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Mandibular Repositioning as TMD Treatment– A Guide for Patients

Patients who develop symptoms of temporomandibular disorders (TMDs), face certain challenges when weighing the benefits and risks of new treatments. Because the TMD field is well known for having diverse opinions, different practitioners may offer a wide variety of treatment options for the same condition.

Temporomandibular Disorders, Dental Care and You

The daily routine of brushing and flossing your teeth can be difficult when you suffer from Temporomandibular Disorders (TMD). A study published in the Journal of Orofacial Pain states that patients felt their TMD symptoms made it difficult for them to do routine mouth care at home.

The Case for Temporomandibular Disorders Heritability

From time to time, The TMJ Association has reported research findings indicating that one or another form of a gene is found more frequently in patients with Temporomandibular Disorders (TMD) than in non-patients, suggesting a role for genetic factors in

Patient Bone-Related Safety of Botox® for Treatment of TMD

Karen Raphael, PhD, a long-time TMD researcher now at the New York University College of Dentistry, has provided the following commentary on the Susan Herring Botox® article, along with information on her plans for clinical studies of TMD patients who have been treated with Botulinum Toxin for TMD Pain.

Further Evidence that Botox® Injections Cause Bone Loss in the Jaw

An article published online in the journal Bone* by a team of French investigators confirms that injecting Botox® into jaw muscles leads to significant bone loss in adult rats.


  • 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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