Pre-Operative Information for Patients Undergoing Temporomandibular Joint Surgery

The following information represents a summary of the details your doctor has discussed with you regarding your upcoming surgery. Please read it carefully and if you have any questions or concerns, please contact our before surgery.

1.) Temporomandibular Joint (TMJ) Surgery is performed on the jaw joint to restore normal anatomy in the jaw joint. By restoring normal joint anatomy, the jaw joint will have significantly improved mobility and better function while chewing, talking and swallowing. The surgery will often eliminate the chronic pain which plagues many of our patients.

2.) Their are two common forms of TMJ surgery: Arthroscopic Joint Surgery and Open Arthroplasty. Arthroscopic TMJ surgery is performed through small incisions, placed just in front of the ears, through which an instrument is passed with a tiny camera attached. Open arthroplasty is performed through an incision made in the natural skin crease and hairline in front of the ear. The result of such incisions, once healed, is a nearly invisible cosmetic scar which has not been a problem for any of our patients regardless of their hair style. In any case, there will be some sutures (stitches) in the skin which will be removed 4-6 days following surgery.

3.) You should expect some swelling associated with TMJ surgery which will appear in front of the ear and on the side of the face where surgery is performed.This will reach its maximum point two to three days following surgery and will gradually disappear over the next seven to ten days.This may be accompanied by some bruising, but usually only a faint yellow color will appear around your ear. Medications (Solumedrol) and a pressure bandage may be used during the first 24 hours after surgery to help keep swelling and bruising to a minimum.

4.) Swelling also occurs in the structures inside the jaw joint as well.You will notice some limited mobility in you jaw joint and a minor alteration in your bite following surgery due to this swelling.The sensory nerves of the skin surrounding the incision will feel numb (as if affected by Novocain) as a result of this swelling. This is to the patient’s benefit, because it will reduce the pain of surgery during the healing phase. This numb sensation (parasthesia) is transient, usually lasting 8-10 weeks following surgery. Of course, perscription pain medication is available if needed, but in many instances patients feel so much better compared with the chronic pain they suffered prior to surgery that they use it only minimally.The most common complaints following surgery are earaches, muscle aches, or headaches all related to spasms in the muscles attached to the jaw joint and inflammation in the healing wound. Such complaints are certainly considered normal and will come and go over the first 6-8 weeks of the healing phase.

5.) Your diet should be a very soft (i.e., non-chewing diet) during the early healing phase (approximately 6 weeks following surgery). Food should be of the consistency of mashed potatoes, scrambled eggs, apple sauce, or ice cream. Your doctor will monitor your healing and let you know when you can begin to chew tougher foods.

6.) It is most important that you follow your doctors instructions carefully with regards to the bite splint you have been wearing.The minor alterations in your bite due to the surgery must be protected or you can damage the repair work which has been done during surgery. Usually, patients are instructed to wear the splint 24 hours a day including eating and sleeping (when the jaws are in greatest function). The splint is removed for oral hygiene purposes and replaced immediately. Gradually the splint therapy will be modified as healing progresses. Usually patients use the splints a minimum of 6-8 weeks following surgery,although some wear it longer depending on their individual situation. Depending on the nature of your particular problems, your doctor will discuss the need for bite adjustments (equilibration), bite reconstruction and or orthodontics following splint therapy. Remember, opening motions will not damage the joint. It is biting down on a newly surgerized joint that may damage the repair. Although the temptation is great, don’t try to chew food until your doctor gives you the okay and keep your splint in place at all times.

7.) After the first 7-10 days, your doctor will usually instruct you to see a physical therapist. The therapist will teach you exercises to begin to increase the mobility of your jaw joint.The eventual success of surgery is closely related to the rehabilitation of a stable bite and proper joint function.These exercises should be performed 4-5 times per day for 10 minutes a session.You may need to perform these exercises over the next several months depending on your response to surgery and your willingness to work hard at these exercises.Your doctor will monitor your progress carefully and let you know when to start exercising and when you can stop exercising and wearing your splint.

8.) If you haven’t done so already, you need to schedule an appointment with your family physician 7-14 days prior to surgery. He/she should perform your pre-surgical history and physical and complete the enclosed form. You must bring the completed physical form, the doctor’s order form and the signed consent form with you to the hospital for your pre-admission testing appointment.You will also meet with the doctors from anesthesia at the hospital prior to surgery.They will be happy to answer any questions you have regarding the anesthesia used during surgery.

9.) Finally, you must have a signed medical insurance form on file with our office prior to surgery. You can bring it along on your pre-operative visit or simply mail it to the office before your surgery. If this is not on file at the office prior to surgery, your surgery may have to be cancelled.

We hope you have found this information helpful. Keep this letter and refer to it after surgery as necessary. If you have any questions, please write them down so you can ask your doctor at your final appointment prior to surgery.

Good luck with your upcoming surgery. If you have any questions please do not hesitate to contact our office.