Within the TMJ there is a disc that is made of cartilage. The disc separates the socket (temporal bone) and the head of the lower jaw (mandible). The head of the jaw slides in the socket during the opening and closure of the mouth. The disc accommodates the movement of the jaw. Unfortunately, in some people, the disc slips forward resulting in a spatial change in the joint that may affect the opening and closure of the mouth. The opening and closure may produce clicks caused by sliding of the head over the disc. This can potentially cause pain when chewing, and limiting an individual’s ability to open the mouth wide enough to eat, brush teeth or to have a dental procedure.
Initial treatment is taking painkillers and the avoidance of heavy chewing. Physiotherapy, massage, stretching exercises, acupuncture, and the wearing of splints could be used to ease the pain associated with the mispositioned disc. In some patients, these treatments for painful clicking and locking TMJs are not successful and surgical treatment may be considered.
Following the examination in the doctor’s office, a patient needs to have an x-ray (Panorex) to rule out a trivial bone problem. However, the main method to assess the disc position is by MRI scan. If the scan confirms the disc displacement in a patient who has not had any relief from previous treatments, then the surgical repositioning of the disc can be contemplated.
The operation is done at Hospital under general anesthesia. While a patient is asleep, the hair patch in front of the ear is shaved. The incision is placed in the skin crease along the front of the ear. When the joint is opened the disc gets repositioned backward to its usual position and gets pinned to the bone with a special anchor.
After the surgery, the patient goes home. The drain from the TMJ area is removed on the next day and stitches are removed in one week.
During the first week, the diet is non-chewing, such as liquid foods. Then a soft diet is recommended for 5 weeks.
6 weeks after the surgery, the patient may start eating normal foods and stretching the mouth.
Side effects of the operation include numbness of the ear lasting 3-6 months. In very rare situations the eyebrow and a corner of the mouth can be temporarily weak.
80-94% of patients report improvement in pain and mouth opening.
All surgical and non-surgical results are subject to the individualities of the patient and the normal variability of clinical procedure results. For more information, review our full disclaimer