Temporomandibular joint disorder (or TMJD) results from problems with the jaw, jaw joints and surrounding muscles. They can be quite debilitating, causing pain in routine movements such as chewing, talking and yawning (source).
Causes of TMJ Disorders
There is no single clear cause of most TMJ disorders, but rather a variety of contributing factors. TMJ problems can be caused by stress, injuries, and grinding or clenching of the teeth, as well as other genetic and environmental factors. Because TMJ problems are usually caused by repetitive stress on the jaw muscles, the symptoms of the disorder are usually chronic. Online TMJ symptom information can help you match your symptoms to those of the disorder. Some symptoms of TMJD include ear, jaw and face pain, headaches, neck and shoulder pain, muscle aches, eye, teeth and gum problems, and locked/clicking jaw.
Diagnosing TMJ Disorders
There is currently no widely-recognized way to diagnose TMJ disorders, so identifying TMJD can be a confusing process. Talk to your doctor and/or dentist, who will obtain your patient history, consider the symptoms and examine the head and neck to most accurately diagnose the problem. Sometimes imaging studies of the jaw and teeth can aid in diagnosing TMJ disorders.
Treatment for TMJ Disorders
Treating TMJ problems should begin with conservative self-care measures- those that don’t permanently change the structure of the jaw. Applying hot and cold packs, wearing a mouth guard, eating soft foods and practicing gentle jaw exercises are all methods that can be used to relieve TMJ symptoms and jaw/muscle pain.
However, self-care methods work best for treating mild symptoms, so they will not relieve more severe cases of TMJD. In these cases, more invasive methods of treatment are required to relieve the severe and chronic pain that comes with TMJD. When TMJD is left untreated, the symptoms which began as a minor annoyance can worsen and worsen. In this case, a permanent solution such as TMJ surgery might be the best option for treatment.
There are several options for surgical procedures used to treat TMJ disorders. The least invasive options should always be considered first, with the more permanent and invasive operations left for more severe and unresponsive cases of TMJ disorders. Additional TMJ surgery information should be acquired through your health care provider.
Types of TMJ Surgery
The first option to consider is the least invasive: arthrocentesis, or joint irrigation. This process only takes about fifteen minutes from start to finish and only requires a local anesthesia so is relatively low-risk. During arthrocentesis, the joint is flushed through an injection in order to remove inflamed fluids. This surgery is the lowest-risk, but there is still the possibility of reaction to anesthesia or infection. Side effects are mild and generally include nausea form the anesthesia and swelling in the jaw area. If the jaw pain goes away, the surgery was successful; if not, the surgeon may look to a more invasive type of procedure called arthroplasty.
Arthroplasty is a category of “open” surgeries used to treat TMJ disorders. These surgeries range from lower-risk to more invasive procedures. Arthroplasty is performed under general anesthesia and has a longer recovery time than arthrocentesis. During an arthroplasty, the surgeon make an incision similar to that of a face lift to expose the joint area. They can then remove any adhesions or bone spurs, repair the disks or insert muscle grafts. The following are different types of arthroplasty, from least to most invasive:
One of the less invasive types of arthroplasty is called disk repositioning, and is useful if the TMJ problems have been caused by a slipped disk in the temporomandibular joint. With this surgical tactic, the surgeon will reposition the cartilage disk that has slipped out of place in the joint. This procedure only requires an overnight hospital stay, performed under local anesthesia. Side effects include nausea, swelling and pain at the surgical site, which usually passes after a few days. The disk is sewn back into place, but there is still the possibility that it could slip again, requiring a more extensive surgery later.
In a diskectomy, the surgeon removes the disk completely. The cartilage disk normally provides protection and padding to the TMJ, but it can be removed if it is damaged or not working correctly. This is more extensive than a disk repositioning and has a recovery time of two to three weeks. You should notice a reduction in pain and be able to fully use the jaw again within six weeks of surgery.
Temporalis Muscle Graft
The surgeon implants a piece of the temple (temporalis) muscle between the joint to provide cushioning, relieving the pain coming from bone-on-bone contact.
Articular Eminence Recontouring
In this type of surgery, the surgeon smoothes out the articular eminence, or “socket” part of the temperomandibular joint. This type of TMJ surgery is quite invasive and is usually performed along with a partial or total joint replacement surgery.
Partial/Total Joint Replacement
In more severe cases of TMJ, the surgeon may need to replace one or more parts of the temperomandibular joint which have been damaged or diseases. The disk, ball, socket, or multiple of these are replaced with either metal parts or bone grafted from another part of the patient’s body. This is a major surgery requiring a longer recovery time than the others, and the patient will need to adjust their lifestyle to allow the joints to fully heal. The jaw should be functional in about a month, but hard foods can no longer be eaten as they could damage the new jaw joint.
TMJ Surgery Recovery Tips
Though TMJ surgery can vastly improve your quality of life, it can be a nerve-wracking process if you don’t take the time to inform yourself and prepare. Nearly all TMJ surgery patients say that becoming knowledgeable on their condition and preparing for the operation and recovery helped them feel calmer before and after surgery.
Test out Foods Before
After TMJ surgery, you’ll need to limit your diet to soft foods (shakes and drinks in the beginning.) Try out protein shakes before surgery to see what you like.
Get all of your medications before you go in for surgery so it’s one less thing to worry about afterward.
Prepare Your Bed
Find supportive pillows you like to keep you comfortable in bed during recovery. Back wedges and neck supports can be especially helpful. Set up the bed area and nightstand with everything you need so you won’t be bending around to find things during recovery.
During recovery from TMJ surgery, it’s easiest to wear clothing that doesn’t go over the head. Stock up on robes and button-up shirts.
Stock Up on Foods
Make sure to have a good supply of the foods and drinks you like before you start recovery. Prepare soups beforehand and store them in the freezer. Yogurts, shakes, soft fruits and ice cream are all other good options.
Reference: Mayo Clinic