ disorder

Often the cause of a TMJ is not known. However, in most cases it is due to degeneration of the jaw joint or trauma through injury or accident. Joint degeneration can occur due to degenerative disorders such as arthritis and even through emotional and physical stress. Often a TMJ disorder will develop through clenching and grinding your teeth, or even through stress on the jaw via a misaligned bite.

Without a known cause, sometimes the treatment of TMJ disorder can be difficult. However, our team at OMFS are highly trained and have a wide range of experience in treating such conditions.

Non-surgical TMJ treatment

In most cases, your surgeon’s first treatment option will be non-surgical. Initially, your previous medical history will be discussed and symptoms will be identified. Upon clinical examination, your surgeon will inspect the TMJ and surrounding areas, evaluating jaw movement and listening to any audible symptoms such as clicking and popping. Tests may be performed such as blood tests and certain radio imaging to help give a precise diagnosis.

Your surgeon may consult with other healthcare professionals to ensure that an effective treatment is given. Usually the most simple and conservative approach available is adopted. This may include techniques such as modifying the patients diet, using hot and cold packs, stress management, avoiding extreme jaw movements, behaviour modification therapy to reduce stress, physiotherapy, medication, and prosthodontic treatment. Prosthodontics or dental treatment may involve the use of a bite splint to reduce stress placed on the TMJ whilst asleep.

Surgical TMJ treatment

Put simply, the aim of surgical TMJ treatment is to reduce or eliminate symptoms and improve jaw function. Surgery will only be performed if all other conservative, non-surgical options have been exhausted without any success and when the TMJ is causing chronic pain and disfunction.

Your surgeon will discuss your surgical options with your and decide upon the most appropriate for you situation. Surgical treatment options include:

  • Arthrocentesis and lavage – Essentially this is a washing out procedure that can help to remove inflammatory products, improving symptoms of pain and locking in the jaw.
  • Arthrotomy – This is a form of open surgery that allows for examination and biopsy of tissue. After surgery, arch bars may be attached to the teeth to control the bite and help healing.
  • Total TMJ replacement – In severe cases and when all other options are exhausted, the TMJ may need to be replaced. The TMJ is replaced with an alloy prosthesis that helps to improve function and quality of life for the patient.

Recovery

Recovery can vary among patients depending on their condition and the treatment they receive. Generally recovery from surgery is approximately two weeks. Swelling and bruising is normal and will begin to dissipate in the weeks following surgery. Appropriate painkillers will be prescribed, with any discomfort usually subsiding within four days after surgery. Sticthes can be removed around one week after surgery and the incision site must be kept clean with warm water, soap and anti-septic solution twice a day, for ten days after surgery.

A soft food diet is usually recommended for six weeks after surgery until the TMJ begins to heal completely. Physiotherapy may be needed for some patients in order to facilitate complete function and movement.

TMJ management including surgery at OMFS Melbourne

If you have been referred for TMJ management including surgery, fill out our patient registration form here!