Denver Plastic Surgery, TMJ TEMPOROMANDIBULAR JOINT DYSFUNCTION
Denver Colorado Plastic Surgeons

Temporomandibular joint dysfunction is a very complex entity. Although it is usually caused by systemic factors, it is probably best initially treated by a dentist and physical therapy. Patients who do not respond to conservative treatment will need a more extensive work-up and treatment.

Although the pain is often localized to the temporomandibular joint, its cause is often the facial structure and resulting dental occlusion of the patient.

Several clinical situations may be present. One is an isolated instance of TMJ pain or pain in the associated structures. This can often be attributed to stress or a minor traumatic incident. If there are not aggravating conditions, anti-inflammatories and physical therapy will often take care of the symptoms. If the patient odes not respond to this, the next step is to see a dentist for an occlusal evaluation and splint therapy.

If a patient has a significant occlusal disharmony, initial management is the same, i.e., anti-inflammatories, physical therapy and a splint. However, in order to stay the degenerative process and prevent recurrence the dental occlusion must be addressed. Malocclusion can be due to malpositioned teeth or an imbalance in the facial skeleton. In the former situation, orthodontics and/or occlusal equilibration will often correct the situation. However, if a facial skeleton problem is present, this may require orthodontics, maxillofacial surgery, and in some cases, restorative dentistry. In these cases, although conservative treatment is often times initially effective, there is a high likelihood of continued degeneration and recurrence. This treatment is often times consuming and expensive.  Costs can range as high as $35,000 to $40,000 once all aspects are covered.

The third and final one is a situation in which degeneration of the joint is severe enough to require corrective surgery. In this situation, the patient should be assessed for aggravating factors, i.e., occlusal disharmony even though there is often a precipitating event such as an auto accident. Joint surgery, in the presence of aggravating factors, often fails so these need to be addressed before operating.