JAW SURGERY

TMJ surgery

The Temporomandibular joint (TMJ) is the 'jaw joint' and is a common site of pain and problems. Most patients can be effectively managed with simple jaw physiotherapy and other non-surgical techniques. Occasionally, the fibro-cartilage disc within the joint gets damaged or stuck, and these cases often require some form of surgery to improve symptoms.

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TMJ joint surgery, anatomical illustration

Quick answer about this procedure

QUICK ANSWER

TMJ surgery covers a range of procedures for jaw joint conditions, from key-hole arthroscopy and arthrocentesis through to open joint surgery and total joint replacement (arthroplasty). Both OMS surgeons have travelled to the USA to learn minimally invasive jaw-joint techniques.

Procedure
Arthrocentesis · Arthroscopy · Open joint · TJR
Anaesthesia
Sedation (arthrocentesis) · GA (open/TJR)
Duration
30 min – 4 hrs
Stay
Day-stay or hospital admission
Recovery
1–6 weeks depending on procedure

IS THIS FOR YOU?

TMJ surgery is usually considered when:

  • Conservative treatment (physiotherapy, splints, medication) has not relieved jaw joint pain
  • The fibro-cartilage disc within the joint is damaged or displaced
  • Jaw locking, restricted opening, or persistent clicking affects daily function
  • Imaging confirms internal derangement, arthritis, or ankylosis of the joint
  • A staged escalation, from key-hole to open surgery to replacement, has been discussed

HOW IT IS PERFORMED

A staged surgical approach

  1. Stage 1: Arthrocentesis

    Minimally invasive flushing of the joint to wash out inflammatory mediators and free a stuck disc. Performed under local anaesthesia with sedation, day-stay, with most patients returning to normal activity within a few days.

  2. Stage 2: Arthroscopy

    Key-hole jaw joint surgery using a small camera and instruments to directly visualise and treat the joint. Both OMS surgeons have trained in these minimally invasive techniques in the USA. Surgical TMJ disease is a regular area of practice.

  3. Stage 3: Open joint surgery or total joint replacement

    For more advanced disease, open joint surgery (arthroplasty) or total joint replacement is appropriate. These are hospital procedures under general anaesthesia, with a longer recovery window and structured rehabilitation.

WHO PERFORMS THIS

The surgeons who perform this procedure

Both surgeons listed below perform this procedure at OMS Specialists. Each carries dual qualifications in medicine and dentistry plus Fellowship from the Royal Australasian or English College.

Mr Richard Cobb, Specialist Oral and Maxillofacial Surgeon

Mr Richard Cobb

Specialist Oral & Maxillofacial Surgeon

BDS · MBBS · MFDS(Eng) · MRCS(Eng) · FRCS(OMFS)

  • Oral Surgery
  • Jaw Surgery
  • Facial Surgery
  • Skin Surgery
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Mr Ryan Smit, Specialist Oral and Maxillofacial Surgeon

Mr Ryan Smit

Specialist Oral & Maxillofacial Surgeon

BDS · MBChB · MRACDS(PDS) · FRACDS(OMS)

  • Oral Surgery
  • Jaw Surgery
  • Facial Surgery
  • Skin Surgery
View full profile

RECOVERY TIMELINE

Recovery timeline

  • 0–7 days

    Arthrocentesis / Arthroscopy

    Day-stay procedure. Soft diet for several days and gentle jaw range-of-motion exercises. Most patients return to desk-based work within 3 to 5 days.

    Red flags · Severe pain not relieved by prescribed medication, fever, or worsening jaw locking.

  • 1–4 weeks

    Open joint surgery

    Hospital admission followed by structured jaw rehabilitation. Soft diet for several weeks. Return to work timing depends on procedure complexity.

  • 6–12 weeks

    Total joint replacement

    Longer rehabilitation with formal jaw physiotherapy. Most patients regain functional jaw movement over 3 months, with continued improvement up to a year.

RISKS & HONESTY

Risks we discuss before consent

  • Facial nerve injury

    The branches of the facial nerve pass near the TMJ. Careful surgical technique minimises the risk of temporary or permanent weakness of the muscles of facial expression.

  • Persistent or recurrent symptoms

    Not every TMJ procedure fully resolves symptoms; staged escalation is sometimes required. Realistic expectations are discussed at consultation.

  • Infection

    Infection of the surgical site is uncommon and is managed with prescribed antibiotics. Joint replacement carries a small but serious risk of prosthesis infection.

  • Bleeding and bruising

    Some bleeding and bruising around the joint is expected. Significant haemorrhage is rare.

FREQUENTLY ASKED

Common questions about TMJ surgery

Do I need TMJ surgery, or can my pain be managed without it?

Most patients with TMJ pain can be effectively managed with simple jaw physiotherapy and other non-surgical techniques such as splints, medication and behaviour modification. Surgery is usually considered when conservative treatment has been tried for an adequate period without relief, when imaging confirms internal derangement or arthritis, or when jaw locking and restricted opening significantly affect daily function. At consultation we will assess your case in the context of the full TMJ pathway and recommend the least invasive effective option.

What does TMJ arthroscopy involve?

TMJ arthroscopy is a key-hole jaw joint procedure using a small camera and instruments inserted through tiny incisions in front of the ear. The joint is visualised directly and adhesions or displaced disc tissue can be addressed. It is performed under sedation or general anaesthesia depending on the case. Both OMS surgeons have trained in minimally invasive jaw-joint surgery in the USA, with surgical TMJ disease a regular area of practice.

How long is recovery after open joint surgery or joint replacement?

Recovery varies significantly with the procedure. Arthrocentesis and arthroscopy patients are typically back to normal activity within a week. Open joint surgery requires several weeks of soft diet and rehabilitation. Total joint replacement involves formal jaw physiotherapy and most patients regain functional jaw movement over 3 months, with continued improvement up to a year.

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