TMJ (or temporomandibular) joint disorder, also called a jaw joint disorder, occurs when your TMJ can’t open and close your jaw smoothly. The jaw joint is one of the smallest in the body and allows the lower jaw to move up and down against the fixed upper jaw and to rotate. It is surrounded by a protective cartilage which cushions the bones as the jaw joint moves. The small disc of cartilage slides backwards and forwards as the lower jaw moves. If the disc becomes displaced, it snaps back into place and the jaw ‘clicks’. Inflammation and a loss of movement can occur if the disc becomes deformed and can’t spring back.
What can cause TMJ disorder?
There are a number of reasons why you may have TMJ disorder. It could be a problem with the joint, the cartilage or in the muscles which move the joint.
- Osteoarthritis can the affect the jaw joint and is caused when the cartilage around the joint becomes worn or damaged which results in inflammation and pain
- Inflammatory arthritis including rheumatoid arthritis can affect the jaw joint
- Traumatic injury
- Overusing the muscles around the jaw. Many people with TMJ disorders grind their teeth which is called bruxism, or clench their jaw
What are the symptoms of TMJ disorder?
The symptoms of TMJ disorder include:
- The jaw clicking when it’s moved
- The jaw feeling as if it has got stuck
- Restricted jaw movement, for example not being able to yawn
- Pain coming from the jaw joint or moving into the cheek, temple and ear or into the lower jaw and neck
- Problems with the ear including ringing in the ears (tinnitus), dizziness or pain
How is TMJ disorder treated?
TMJ disorders can often be easily treated without medical or surgical intervention.
There are a broad range of treatments available and it is important to start with the least invasive. You may need different types of treatment to resolve the problem with your jaw.
At your initial consultation, your consultant will conduct a full examination and will look at how much function you still have in both your jaw joints. You may need to have a scan to find out what’s happening inside the joint. The consultant will then give you a diagnosis and a treatment plan.
Non-surgical treatment
Many TMJ disorders can be treated using massage, physiotherapy, anti-inflammatory medication, muscle relaxants or changing the way you chew. Steroid injections into the affected joints can also be used.
If bruxism is contributing to your TMJ, you may be given a dental appliance to stop your teeth from rubbing against each other or to properly align the jaw. You may also be a candidate for BMAC (Bone Marrow Aspirate Concentrate).
Surgical treatment
In some cases, you may need surgery to treat your condition. This could involve a jaw joint arthroscopy, TMJ open surgery or in more complex cases, jaw joint replacement.
Jaw joint arthroscopy
A TMJ arthroscope is put into your jaw joint while you are under general anaesthetic. It can be used for further diagnosis as well as treatment. It is a minimally invasive procedure and allows the surgeon to remove or adjust tissue as necessary. An arthroscopy is often used in combination with an arthrocentesis which washes out the joint to help break down adhesions and flush out inflammatory particles which are damaging the joint.
TMJ open surgery
There are three types of TMJ open surgery: disc reduction and fixation (discopexy/meniscoplasty), disc removal and grafting (discectomy/meniscetomy) and resection of tumour or diseased tissue with or without reconstruction or grafting. These procedures enable the surgeon to remove bony growths or excess tissue and to repair or reposition the disc if it’s out of place or damaged. If the disc can’t be repaired, it can be replaced with your own tissue or an artificial one. All the procedures require you to have a general anaesthetic.
Jaw joint replacement
This procedure involves replacing the joints between the lower jaw and the base of the skull with custom-made prosthetic joints. You may need a jaw joint replacement if your jaw has been smashed in an accident or the joint or part of the jaw bone has been removed due to a cancerous tumour, a deep-seated bone infection or because of a destructive joint disease. Planning for the operation and manufacture of the joint replacement is complex and takes around three months. You will be in hospital for a week and will be regularly reviewed.
Regenerative treatment
Regenerative treatments such as Activated Mesenchymal Pericyte Plasma injections (AMPP®), Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) can be used to treat TMJ disorder. They harness the body’s natural capacity for self-repair through the re-injection of growth-promoting cells taken from elsewhere in your body to promote healing in the damaged jaw. The treatments regenerate the cell tissue in the jaw joint, reduce pain and inflammation and increase the mobility of the jaw.
Activated Mesenchymal Pericyte Plasma (AMPP®) injections
These contain a combination of fat and blood cells. The Lipogems® procedure, which involves taking fat tissue from the thigh or stomach, is used to separate the regenerative cells taken from your own fat tissue. The cells are then combined with platelets extracted from your blood (Platelet Rich Plasma – PRP) and injected into the jaw joint.
Platelet Rich Plasma (PRP)
This involves extracting platelets from your blood and re-injecting them into the damaged jaw to encourage cell repair and regeneration.
Bone Marrow Aspirate Concentrate (BMAC)
This is a non-operative minimally invasive procedure which uses stem cells harvested from bone marrow (the spongy tissue in the middle of bones). The bone marrow is taken from the pelvis bone. The BMAC promotes healing in the damaged jaw by accelerating the body’s natural ability to repair and regenerate itself.
The risk of complications from these procedures is low as the fat, platelets and bone marrow are harvested from your own body and the regeneration of the cells is stimulated using the body’s natural healing mechanism. They are also minimally invasive with no major incisions.
You can read more about regenerative treatments here.
Why choose Harley Street Specialist Hospital?
At Harley Street Specialist Hospital, you can expect:
- Our team of expert oral and maxillofacial surgeons to offer rapid assessment and the latest treatments in comfortable central London surroundings, as well as video consultations from the comfort of your own home.
- Holistic care, where you are an equal partner in the creation of your individualised treatment plan.
- State of the art diagnostic imaging – you don’t need to go elsewhere as we have in house CBCT, X-ray, ultrasound and image intensifiers.
- Day-case and outpatient investigations and surgical procedures in a modern clinical setting.
- No waiting lists and your treatment can take place at a convenient time for you.
We welcome patients with private medical insurance or those wishing to pay for their own treatment.
Further information
Our TMJ consultants
Search our consultants
