Temporomandibular joint management and surgery
This is a really complex joint that gives lots of people problems
Your temporomandibular joint (TMJ or jaw joint) joins your bottom jaw to your skull on each side of your head. Most TMJ problems can be resolved without surgery, but for about 5% of people with TMJ problems, surgery is required.
Your TMJ can be affected by degenerative arthritis, accident or injury. Many people who are anxious clench or grind their teeth (often in their sleep) which places stress on this joint, causing wear and tear. Having a poor bite can also affect this joint.
Symptoms of TMJ syndrome include pain or tenderness in your jaw or the joint itself, pain around your ear, toothache, pain while chewing, an aching face and difficulty opening or closing your mouth.
Before opting for surgery
Because the discomfort of TMJ syndrome often goes away without surgery, Dr van Mourik will consider non-surgical options first.
These options include dietary modifications, using hot and cold packs, avoiding extreme movements of your jaw, and trying stress management techniques. Physiotherapy, pain medications or medications to relax the jaw muscles may also be successful in relieving your problem. Many people wear a device called a ‘bite splint’ to reduce stress on the TMJ while they’re asleep.
4 Types of TMJ Surgery
1. Arthroscopy
Dr van Mourik makes a small incision in front of your ear and inserts an arthroscope (an instrument with a camera and light on the tip). He looks for any defects and repairs them, if possible.
2. Washing out the joint
This is also known as ‘arthrocentesis and lavage’. It’s a minimally invasive technique that can help to reduce symptoms by removing substances that are causing inflammation in the joint.
3. Arthrotomy
This is a type of open surgery where an incision is made in front of your ear. It enables Dr van Mourik to visually examine the joint and, if necessary, to take samples of tissue for biopsy.
4. Total joint replacement
If nothing else has helped your discomfort, it may be time to consider a TMJ joint replacement. This involves the damaged joint being replaced with a metal prosthesis. This is a major surgery with a longer healing time.
Where TMJ surgery is performed
Dr van Mourik performs TMJ surgery in a private hospital. The surgery is performed under general anaesthetic administered by a specialist anaesthetist. The anaesthetist is also in charge of providing your post-surgery pain relief.
The surgery takes 30 minutes to 2 hours, depending on its complexity.
Recovery after TMJ surgery
Hospital stay: Arthroscopy and arthrocentesis may be performed as a day surgery, so once you’ve recovered from the anaesthetic, you’ll be ready to go. Because you’ve had general anaesthetic, you’ll need someone to pick you up and take you home.
For more complex surgery you will need to spend between 3 and 4 days in hospital.
Pain management: For arthroscopy, arthrocentesis and arthrotomy, discomfort can usually be controlled with pain tablets such as Nurofen® or Panadeine Forte®.
If you’ve had a joint replacement, you’ll initially be given IV analgesia, prescribed by the anaesthetist, which you can self-administer by pressing a button. Usually by 48 hours after the operation, pain tablets such as Nurofen® or Panadeine Forte® are sufficient to keep you comfortable.
Work/School: For arthroscopy, arthrocentesis and arthrotomy you’ll need to allow approximately 3 days off. For joint replacement you’ll need approximately 2 weeks off.
Stitches: Dissolving stitches are used in most cases. They gradually dissolve over 1 to 2 weeks.
Diet: You’ll need to stick to soft foods for 3 to 4 weeks after surgery.
Follow up care: Dr van Mourik will want to see you periodically to monitor your healing.
Dr Van Mourik will give you detailed post-operative instructions during your pre-surgery consultation. To maximise your chance of making a quick recovery without complications, please pay careful attention to these instructions. General information can be found on the Post-op and Patient Care page.
Possible Complications
It’s unusual to have complications with TMJ surgery when you have a skilled oral and maxillofacial surgeon to perform the procedure. However, all surgeries have some potential risks and complications and for TMJ surgery they include:
- Facial and oral numbness caused by nerve injury
- Infection
- Relapse or deterioration of the jaw joint and/or bite.
TMJ Surgery Cost
Medicare will reimburse you for part of your initial consultation.
Dr van Mourik will give you a written quote for the cost of your TMJ surgery at the initial consultation. We’ll help you make applicable Medicare and private health insurance claims so that you’ll know how much of the cost will be covered.
If an anaesthetist is required, we’ll give you contact details for the anaesthetist so you can obtain their fee schedule. Medicare and private health insurance will cover part of the anaesthetist’s costs.
Dr van Mourik is a highly experienced oral and maxillofacial surgeon. He explains things clearly and he’s a good listener, so do ask him questions about your temporomandibular joint management options and tell him your concerns — he’ll take the time to answer you and manage your concerns sensitively.
(02) 9416 4809
admin@kristianvanmourik.com.au
Suite 5, 12 Tryon Rd, Lindfield 2070, NSW
Suite 104, 568 Oxford St, Bondi Junction 2022, NSW