Siavash Siv Eftekhari, M.D., DMD


TMJ Diagnosis: Treatments, Procedures, and Surgery

TMJ Diagnosis: Treatments, Procedures, and Surgery

When we refer to the temporomandibular joint, or TMJ as it’s more commonly known, we’re talking about the hinge that connects the jaw to the skull. You may have never thought about its function, but the TMJ is critical in our daily life. Without it, our jaws wouldn’t be able to move up and down or side to side. The TMJ also allows us to talk, chew, and yawn.

Some people suffer from TMJ disorder, which causes them to experience pain and discomfort in the jaw. The symptoms of TMJ disorder commonly manifest themselves in several ways. These symptoms, which we’ll discuss in greater detail below, can be quite debilitating and require attention from a medical professional.

What Causes TMJ?

TMJ is caused by specific injuries or disorders, general wear and tear, or oral habits. These include:

  • Trauma, such as grinding (bruxism), clenching, or receiving a blow to the jaw
  • Arthritis (both osteoarthritis and rheumatoid arthritis)
  • Extreme gum chewing
  • Braces
  • Cancer
  • Joint infection

Despite the apparent associations between these problems and TMJ, physicians are unclear whether these issues are a result of the disorder or if they cause it.

TMJ Symptoms

Diagnosing TMJ is relatively straightforward. Because symptoms occur in such a high-use joint, TMJ disorder can have an extremely adverse effect on your quality of life and are easily noticeable. Some of the most typical signs include:

  • Locking of the jaw
  • Ear pain
  • Pain near the temple
  • Jaw pain
  • Stiff and sore jaw muscles
  • Headache
  • Neck pain
  • Popping of the jaw

What Types of Doctors Treat TMJ?

Typically, the first person that will diagnose and treat TMJ is a primary care physician. In less severe cases, your primary care physician could be the only person that manages your condition. However, if your symptoms require more specialized care, your doctor will likely refer you to different types of specialists:

  • An oral and maxillofacial specialist
  • A dentist that specializes in jaw disorders
  • An otolaryngologist (ear, throat, and nose doctor)

How to Fix TMJ—Treatment Options

Though TMJ pain can be debilitating, there are plenty of treatment options, which are usually a combination of non-surgical TMJ pain treatment as well as lifestyle changes.

  • Rest
  • Cold compresses
  • Physical therapy
  • Over-the-counter anti-inflammatory drugs, like ibuprofen or acetaminophen
  • Stress management and relaxation techniques
  • Massage
  • Switching to eating softer foods
  • Not chewing gum

Other Procedures to Treat TMJ

While the methods we mentioned above quite often provide effective TMJ pain relief, sometimes they are not enough. Your doctor may recommend additional procedures if you are still experiencing pain. For cases of chronic TMJ, your physician will develop a long-term approach to manage pain. They may suggest any number of the following:

  • Steroid injections
  • Acupuncture
  • The use of a dental splint or a mouth guard
  • Low-dose antidepressants can help patients control bruxism, as well as help with insomnia and pain relief.
  • Counseling is useful for patients with behavioral problems that aggravate TMJ, such as nail biting, gum chewing, or grinding. A counselor helps you learn about why you engage in these behaviors and develop techniques to avoid them.
  • Physical therapy. A physical therapist works to improve joint mobility, reduce pain, and strengthen muscles in the area.

What Is TMJ Surgery?

For some individuals, these treatments and procedures prove ineffective at relieving the pain associated with TMJ. In these cases, jaw surgery for TMJ may be the best solution. There are various types of surgery to treat TMJ. Some are minimally invasive and have short recovery times, while others are reserved as a last resort in severe cases.


This outpatient surgery is simple. The physician injects fluid into the joint, which serves two purposes. It helps flush out chemical products of inflammation, and it alleviates pressure.

Arthrocentesis is a minimally invasive procedure. It provides excellent results, which means that it’s typically the first surgical intervention that doctors will try.


Another common TMJ surgical procedure is arthroscopy. During the arthroscopy, the physician opens a small hole in the skin directly above the joint. They then put a cannula, or a narrow tube, into the hole until it reaches the joint.

When the cannula is in place, the doctor inserts an arthroscope. The arthroscope has a light and a camera that allows them to assess the condition of the jaw. Once they identify pain-causing issues, the physician then uses small surgical tools to fix them.

Like arthrocentesis, arthroscopy is a less invasive procedure with quick recovery time. It is a popular method for treating more severe TMJ cases.

Open-joint Surgery

The final surgical option for TMJ patients is open-joint surgery. This more invasive procedure is a last resort option that requires the doctor to make an incision above the joint. Despite a long recovery time, open-joint surgery does have a high success rate.

TMJ Surgery Recovery

The length of time needed to recover from TMJ surgery depends on the procedure you have done.

Arthrocentesis and arthroscopy, as they are both minimally invasive, are outpatient procedures. Though you’ll need to take a day or two off work, you get to go home the day of the surgery with a bandage on your jaw. Open-joint surgery, on the other hand, requires a hospital stay of a few days, and a recovery time of up to a month or longer.

Whatever surgery you undergo, there are some general tips to follow that will help you recover faster:

  • Take NSAIDs to help with the pain
  • Apply ice packs to the area to reduce inflammation
  • Change the dressing regularly
  • Wear the devices your physician instructs you to, such as a splint, until told otherwise
  • Do exercises as instructed by your physical therapist
  • Advise your doctor if anything seems out of the ordinary

Pros and Cons of TMJ Surgery

TMJ surgery, though effective at treating this condition, is not without its downsides. Here are some advantages to the procedure, as well as some TMJ surgery risks worth mentioning.


  • Reduced pain
  • Reduced stiffness
  • Effective treatment for people who have not had luck with other remedies


  • The operation can be quite painful
  • Recovery times can be long
  • Increased risk for infection
  • Adverse reactions to anesthesia
  • Risk for bleeding
  • Possible nerve damage to the jaw

How Much Does TMJ Surgery Cost?

Because there are many treatments available, TMJ surgery cost depends on which one you’re having. Prices also depend on whether or not you have insurance.

Insurance often covers these procedures, but it’s best to check your coverage before visiting a TMJ oral surgeon.

Can TMJ Be Cured Permanently?

Luckily, both TMJ treatment and TMJ surgical procedures mean that the prognosis for this disorder is favorable. Like we mentioned previously, TMJ disorder has many causes. When the physician can diagnose the underlying condition, the prognosis is more favorable.

For example, if TMJ is caused by behavioral habits such as grinding, it’s easier to manage the condition long term. Counseling can help the patient identify triggers that cause grinding and avoid them. Though times of stress may lead to a relapse, the prognosis in these cases is favorable.

Autoimmune conditions are trickier, however. Since they are not habit-based, controlling them is more complicated, and the conditions may cause the pain to return.

TMJ Prevention

Once TMJ disorder is under control, it’s vital to take steps to prevent the symptoms from recurring. Many symptoms stem from lifestyle choices and stress, which is good news, as this means that managing the condition is a matter of self-care. We recommend the following:

  • Avoid chewing gum or biting your fingernails
  • Eat soft food and take care to avoid chewy or hard food
  • Self-massage regularly
  • Use dental devices as instructed
  • Work on maintaining proper posture
  • Implement stress reduction techniques in your day-to-day life

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