What to Expect After TMJ Surgery
About the Author:
Jack Klausner has published extensively in clinical journals, including the Am Dental Assoc, Pain Medicine and Clinical Sleep Medicine. Klausner has been involved in pain research and is assistant-professor at New York University College of Dentistry, where he received his dental degree. He is a contributor to the blog hometest4.
Temporomandibular joint surgery is considered when jaw joint symptoms interfere with normal jaw functions or if the jaw gets stuck or locked when eating, talking or yawning. Surgery is not generally considered if a person has painless clicking or when pain is thought to be coming from muscles instead of the joint. Surgical procedures to treat TMJ symptoms include arthrocentesis – simply removing joint fluid — and/or arthroscopic surgery — looking into the joint and flushing and removing scar tissue. After surgery, limited mouth opening is common, as is pain and swelling.
Pain after TMJ surgery is normal and is different from the pain before surgery. Pain after surgery comes from tissues that become inflamed from the surgery. This pain is often managed with opiates — powerful painkillers — and steroids during the first week and then, if needed, ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Muscle relaxants and sedatives may also be prescribed for about a month to reduce tooth grinding and clenching and to improve sleep. In the first 24 hours after surgery, ice packs are repeatedly applied to help with inflammation and pain. Beyond 24 hours, moist heat is used.
Limited Mouth Opening
Limited mouth opening after TMJ surgery is common and is attributed to inflamed joint tissues and protective nonuse of the surrounding muscles to avoid pain. This is in contrast to any mouth restriction that may have existed before surgery, which was related to improper joint function. Assorted jaw exercises may be performed several times a day to slowly improve mouth opening. A common exercise involves placing the thumbs against the biting edges of the upper front teeth and the index against the biting edges of the lower front teeth and then gently stretching the mouth open with the fingers. Achieving normal mouth opening can take several months to a year.
Experiencing difficulty with chewing is very common after TMJ surgery. A soft food diet or liquid diet, which may involve using a straw, is usually advised for up to a couple of weeks. During this time, regular foods can be placed in a blender or mashed up by hand. Also available are prepackaged nutritional shakes and drinks — such as Ensure and Boost — which can help maintain proper nutrition.