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Educational Brochures on Chronic Overlapping Pain Conditions

This brochure addresses what are Chronic Overlapping Pain Conditions (COPCs), how COPCs are diagnosed, the complexity of the chronic pain experience, and how to work with your health care provider to develop a treatment plan. It is available by postal ma

Study Highlights TMD Evidence and Current Practice Gaps

The TMJ Association has long championed the need for strong evidence-based demonstrations of the safety and efficacy of TMD diagnostics and treatments. Sad to say, as the following journal article indicates, even among a network of research-oriented practices, dental providers are still resorting to such TMD treatments as occlusal adjustments in which teeth are irreversibly moved, ground down, or in other ways altered, a treatment for which there is no scientific evidence of efficacy.

Beware of Ticks and Lyme Disease

We are currently in the peak season for Lyme disease. Each year at this time we highlight this topic because we have heard from a number of patients over the years who were misdiagnosed and underwent unnecessary TMD treatments when they actually had Lyme

#*!"@!**! ... May Help Your Pain... and Improve Strength!

Our headline is adopting the comic strip convention of using symbols to denote swear words because we are intrigued by a report that swearing may have some health benefits.

Predictors of Opioid Efficacy for Chronic Pain Patients

Opioids are increasingly used for treatment of chronic pain. However, they are only effective in a subset of patients and have multiple side effects. Thus, studies using biomarkers for response are highly warranted.

ARTHROSCOPY

  • Jun 18, 2014

TMJ arthroscopy is a procedure that is a little more involved and invasive than an arthrocentesis done with two hypodermic needles. This procedure is almost always done in an outpatient facility in the hospital. An arthroscope is used to look inside your joint to see what is causing your problems. Some surgeons will not only look inside and wash out the joint, but also perform surgical procedures like removing scar tissue, smoothing the bone and even attempt repositioning the disc.

You will be checked in prior to your surgery time and an IV will be started. The anesthesiologist will visit and take a look at your mouth opening and discuss the anesthetic procedure. Usually, before the surgery, the surgeon will visit you to discuss what he will be doing and what it will be like when you wake up. You should have had a pre-operative appointment to discuss all of this information, so this is just to make sure you have no additional questions. Don’t hesitate to ask any questions you may have. No question is a dumb question.

After this, the anesthesiologist or nurse will probably give you some medicine to help you relax, and then, you are off to the operating room. You might remember this or you might not. If you do, you will notice that the room is very cold and that there are a lot of people buzzing around getting ready for your surgery. Take a deep breath and close your eyes- try not to let it bother you. After all, they are all there to make sure you are okay. If at any point you aren’t, speak up!

When you wake up, you will be in the recovery room. You might feel pain in your jaw joint from the surgery. Please let the nurses know if you are in pain, because they are there to give you medication and make sure you are comfortable.

Recovery time from this surgery is several days to a week. You will probably want to take off from work for three days or so, but make sure the time off is flexible in case you need extra time. Your surgeon may tell you to maintain your soft diet for a few weeks. After several days, you will probably start jaw exercises or physical therapy.

As with all surgeries, there are advantages and disadvantages to this procedure. It does allow the surgeon to look into the joint and remove any adhesions or any other pathologic tissue. The recovery is shorter and easier than with an open joint procedure and the scar is smaller (virtually undetectable). However, this surgery takes longer than an arthrocentesis done with only hypodermic needles and requires general anesthesia. Also, many studies have reported that arthrocentesis with hypodermic needles can be equally successful as arthroscopy. Because of this, and the fact that arthrocentesis with needles is so much easier to perform, many surgeons may advise doing that first.

As with all invasive procedures, we recommend exhausting all conservative options first and getting independent opinions before submitting to any surgery.

Latest in TMJ Science for Arthroscopy

  • Arthroscopy for temporomandibular disorders  "Temporomandibular disorder (TMD) is a term describing problems with the chewing muscles or the jaw joint and associated structures, or both. There are different types of treatments for TMDs. Arthroscopy (a form of surgery) has been used to reduce signs and symptoms of patients with TMD, but the effectiveness has still not been totally explained. This review found no differences after treatment in mandibular functionality or in clinical evaluations. Arthroscopy led to greater improvement in maximum interincisal opening after 12 months than arthrocentesis. When compared with arthroscopy, open surgery was more effective at reducing pain after 12 months." (May 11, 2011)

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In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health