Surgical Treatment of TMJ Requires a Rigorous Diagnosis Process

The progression from non-surgical treatment to surgery requires a thorough review of the patient’s condition.

For patients that have not been treated for jaw joint pain but a significant TMJ derangement is suspected:

Symptomatic pain and function management with an oral orthotic (bite splint) is recommended for 1 month. This is generally a device that is custom made and adapts to the lower teeth. The splint should be worn continuously. The lower device has less adverse interference with speech function. 

The orthotic is not expected to be worn during eating. During this period, pain while wearing the orthotic and pain during normal jaw function, eating, is assessed. 

If significant improvement is experienced by the patient with wearing the splint, continuous wear is discontinued and night time only wear is begun.

If the splint does not correct the problem and the patient still experiences joint instability, pain, or the joint still does not function normally such as during eating, further investigation with MRI or diagnostic arthroscopy is recommended.

For patients who have known TMJ surgical disease or already have failed at non-surgical management:

• Consultation and definitive diagnosis with MRI or diagnostic arthroscopy is required.
• Surgical treatment of the TM joint itself without jaw wiring followed by physical therapy.
• Continuous wear of lower jaw orthotic, bite splint, for 1 month followed by night time wear indefinitely.
• Non-chewing diet for at least 4-6 weeks followed by dietary counseling to eliminate excessive chewing loads and repetitive motion.

Long term follow-up includes making sure that functional joint loads are not excessive and that the teeth are supporting the joint(s) properly. Co-ordination with general dentists and other dental specialists relative to this aspect is very important.

Contact your care provider to discuss your possible TMJ treatment options for relief from jaw joint pain.