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Updated on June 16, 2022

TMJ Surgery: Types, Costs, Procedure and Recovery

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What is Temporomandibular Joint Disorder (TMD)?

The temporomandibular joint (TMJ) is either one of the two joints connecting your lower jaw (mandible) to your skull.

Medical Images of Temporomandibular Joint Disorder

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Image of a healthy temporomandibular joint.
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Image of a damaged temporomandibular joint.

TMJ disorders (TMDs) are problems with one or both of these joints. TMD symptoms include:

  • Pain at the jaw joint, including pain that spreads to other areas
  • Painful popping or clicking of the jaw
  • Jaw stiffness
  • Jaw locking or limited ability to open and close the jaw
  • Buzzing or ringing in the ears

The exact causes of most TMDs aren’t well understood, but experts have found associations with certain genetic and hormonal factors.

Your genes play a role in how you perceive pain, both physically and psychologically, and differences in these processes may affect the development of TMDs. Higher estrogen levels have also been associated with TMDs.

An injury to the jaw or TMJ may also contribute to the development of a TMD.

TMDs often come on suddenly and resolve on their own just as quickly. But in some cases, they are persistent (chronic) and require professional attention.

If more conservative treatments fail to relieve jaw pain or dysfunction, that professional attention may include TMJ surgery.

Who Needs TMJ Surgery?

Doctors and dentists are unlikely to recommend TMJ surgery as a first-line treatment. Surgical procedures are most often considered a last resort meant for severe cases where other treatments have failed.

TMJ surgery is generally irreversible. Anything that involves a permanent change to the way your teeth or jaw bones fit together may not necessarily solve the problem.

For these reasons, experts generally recommend people suffering from TMDs to try conservative, non-invasive treatments first. But surgery may be a logical next step in cases where other treatments have failed to resolve serious TMJ dysfunction. Your doctor can help you decide if surgery is necessary.

They might recommend orthognathic surgery, which corrects bite problems, if your TMJ issues are related to other bite problems. However, even if you are a candidate for surgery, your doctor will likely want to begin with the least invasive procedure(s) possible.

Non-Surgical Treatment for TMD

Before recommending surgery, your doctor or dentist may provide any or all of the following:

  • Physical (manual) therapy, which gently stretches and strengthens the muscles and soft tissues of the TMJ area. This may be in addition to heat or cold packs.
  • Cognitive behavioral therapy (CBT), which can help you stop clenching your jaw or grinding your teeth unconsciously. For example, sometimes placing the tongue on the roof of the mouth can help separate the upper and lower teeth.
  • Medications to manage pain and inflammation such as Aleve, Advil, and/ or Flexeril, amongst others.
  • Orthotic devices such as night guards or occlusal splints.
  • Complementary treatments like acupuncture, which are unconventional but may be combined with conventional ones.
  • Botox injections to temporarily relieve pain.
  • Diet changes (no chewing gum, sticky foods like caramel, or hard foods like nuts)

In most cases, doctors and dentists only recommend TMJ surgery after these procedures have failed.

5 Types of TMJ Surgery

Five types of surgical procedures address TMJ disorders. They range from minimally invasive outpatient treatments to intensive open-joint surgery.

Keep in mind: Surgery is considered a last resort for TMJ problems that don’t respond to more conservative and less invasive treatments.

1. Arthrocentesis

Arthrocentesis (the Greek word for “joint puncture”), also known as joint aspiration, is a minimally invasive procedure. It involves flushing the jaw joint with fluid from a syringe to clear away tissue debris and reduce inflammation.

What to Expect 

Arthrocentesis may be performed under general anesthesia or a combination of local anesthesia and IV sedation.

It’s generally an outpatient procedure, so you'll be able to go home the same day. It may take about half an hour to perform. 

During the procedure, a surgeon will:

  1. Insert one or two hypodermic needles into the jaw joint.
  2. Flush the jaw joint with a sterile fluid, such as a saline solution. This will help remove any unwanted material, such as inflammation or tissue breakdown byproducts.
  3. Possibly remove scar tissue and inject the joint with medication.

Cost

Arthrocentesis may cost $300 or more. Talk with your doctor and insurance provider to determine the exact cost.

2. Arthroscopy

What to Expect 

TMJ arthroscopy requires general anesthesia. It’s slightly more invasive than arthrocentesis and may take longer. 

It’s an outpatient procedure during which a surgeon will:

  1. Make small incisions around the TMJ in order to insert a thin metal tube called a cannula.
  2. Use the cannula to insert an illuminated camera called an arthroscope. They’ll use the arthroscope to inspect the joint.
  3. Perform any needed repair or removal procedures with surgical tools inserted through the cannula.

Cost

Though only somewhat more invasive than arthrocentesis, this procedure may cost as much as $5,000 or more per joint. Your doctor and insurance provider can provide more information regarding the exact cost.

3. Arthrotomy or Arthroplasty (Open-Joint Surgery)

Rather than simply inserting tools through tiny incisions, open-joint surgery is more intensive. The joint space is opened completely in order to expose the jaw joint.

What to Expect 

Open-joint TMJ surgery may take 1 to 2 hours and is performed under general anesthesia. You may need to spend the night in the hospital afterward. During the procedure, your surgeon will:

  • Expose the joint to be operated on by carefully making an incision a few inches long.
  • Repair, reposition, or modify parts of the joint once they’ve opened up the joint space. This may include the cartilage disc of the TMJ.

Cost

The cost of open-joint surgery for TMJ disorders varies widely depending on the specifics of the procedure. It may cost $5,000 on the low end or up to tens of thousands of dollars.

Insurance coverage varies for this procedure. Talk with your provider and your doctor to determine the cost.

4. Temporomandibular Joint Replacement

TMJ replacement is a special kind of open-joint TMJ surgery. Once the joint is exposed, it is either replaced with bone taken from elsewhere in the body or with a prosthesis.

What to Expect 

Joint replacement surgery is an inpatient procedure and may take more than an hour under general anesthesia. A surgeon will:

  1. Make one or more incisions to expose the joint.
  2. Reshape or remove certain tissues.
  3. Replace part of the TMJ, or the entire TMJ, with a prosthesis.

Cost

TMJ replacement costs include both open-joint surgery and the replacement material itself. It may cost several tens of thousands of dollars.

Like most open-joint surgeries, joint replacement for TMD may not be covered under insurance. Talk to your provider and doctor for more information about costs.

5. Modified Condylotomy

A condylotomy is a kind of osteotomy, which is essentially a controlled fracture. 

The name condylotomy comes from the condyle, which is the rounded end of your lower jaw that fits into the TMJ. Increasing the amount of space for the condyle to move may ease TMJ pain and locking.

What to Expect 

A modified condylotomy takes place under general anesthesia and generally lasts less than 2 hours. You may be able to go home the same day, but you’ll need several weeks to fully heal. 

During the procedure, a surgeon will: 

  1. Make an incision from the inside of your mouth to gain access to the bone.
  2. Cut the bone and position it properly 
  3. Put the soft tissue surrounding the bone back in place.

Cost 

A modified condylotomy typically costs between $15,000 and $30,000. Discuss costs with your doctor and ask your insurance provider how much they will cover.

Preparing for TMJ Surgery

If your doctor has recommended TMJ surgery for you, they’ll provide instructions to follow before and after the procedure.

The surgery itself is only part of the process of correcting TMD. Your doctor will likely give you orthotic devices, physical therapy, and medication after surgery to help your jaw recover and heal properly.

This process can take days to months, depending on the procedure. Be prepared with soft foods, a positive mindset, and as much information as you can get from your doctor.

Potential Complications of TMJ Surgery

Complications may result from invasive TMJ procedures. These include:

  • Post-operative bleeding
  • Infections
  • New or persistent problems with the TMJ or other structures (e.g., injury to facial nerves or other nearby structures)

In some cases, these issues may require additional surgeries. Talk to your doctor for a better understanding of the procedure and to discuss specific risk factors.

TMJ Surgery Recovery Timeline 

Recovery time from TMJ surgery depends on the specific procedure. Generally, the more invasive the surgery, the longer your jaw will take to heal.

Arthrocentesis (Minimally Invasive) After 1 to 3 days, you should be able to return to work, school, or other obligations. Your doctor might recommend jaw exercises and a soft diet.
Arthroscopy (Minimally Invasive) Recovery can take anywhere from a couple of days to a week.You may receive physical therapy following recovery.You might be required to keep a soft diet for several weeks as your jaw heals.
Open-Joint Surgery or Joint Replacement (Invasive) A full recovery may take anywhere from 2 weeks to several months.Recovery may be more painful than for less invasive procedures.Physical therapy will be a part of the recovery process.
Modified Condylotomy (Invasive) You may need up to a week to rest before returning to work, school, or other obligations.Your doctor will use rubber bands to hold your upper and lower jaws together for several weeks.You’ll be required to follow a soft or liquid diet.

Aftercare Tips 

Depending on the kind of surgery you’ve had, you may need days, weeks, or even months to fully heal and resume normal activities. 

In the meantime, here are some guidelines:

  • Listen to your doctor. They’ll advise you on how long to rest, when you can go back to work or school, and what you need to do in the meantime.
  • You may be required to maintain a soft or even entirely liquid diet for some time following surgery.
  • Your doctor might provide orthotic devices (such as mouth guards) and physical therapy sessions to help your jaw heal and strengthen.
  • The pain and swelling following surgery may be intense. Your doctor may prescribe pain medication.
  • Attend any follow-up appointments your doctor schedules. You may need to have stitches removed if they aren’t resorbable.
  • If you experience severe pain or have other symptoms such as fever or difficulty breathing, contact your doctor immediately.

Talk to your doctor about your options, surgical and otherwise. TMJ surgery may improve your quality of life if your TMD is severe. However, surgery permanently changes your jaw and is a decision you should not take lightly.

12 Sources Cited
Last updated on June 16, 2022
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
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