Treating jaw joint disorder

Jaw joint disorder is also known as temporomandibular joint disorder – TMJ disorder for short. Mr Cascarini is one of the UK’s leading experts in treating TMJ.

Your initial consultation: what happens?

When you first come and see me, I take a full history of your symptoms and the listen to how your jaw joint problems have affect you.

I then conduct a full examination, looking at how much function you still have in both your jaw joints. In some cases, I then need you to have a scan to look what is going on inside the joint.

Being thorough at this first stage allows me to develop an understanding of your TMJ disorder, form a diagnosis and make a treatment plan.

My approach to treating TMJ disorder

A broad range of treatments options are available. It is important to start with the least invasive and it is not uncommon for people to need several types of treatment to resolve the problem fully.

The overall idea is to start with the easiest, least invasive treatment to see if they work first. If they don’t bring about sufficient improvement in your symptoms, I then move onto the next procedure until your jaw joint problem is solved.

Conservative treatments

Conservative treatments, include physiotherapy and chiropractic treatment. TMJ exercises can help with some types of clicking and joint aching. These are also useful after TMJ surgery.

Some patients benefit from the manufacture of a custom made splint, which fits over the teeth. This can help stop the habit of tooth grinding while sleeping and can also help with some early internal joint problems.

I would recommend you to have a splint made by one the specialists in this area that I work with regularly. A splint incorrectly made can make the initial complaint worse.

Medical management

You might also benefit from a course of anti-inflammatory medicines. This is especially true if you have an acute problem (its come on quite quickly and you are in quite a lot of pain) and definitely after TMJ surgery.

Surgical treatments

Arthroscopy

In some cases I may need to look around inside your jaw joint using a TMJ Arthroscope.

This is just a couple of millimetres in diameter and is put into your jaw joint while you are asleep under a short general anaesthetic in the operating department. It is a minor procedure and you can go home the same day.

You may need a short course of physiotherapy afterwards.

Arthroscopy is often used in combination with arthrocentesis, a type of joint wash out. Like the arthroscopy, this wash out can help break down adhesions and flush out inflammatory particles that may be damaging to the joint. I sometimes use additional agents as I flush out the joint, such ashyaluronic acid or steroids, to help tackle the inflammation.

Jaw joint surgery

Meniscoplasty

The jaw joint has a tiny disc that moves as the haw moves up and down. This is known as the mensicus. If the disc/meniscus is displaced but not too badly damaged I can put it back in its proper place and fix it there with tiny sutures.

This involves a day case operation under general anaesthetic and you will need an incision in front of the ear plus some anti-inflammatory medicines and physiotherapy afterwards.

Meniscetomy

This is a similar procedure to a meniscoplasty but is done if your disc is too damaged to be repaired. In a meniscetomy, I will remove the disc completely. You can still go home the same day and will probably need postoperative anti-inflammatory medicines and physiotherapy.

Jaw joint replacement

Mr Cascarini is one of the UK’s leading surgeons able to offer jaw joint replacement to patients whose jaw problems fail to respond to other treatments.