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TMJ demystified and your treatment options

Recently, I called our local oral surgeon/orthognathic surgeon, Dr. A, to ask about possible solutions for severe TMJ symptoms.  In the 29 years that I have been in practice, there has seemed to be very limited resources and solutions to this common affliction. Sure, we suggest the conservative treatment of wearing a Night Guard, facial massage, heat/cold therapy, and in severe cases, maybe a muscle relaxant. However, what happens if all else fails, and the symptoms persist or worsen?

Rarely, have I run into a patient who said that they had surgery to correct their severe TMJ problem. Why is it that there are so few written articles in dental journals mentioning TMJ surgery as a solution? This was Dr. A’s response:

 “TMJ surgery is typically a final stage last resort after failed attempts at conservative therapy have been exhausted. The reason there are not many surgeons performing TMJ surgery is because it is technically difficult and the success rates are not great. There are some conservative minimally invasive procedures like arthroscopy and arthroplasty that can help certain patients. These procedures have less risk and better outcomes than TMJ replacement surgery. We have a local surgeon in our area who is proficient at TMJ surgery. He is at Swedish First Hill.”

So, it appears that with all the medical advancements that have come to the forefront in today’s new age, a TMJ resolution from interventional surgery, simply has not kept up with the times. We can replace a hip, a knee, a shoulder and we are home that same day from a day procedure, but TMJ remains a bit of a mystery.

If your symptoms are severe and you're worried about your future in terms a worsening TMJ problem, please contact me so that I can pass on a referral.

I'm always here if you need me.

 Fondly, Dr. Ron


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