Temporomandibular joint disorders are common, affecting 25% to 30% of the population. They consist of a group of conditions that cause pain or dysfunction in the jaw joints and chewing muscles. Other problems may include limited mouth opening, jaw locking and clicking in the jaw joint. This group of conditions also includes a number of arthritic conditions that can affect the jaw joint.
Oral and Maxillofacial Surgeons are specifically trained in diagnosing and treating these conditions.
The diagnosis is based on the clinical examination and review of the patient’s history. Sometimes imaging studies like x-rays, MRI scan or CT scan are indicated.
The management of these conditions usually involves a variety of simple treatments that can include medications, physiotherapy and bitesplint therapy. These simple measures help the overwhelming majority of patients.
A small percentage of patients with TMD can benefit from surgical treatment by the Oral and Maxillofacial Surgeon. There are a variety of surgical treatments that can be considered, including injection of medication into the joint or muscles, and washing out the joint.
Arthroscopic surgery is a minimally invasive procedure carried out in hospital on an out-patient basis. A tiny operating telescope (2.3 mm in diameter) is inserted into the joint. A video picture allows direct examination inside the joint. A variety of miniaturized surgical instruments can be inserted to perform clean-out and repair procedures. Some patients will ultimately benefit from open surgery on the joint for repair or replacement of the disc, or even replacement of the entire joint. Joint replacement with either the patient’s own bone grafts or artificial total joint replacements can be very helpful for patients who have had severe or destructive disease affecting the jaw joint.