TMJ surgery: What's involved?

Temporomandibular joint (TMJ) disorders can cause ongoing jaw pain, clicking, locking and difficulty opening or closing the mouth. For many people, symptoms improve with conservative treatments such as physiotherapy, splints and medication. However, when these measures fail and symptoms significantly affect daily life, surgery may be considered. Understanding what TMJ surgery involves helps patients make informed decisions about their care.

When is TMJ surgery recommended?

Surgery is not the first-line treatment for TMJ disorders. It is usually considered when pain, restricted jaw movement or joint damage persists despite non-surgical management. Common reasons for surgery include:

Severe or persistent jaw pain
Limited mouth opening or jaw locking
Structural damage to the joint
Advanced arthritis of the TMJ
Displacement or damage to the joint disc

A thorough assessment by a maxillofacial or TMJ specialist is essential before surgery is recommended.

What types of TMJ surgery are available?

The type of surgery depends on the underlying problem and its severity. The main surgical options include:

Arthrocentesis

This is the least invasive procedure. Small needles are inserted into the joint to wash it out with sterile fluid. It helps reduce inflammation, improve movement and relieve pain. Arthrocentesis is often performed under local anaesthetic and does not involve incisions.

Arthroscopy

Arthroscopy uses a small camera inserted into the joint through a tiny incision. It allows the surgeon to view the joint directly and carry out minor repairs, remove inflamed tissue or reposition the joint disc. Recovery is usually quicker than with open surgery.

Open joint surgery

Open surgery is reserved for more complex or severe cases. It involves making an incision to access the joint directly. This approach may be needed to repair or remove damaged tissue, reposition or replace the disc, or address joint deformity. In rare cases, joint replacement may be considered.

What happens before surgery?

Before surgery, patients undergo imaging such as MRI or CT scans to assess the joint structures. Your specialist will discuss the risks, benefits and expected outcomes, ensuring surgery is appropriate for your symptoms. Pre-operative planning is crucial to achieving the best result.

What is recovery like?

Recovery depends on the type of surgery performed. After minimally invasive procedures, patients may return to normal activities within a few days. Open surgery requires a longer recovery period, often several weeks.

Post-operative care may include:

Pain relief medication
Jaw exercises or physiotherapy
A soft diet for a period of time
Follow-up appointments to monitor healing

Adhering to aftercare advice is essential for restoring jaw function and preventing stiffness.

Is TMJ surgery effective?

TMJ surgery can significantly reduce pain and improve jaw movement for carefully selected patients. However, outcomes vary and surgery cannot guarantee complete symptom resolution. For this reason, it is recommended only after non-surgical treatments have been exhausted.

Making the right decision

TMJ surgery is a specialised treatment that requires careful evaluation. A detailed consultation with an experienced specialist helps determine whether surgery is appropriate and which approach is most likely to provide long-term relief.