Treatment of TMJ
The treatment of TMJ problems may include first trying conservative therapy such as soft/no chew diet, warm compresses over the joints, anti-inflammatory medications (Ibuprofen, Aleve, etc.), muscle relaxants, and reducing bruxism (medications, splints, bite adjustments by dentist, etc.). If no improvement occurs in 6-8 weeks, advanced imaging such as CT scan or MRI may be ordered to fully evaluate the joint. Based on the imaging, surgical procedures may be recommended including:
- Arthrocentesis- flushing out the joint under sedation performed in the office.
- Arthroscopy- putting a small camera in the joint to look at the condition of the joint/disc
- Arthroplasty- incision in front of the ear to access the joint to allow for repositioning of thedisc or reshaping the bones.
- Modified condylotomy- making a small cut in the lower jaw bone to allow for more space forthe disc to reposition naturally. This involves having the jaw wired together for a brief period of time to allow the bone cut to heal without changing how the teeth fit.
- Orthognathic surgery- making small cuts in the lower (and sometimes upper) jaw bone to reposition the jaws into a better relationship. This involves orthodontic treatment (braces or sometimes invisalign) before and after surgery.
- Total joint replacement- replacement of the condyle and fossa with prosthetic components (similar to a knee or hip replacement).
The goal of any TMJ surgery is to improve function and reduce pain. It is often not possible to completely eliminate pain in the TMJ; however, with thorough discussion and individualized treatment planning, many patients can achieve improvement in function and reduction in pain that significantly improves the overall quality of life.