Dental Surgery Center

Treatment of Jaw Joint Pain

Temporomandibular Joint (TMJ) Disorders

Temporomandibular joint (TMJ) disorders can cause severe, stabbing, or mild pain felt in the TMJ area or surrounding tissues. The pain may be temporary or long-lasting, sometimes persisting for several years, and can occur on one or both sides of the face.

These disorders may limit jaw movement, making chewing, swallowing, speaking, and facial movements difficult, and in severe cases even affecting breathing.

According to global statistics and clinical practice, TMJ disorders are most commonly reported by people aged 20–40. Women are diagnosed with TMJ disorders significantly more often than men (according to various sources, 6–9 times more frequently).

Symptoms of TMJ Disorders

• Jaw pain of varying intensity — from severe to mild
• Limited jaw movement, jaw locking
• Painful clicking or popping sounds when opening or closing the mouth
• Pain near the ear, earache, pressure, ringing in the ears (with no ear pathology found by ENT specialists)
• Feeling of an uneven bite

Occasional clicking or mild discomfort in the jaw joint is common and usually not a cause for concern. In most cases, such issues resolve on their own within weeks or a month without treatment.

However, if the pain is recurrent and lasts more than a month, it is recommended to consult a dentist or an oral and maxillofacial surgeon.

Diagnosis and Evaluation

To assess TMJ disorders, a doctor will:

• Check whether the joint functions properly when opening and closing the mouth
• Evaluate jaw movement and muscle tension
• Listen for clicking or other sounds and assess their intensity and frequency
• Examine the bite

If TMJ dysfunction is diagnosed, additional tests may include:

• Detailed bite analysis
• Detailed joint movement analysis
• MRI and CT scans
• Consultations with other specialists

MRI helps determine the position of the joint disc during movement, while CT scans evaluate bone structures and allow skeletal analysis.

Treatment

Treatment depends on the individual case, symptoms, and their causes.

There are no universally established guidelines for successful TMJ treatment, so a comprehensive, individualized approach based on leading specialists’ experience is essential.

Treatment types:

1. Conservative treatment
2. Conservative or surgical treatment (depending on patient choice and doctor’s recommendations)
3. Surgical treatment (when conservative methods fail)

When Is Jaw Surgery Needed?

Open joint surgery may be performed when:

• Severe joint pain is present
• Jaw locking, dislocation, or movement blockage occurs
• Structural joint changes cannot be treated conservatively
• Other medical indications exist

Surgical techniques vary greatly depending on the surgeon’s expertise and treatment goals. Incision sizes may differ up to 3–4 times depending on the approach.

Surgical Options

Open TMJ Surgery

Performed under the same conditions listed above.

TMJ Arthroscopy

A minimally invasive procedure using a small camera to:

• Assess joint condition
• Remove adhesions
• Treat inflamed areas
• Reposition the joint disc
• Flush the joint with special fluids
• Inject anti-inflammatory medication
• Modify anatomical structures

Orthognathic Surgery (Jaw Correction Surgery)

This treatment is used when skeletal jaw abnormalities cause misalignment that cannot be corrected with orthodontics alone.

Common problems caused by misalignment:

• Difficulty chewing, biting, or swallowing
• Chronic jaw pain and joint dysfunction
• Tooth wear, movement, or spacing
• Breathing problems, snoring, or sleep apnea
• Facial asymmetry and aesthetic concerns
• Psychological and emotional issues

Orthognathic treatment includes:

1. Initial consultation
2. Treatment planning
3. Orthodontic preparation
4. Surgery
5. Recovery and finishing orthodontics

Treatment often takes several years and requires full commitment.

Wisdom Tooth Removal

Wisdom teeth (third molars) usually erupt between ages 18–25 but may:

• Emerge partially or not at all
• Grow incorrectly
• Cause pain, infection, or damage to nearby teeth

Common reasons for removal:

• Improper position or impaction
• Lack of space in the jaw
• Infection or inflammation
• Tooth decay
• Damage to adjacent teeth
• Risk of cysts or tumors
• Orthodontic treatment preparation
• Persistent pain

If a wisdom tooth is healthy, fully erupted, and functional, removal may not be necessary.

Sedation (Conscious Sedation)

Sedation is a medically induced relaxed or sleepy state:

• Reduces anxiety and fear
• Helps patients remain calm
• Patients may not remember the procedure

After sedation:

• Temporary drowsiness and reduced concentration may occur
• Driving is strictly prohibited
• A companion is required

Suitable for patients who:

• Experience severe fear
• Need long or complex treatment
• Have a strong gag reflex

Dental Treatment with Sedation

Sedation is increasingly popular and can be used for:

• Fillings
• Prosthetics
• Implants
• Root canal treatment
• Surgical procedures

Tooth Extraction with Sedation

Especially useful for complex extractions (e.g., impacted wisdom teeth), ensuring comfort and reducing anxiety.

Before Sedation

• Do not eat for 6 hours and drink for 4 hours before the procedure
• Wear comfortable clothing
• The procedure is monitored by an anesthesiologist