Surgical Treatment of TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint. If you have had symptoms like pain or a “clicking” sound, we hope you are receiving treatment or have done so in the past.  TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull.  Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. TMJ disorders occur when the jaw and chewing muscles do not work together correctly. If you are being referred to Dr. Kalant or Dr. Pink, it is because all other treatment measures, such as, physical therapy and/or splint therapy for TMJ Disorders have not worked for you. Dr. Kalant or Dr. Pink do not consider TMJ surgery unless the jaw cannot open, is dislocated, non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully. 

How do TMJ Disorders occur?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disc, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ Disorder?  

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat, or yawn?
  • Have you ever injured your neck, head, or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

TMJ Surgery Overview

For a brief narrated overview of the TMJ surgery process, please click the image below. It will launch our educational MiniModule in a separate window that may answer some of your questions about TMJ surgery.

Treatment

Dr. Kalant and Dr. Pink strongly recommend seeking initial treatment for your TMJ Disorder prior to a surgical consultation at our office. They have many professionals they recommend who may offer self-care treatment options (listed below). Once you’ve had non-surgical treatment for your TMJ Disorder and have been unsuccessful, Dr. Kalant or Dr. Pink will determine the surgical plan after a TMJ surgical consultation at our office.  It is important to note that treatment always works best with self-care combined with professional care and may take months to see results.  

Self-care treatments can often be effective, which include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Physical therapy of the TMJ
  • Practicing good posture

Stress management techniques such as biofeedback or physical therapy may be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night-guard helps you stop clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disc re-positioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day, or just at night, to move your jaw into proper position. Appliances also help protect tooth wear.

What About Bite Correction or Surgery?

If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases.