How To Eliminate TMJ Pain Through Oral And Maxillofacial Surgery
Not all TMJ pain responds to non-surgical therapy. You may need to have oral and maxillofacial surgery for chronic TMJ.
Temporomandibular joint or TMJ pain is a disorder affecting the jaw that is sometimes treated with oral and maxillofacial surgery. TMJ disorder causes a variety of symptoms. These include:
- A grating, popping, or clicking sound or sensation (accompanied by discomfort) when opening or closing your mouth
- Tenderness and pain in and around the jaw joint
- Difficulty opening your mouth fully or difficulty chewing
- A feeling of the jaw joint being locked up, limiting movement of the jaw
- Headaches, facial pain, or pain in the area of the ear
- A sense of fluid buildup in the ear that is not associated with ear infection
- Tinnitus (ringing in the ears), perhaps accompanied by dizziness or balance problems
What Causes TMJ Pain?
The jaw joint is made up of many moving parts. If the bone, cartilage, connective tissue, or muscles in this area become overworked, damaged, misaligned, or inflamed, this can result in pain and loss of full function. Trauma from a blow, repetitive strain from grinding or clenching your teeth, and immune disorders such as arthritis are some of the identifiable triggers for TMJ. Being born with facial or jaw asymmetry can also lead to temporomandibular joint discomfort. The disorder may also occur without a clear cause. It may come and go, or the condition can be chronic.
Oral and Maxillofacial Surgery Treatments for TMJ
If your TMJ does not respond to non-surgical therapies, your doctor may recommend seeing an oral surgeon for further intervention. There are several surgical approaches that can be used to relieve TMJ pain. Your recommended treatment will depend on which structures in your jaw are involved. For example, jaw clenching due to muscle spasms might not be treated with a surgical approach since medications and physical therapy might be more effective. On the other hand, trauma or degeneration of the bone and cartilage might not respond to less invasive methods of treatment.
If inflammation has caused fluid and other substances to build up in the temporomandibular joint, this material may be flushed out using a needle. The procedure is caused arthrocentesis and it is performed under general anesthesia. When the area is cleared of buildup, the swelling that was causing pain should recede.
If a misaligned bite is the cause of your TMJ pain, an oral and maxillofacial surgeon may use bite correction to bring your jaw back into the correct position. This may involve:
- Using orthodontics to move teeth
- Adjusting (filing) the biting surfaces of the involved teeth
- Replacing/repairing missing teeth, prostheses, or fillings in the mouth
Local anesthetic and conscious sedation may be used depending on the type and extent of dental work being done.
In cases of facial or jaw asymmetry, the jaw itself may need to be surgically realigned. Or, the jaw joint may need to be repaired or replaced. This type of oral and maxillofacial surgery may involve removing or repositioning the cartilage disc that is positioned between the ball and socket sections of the jaw joint. The socket of the jaw joint may need to be reshaped in some patients to allow smoother movement.
In cases involving degenerative osteoarthritis, one or more components of the jaw joint may be completely replaced with metal or bone prostheses. Oral and maxillofacial surgeons have had particularly good results when packing the area around the stabilized jaw with fat grafts taken from the abdomen. These fat grafts appear to help limit complications such as bone tissue growing where it shouldn't and fibrous scar tissue developing around the surgical site causing mobility problems.