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Scientific News: Sleep and TMD

Dr. Anne Sanders was kind enough to write the following synopsis of a recent study on sleep and TMD.     A recent study of the OPPERA group reported in The Journal of Pain, sheds new light on the understanding of poor sleep in relation

TMJA Office Update - Spring 2016

After President Obama submits his budget to Congress, the work of Representatives and Senators begins. It is at this time that we tell our elected officials what YOU, TMJ patients, need to have addressed. The past two months have been busy ones outsid

National Pain Study Released

The Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services recently released the National Pain Strategy, outlining the federal government's first coordinated plan for reducing the burden of chronic pain that affects millions of Americans. Developed by a diverse team of experts from around the nation, the National Pain Strategy is a road map toward achieving a system of care in which all people receive appropriate, high quality and evidence-based care for pain.

New Safety Warnings Added to Prescription Opioid Drugs

The U.S. Food and Drug Administration (FDA) has issued a consumer warning regarding several safety issues with the entire class of opioid pain medicines. The new safety risks include potentially harmful interactions with numerous other medications, problems with the adrenal glands, and decreased sex hormone levels. The FDA is requiring companies to make changes to the opioid medication labels warning consumers of these risks as described below.

Unclear Results of Botulinum Toxin Therapy for TMD Pain

Increasingly, clinicians, research scientists like myself, and advocates at The TMJ Association are asked, "What about Botox® therapy for treatment of my painful muscles? Does it help?"

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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