Weill Cornell Medical College

The temporomandibular joints (TMJ) are the joints located on each side of your face, just in front of the ear, that connect your lower jaw to your skull. These joint are heavily used in any action that requires opening the mouth, such as chewing, talking, yawning, kissing, swallowing, or any movement of the jaws backwards, forwards, and from side to side.

Disorders of the TMJ are a frequent and troubling source of pain for as many as 10 million Americans, and cause chronic jaw discomfort or soreness, as well as symptoms such as clicking, popping or locking of the jaw, limitations to mouth movement, headaches, earaches, and pain throughout the face, neck, and shoulders. Although TMJ problems are initially functional in nature, they can eventually lead to structural changes and degeneration of the joint or muscle.

Most specialists agree that 90% of TMD sufferers will respond to conservative and non-surgical care. Surgery and other irreversible procedures should be considered after conservative measures have failed to relieve symptoms, or in those specialized situations of structural damage to the joint.

A range of surgical techniques can now be used to treat TMD that does not respond to non-surgical treatment. A full evaluation by your oral surgeon can determine which part of the joint is affected and what type of surgery is appropriate. Three basic types of surgical treatments exist. Arthrocentesis involves washing out the joint with a solution injected into the joint-space with a syringe; it can be performed in the office using local anesthesia with intravenous sedation. Arthroscopic surgery is a minimally invasive procedure that uses tiny instruments and fiberoptics to access the joint without open surgery - it generally results in less scarring and shorter recovery time than open surgery. Some treatments are better approached with open surgery, which allows better visualization of the joint and enables greater bony and/or soft-tissue repair.