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TMJ: Surgery & Recovery Time

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

The temporomandibular joint, also known as the TMJ, is the joint on both sides of the face that hinges the lower jaw with the rest of the skull. Read this lesson to learn about surgical procedures used to treat TMJ dysfunction along with their expected recovery processes.

Temporomandibular Joint Dysfunction

Janice has been experiencing pain in her right temporomandibular joint (TMJ) for quite some time. The TMJs, or joints connecting the jaw bone with the skull, are symmetrical joints located just in front of your ears, with one on each side. Because Janice's TMJ dysfunction has progressed to the point of preventing her from eating due to pain, she sees her primary care provider for a medical evaluation.

Treatment Options

Typical symptoms of TMJ dysfunction include:

  • Pain: Pain may be present behind one or both eyes, present as headaches, or can be felt directly in the jaw. Pain can be muscular or structural (related to the bone) in nature.
  • Unusual sounds: Popping or clicking may be heard when opening or closing the mouth, yawning, or eating, all of which may indicate joint dysfunction.
  • Stiffness: Stiffness, or the jaw's ability to move smoothly, may occur with TMJ dysfunction.

On top of these common symptoms of TMJ dysfunction, Janice has been experiencing severe stiffness. She is diagnosed with a severe case of TMJ dysfunction, and her doctor recommends a specialist consult (medical opinion of a surgical specialist).

Janice sees the oral surgeon, who completes a full assessment of her jaw and asks about her symptoms. She is sent for diagnostic testing, and has an x-ray taken of her jaw. It is determined that the cause of Janice's discomfort and issues is structural, making her a candidate for surgery. If the cause of her dysfunction was muscular in nature, it is unlikely that surgery would be recommended.

Understanding the Options

Because the nature of Janice's TMJ dysfunction lies in her bone structure, she works closely with her doctor to determine what surgical procedure might be the best option to greatly reduce or eliminate her symptoms.

Arthroscopic Surgery

This type of surgery is conducted with the use of tiny tools, or surgical instruments, to reposition the joint disk (piece of cartilage between two bones), or make small adjustments to the bone itself. Arthroscopic surgery requires a very small incision, just larger than the size of the instrument, close to the joint. This procedure is the least invasive option to surgically treat TMJ dysfunction with the shortest amount of downtime: a few days to a week.

Open Arthroplastic Surgery

Requiring a surgical incision slightly larger than the arthroscopic procedure, open arthroplastic surgery is more invasive (requiring a small or medium incision depending on the extent of damage) than an arthroscopy and can make significant changes to the TMJ. This procedure allows for complete disc replacement or removal, making a large impact on stiffness and severe joint pain. Recovery for arthroplastic surgery can range anywhere between 2-6 weeks.

Joint Replacement

A joint replacement procedure is the most invasive option to correct extremely severe cases of TMJ dysfunction. Usually reserved as a last resort after other treatment options have failed or brought little relief, a joint replacement typically includes two incisions: in front of the ear and below the jaw. These openings allow the surgeon to surgically remove and replace the complete temporomandibular joint, requiring the longest amount of recovery: 4-6 weeks.

As Janice and her doctor discuss different procedures, they find that the open arthroplastic procedure would best meet her needs at this time. Janice agrees with the doctor and schedules her surgery.

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