TMJ Disorders: Facts and Treatment

The most persistently used joint in the body, the temporomandibular joint (TMJ), is responsible for the movement of the lower jaw (mandible). Without this joint, which connects the lower jaw with the skull, we would not be able to open our mouths to eat, chew, breathe, or talk.

What is TMD?

TMD (Temporomandibular Joint Disorder) is characterized by pain and aching in the jaw, persistent clicking, limited range of motion and sometimes headaches or earaches. If you have any of these symptoms of TMD, it’s important to consult an oral and maxillofacial surgeon, as we specialize in treating problems with the facial bones, in particular the jaw. TMJ disorders may be mild to severe, short or long term. Therefore, Dr. Wasson treats each patient’s situation uniquely.

Causes of TMJ Disorders:

  • Bruxism (grinding): Often, people grind or clench their teeth at night while they are sleeping. This involuntary activity puts an enormous amount of pressure on the joint, creating inflammation.
  • Displacement or dislocation of the disk: The TMJ or articular disk lies between the jawbone (mandible) and the socket that can become displaced, dislocated or damaged, causing damage and pain.
  • Trauma: An injury to any part of the jaw can cause pain in the joint.
  • Stress: Painful spasms and trouble moving the jaw are sometimes the result of stress.

Minimally Invasive TMJ TreatmenT

  • Most (roughly 90%) of TMJ disorders involve only the muscles of the mouth and face and not the actual TMJ. These disorders require no surgical treatment and can most often be managed through the following: 
    • Night Guards and Splints
      • More recent research reveals that splints and night guards are not as helpful as once believed for the treatment of TMD.  However, if you clench or grind your teeth, splints or guards are invaluable resources to protect your teeth from damage while clenching or grinding.   
    • Physical Therapy
      • As with other joints in your body, strengthening the area and improving Range of Motion (ROM) are crucial in the treatment in TMJ disorders.
    • Home Care
      • Soft Foods
      • Anti-inflammatory medications
        • Naproxen or Ibuprofen
      • Stress Management
    • Relaxation Techniques
  • Surgical Treatment
    • Only 10% or less of TMD disorders require surgical intervention.  These disorders typically involve the Temporomandibular Joint itself and not merely the muscles of the jaw and face.  
    • When there is displacement of the TMJ disc, damage to the disc, or significant inflammation in the joint then surgical procedures are indicated. 
    • Dr. Wasson prefers Minimally Invasive TMJ Surgery whenever possible.

WHAT IS MINIMALLY INVASIVE TMJ SURGERY?

  • Avoiding Surgery Whenever Possible 
  • Using surgical procedures that minimize large incisions that result in more scarring, pain, swelling, and recovery. 
  • Minimally Invasive Surgical Procedures:
    • Arthrocentesis and Arthroscopy
      • Surgical procedures avoiding incisions and utilizing only 1-3 needle punctures around your TMJ to irrigate the site, remove harmful inflammation, and improve scarring that may be present. 
      • Arthrocentesis:
        • This technique can be performed in the office under local anesthetic or IV sedation.  It involves the placement of two needles into the TMJ that allow irrigation of the joint and placement of medications only. 
      • Arthroscopy: 
        • This technique is similar to arthrocentesis but is an outpatient hospital procedure that involves the placement of slightly larger instruments into the joint.  One of these instruments is a small camera that allows visualization of the joint to better see, diagnose, and treat conditions of the TMJ.  
        • This technique is the main procedure utilized in Minimally invasive TMJ surgery as it allows the best of both worlds-actually being able to see into the joint to better treat disorders while causing minimal trauma and having only tiny puncture sites without incisions (See picture below of patient 5 days after arthroscopy). 
          • Open TMJ Surgery
            • Used as a last resort, Open TMJ surgery provides the benefit of direct visualization of the TMJ for larger procedures but is preferred as a last resort in Minimally Invasive Surgery

Determining the cause of TMJ disorders may seem complex, however we have a variety of tools at our disposal including advanced imaging techniques to accurately diagnosis and treat your TMJ pain. Give us a call at Seattle Office Phone Number 206-632-0220 for more information.