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Temporomandibular Disorders (TMD) - Surgery

Surgery is rarely used to treat temporomandibular disorders (TMDs). Surgical treatment does not guarantee a cure and can further damage the temporomandibular joint. Because most TMDs can be treated nonsurgically, most doctors believe that surgery should be the last option tried and should be avoided if possible.

Surgery may be a treatment option for you if both of the following apply:

  • Other treatments have failed, and chronic jaw pain and dysfunction have become disabling.
  • There are specific, severe structural problems in the jaw joint. These include scar tissue in the joint area, problems with bone alignment, broken or degenerated bones, and occasionally disc displacement or perforation.

The goals of surgery for TMDs are to:

  • Relieve pain in the jaw joint.
  • Correct any structural problems.
  • Restore normal jaw function.
Temporomandibular Disorder: Should I Have Surgery for Jaw Pain?

Surgery choices

  • Arthrocentesis. This is not a true surgery, since there is no incision. But it is an invasive procedure done by an oral and maxillofacial surgeon.

Surgery may include:

  • Arthroscopic procedures, including washing out the joint area (lavage), cutting or removing scar tissue that is blocking joint movement (lysis), cutting tissue that has shortened and is impeding joint function, or shaving part of the disc.
  • Open joint arthroplasty, used for disabling joint problems that aren't easily reached or viewed arthroscopically.

Another type of surgery, called total joint replacement, is rarely done. It has sometimes resulted in permanent jaw damage. Total joint replacement replaces the jaw joint with artificial parts. In some cases the artificial parts have not worked correctly or have broken. The available technology for this surgery is still considered to be experimental and risky.

What to think about

Further pain complications or joint dysfunction can result from temporomandibular joint surgery.

Surgery is not needed in most cases of disc displacement.2 Splint therapy (a dental treatment), jaw rest, and physical therapy, including moist heat and jaw exercises followed by an ice pack, can work very well for treating this condition. If this and other nonsurgical treatment to relax the muscles are not successful, arthrocentesis may effectively treat your condition.

If you are thinking about surgery, get a second opinion on your condition and treatment.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Medical Reference from Healthwise

    Last Updated: November 11, 2013
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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    Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

    You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

    You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

    Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

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