WHEN THE JAW JOINTS ARE IN REALLY BAD SHAPE

It does not happen too often, but there are times when the jaw joints are just really out of place and/or damaged beyond their ability to go back into normal anatomical position without a little help from the friendly surgeon.

When the MRI shows that the articular disc inside the jaw joint is displaced to the extreme—i.e., both sides are medially displaced for example—then wearing the appliance may not be where it ends.

Sometimes the discs are too far damaged and they cannot get back into place on their own. This is when we must inform the patient that a plication surgery may be indicated. What the surgeon does is he goes into the joint and puts the displaced disc back into proper position and stitches it down where it belongs. The surgery is simple and only takes 20–30 minutes on each side. After surgery, the appliance continues to be worn in order to keep the joints open and the stitches from breaking.

This type of surgery is one of the easiest that you could ever experience, when indicated of course, and one of the least invasive. It is important to understand that the jaw joint has many nerve endings traversing through it and when the disc is out of place, it can cause an odd pressure on these nerve endings and send aberrant signals to the brain, i.e., the twitches, tics, etc.

By treating the TMJ when it is indicated, various comorbidities like twitches may also be fixed in the process. It is important that your doctor have a protocol in place to handle the situation when the basic decompression of the joints does not take care of the problem.

Dr Jeffrey L. Brown joined forces with Dr. Brendan Stack in Vienna, Virginia. See their new Wellness Village page on our website.