TMJ

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Jacob, Dr. Aziz, Dr. Amato and Dr. Lee can help you have a healthier, more comfortable jaw.

Diagnosing Jaw Pain & Issues

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.

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Signs of a TMJ Disorder

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat, or yawn?
  • Have you ever injured your neck, head, or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

TMJ Treatment

There are various treatment options for TMJ that Drs. Jacob, Aziz, Amato and Lee can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Drs. Jacob, Aziz, Amato or Lee will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.

The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day, or just at night, to move your jaw into proper position. Appliances also help protect tooth wear.

Bite correction VS surgery

If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases. Drs. Jacob, Aziz, Amato and Lee do not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.

TMJ Disorder First Visit

At Northeast Facial and Oral Surgery Specialists, LLC we recognize that there are many areas of concern when patients present with Temporomandibular Joint (TMJ) and facial pain. The TMJ’s are the hinges or joints that allow your lower jaw to move in all directions while you chew and function. The TMJ’s are unique since one side cannot function well without the other side. The joints are composed of a portion of the lower jaw and upper jaw and there is a soft tissue pad that sits between the two jaws. In addition, the muscles that surround the joint allow us to control the level and comfort of movement. When any portion of the anatomy of the joint is not functioning in concert with the other parts, patients may begin to suffer. This is known as Temporomandibular Disorder or TMD.

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At your first visit, a thorough physical and X-ray examination will be performed as necessary to help in establishing a proper diagnosis. Many times, patients will also require a soft tissue image, known as an MRI performed outside of the office to help us understand the source of your ailment. Once a proper diagnosis has been established treatment can be appropriately guided. Fortunately, many patients with TMD will not require surgery and can be managed with appropriate conservative therapy. This may include a night guard, physical therapy, and/or medications.

For those patients who do require surgery, we will be sure to fully explain all of your options. At Northeast Facial and Oral Surgery Specialists, LLC, we utilize the latest technology to allow the most precise procedures to be performed in the least invasive way possible. Our team is able to answer any further questions you might have. Please feel free to call us at any time.

TMJ FAQ

When is TMJ surgery needed?

The TMJ’s, also known as the jaw joints, are complex joints because there are two of them which have to function well to remain healthy. In addition to the actual joints, we all have muscles and a disk that surround each joint and these structures must all function together to work well.

Also, the way our teeth touch each other when we chew affects how the jaw joints and the surrounding structures function.

TMJ surgery is indicated for patients who have failed conservative measures like medications, night guards (also called splints) and physical therapy. It is also indicated for patients who have significant difficulty with their jaw joints like arthritis.

Can TMJ go away on its own?

The most common problems people have with their TMJ’s are:

  • Pain
  • Joint noises like clicking
  • Popping or scraping
  • Limited ability to move the jaw around and chew foods normally and comfortably.

While these symptoms do not routinely go away on their own, they can cycle between times where the symptoms are worse and other times where they are better.

Many patients can control or improve their symptoms with a well controlled and appropriate course of non-surgical management.

Drs. Jacob, Aziz, Amato or Lee and their staff at Northeast Facial and Oral Surgery Specialists (better known as NEFOSS) will help you determine whether surgery is needed to help and if so, they follow the treatment philosophy of “less is more” and practice with the least invasive modalities possible.

How long does it take for TMJ to go away?

The symptoms of TMJ disorder (known as TMD) vary in severity and duration.

In addition to surgery, the patient’s ability to follow the before and after surgery instructions and a strict course of conservative measures will help the symptoms resolve more quickly.

Drs. Jacob, Aziz, Amato and Lee and their expert staff will spend a great deal of time with you and help to guide you throughout your treatment.

At times, we may call upon your dentist, physical therapist or other medical specialists to help you improve your symptoms.

At NEFOSS we believe that our patients are best managed in a team wise fashion and the patient themselves plays the most pivotal role by following the appropriate home care instructions.

What will happen if TMJ is not treated?

Many patients can continue to suffer unnecessarily by avoiding treatment when it is necessary.

The first step is evaluation and appropriate diagnosis. This involves an examination in the office and often times the addition of appropriate images to help.

At NEFOSS, we utilize the latest technology to obtain these images.

In office CT scanning provides accurate images of the jaw joints with the least amount of radiation possible. Occasionally, patients will also be sent for an MRI which provides clear images of the soft tissues surrounding the TMJ’s.

Together, the clinical, radiographic and MRI examinations will help Drs. Jacob, Aziz, Amato and Lee make the most accurate diagnosis to guide our patients towards a healthier and happier lifestyle.

Is TMJ surgery painful?

While all surgery has some discomfort associate with it, TMJ surgery itself is not typically painful once the surgical wounds have healed.

Our team at NEFOSS will work closely with you to help manage any discomfort that you may have. We are available to our patients to help guide them and maintain a pain free environment: Northeast Facial and Oral Surgery Specialists, LLC Office Phone Number 973-360-1100.

How much does TMJ surgery cost?

TMJ Surgery is typically covered at some level by medical insurance carriers.

However, there typically is some out of pocket costs as dictated by the specific insurance policy including deductibles, co-insurance and any additional procedures excluded or not covered by the medical insurance carrier.

Our team at NEFOSS is specially trained to help you understand not only the physical and emotional components of TMJ surgery but will also help guide you every step of the way from a financial perspective so that our patients are well prepared and informed.

How long does it take to recover from TMJ surgery?

There are several different types of TMJ surgery. Drs. Jacob, Aziz, Amato and Lee utilize the least invasive therapy possible and the latest technology to offer our patients as quick a recovery as possible.

Minimally invasive surgery, including TMJ arthroscopy, is typically performed as an outpatient. The initial recovery is a few days and this is followed by a concentrated course of conservative measures including medicines to help decrease swelling and muscle strength.

For those patients where this surgery is not indicated or on the rare occasion is not successful, a surgery involving a small incision hidden in the ear line is utilized.

This allows Drs. Jacob, Aziz, Amato and Lee to manage any imbalance in the TMJ’s leaving little if any scar. Once again recovery from surgery involves a course of medicines, a softer diet for several weeks, ice packs and occasionally home or in-office physical therapy.

What are the risks of TMJ surgery?

There are few risks associated with TMJ surgery but as with a procedure on any part of the body, each procedure does carry potential consequences.

There are several nerves and blood vessels that are close the surgical sites and these must be protected throughout the procedure.

Drs. Jacob, Aziz, Amato and Lee use the latest technology to help minimize the risk and to provide the safest operation possible.

What is the success rate of TMJ surgery?

Success in TMJ surgery is largely based on a combined effort between the surgeon, dentist, physical therapist and most importantly the patient.

Appropriate follow-up and post-surgery exercises will help improve the success of all TMJ procedures.

By selecting the least invasive surgery and combining that with non-surgical therapy, Drs. Jacob, Aziz, Amato and Lee’s patients have a very high success rate.

The entire team at Northeast Facial and Oral Surgery Specialists are skilled in guiding our patients through to create the most successful experience possible.

Does TMJ surgery leave scars?

There are several different types of operations to treat TMJ Disorder.

Minimally invasive procedures like arthroscopy utilize a very small camera to allow Drs. Jacob, Aziz, Amato and Lee to navigate and treat any jaw joint pathology.

This leaves very little if any scar at all. If a more involved surgery is deemed necessary, a small incision may be needed.

We hide this incision inside of the ear leaving a very little visible scar.

Lastly, some procedures also require a small incision to be made under the jaw line and Drs. Jacob, Aziz, Amato and Lee will hide this incision in the jaw shadow and in a natural skin crease so this too leaves very little scar tissue.