Your First TMJ Consultation Appointment

For patients who are being referred for treatment of their Temporomandibular joints, the following will occur on your first office visit. You will be evaluated and examined by a doctor. A scout radiograph called a Panorex will be taken. Measurements of your jaw opening and side movements will be made and a record of your pain grade will also be made. This grade is on a 0 to 10 scale with 10 being the worse pain imaginable. Once you have been evaluated, obtaining MRI's of your TMJ, as well as, a request for splint fabrication (oral orthotic device) and physical therapy will be requested. If an oral orthotic device is recommended, impressions of your teeth will be made.

Molds will be fabricated of your teeth and then sent out for the device to be made. This usually takes 7 to 10 working days. If an MRI is recommended, you will be given a prescription for the radiographic exam. You will be referred to an approved MRI center for the scan to be performed.

Once the scan is completed, you must have the MRI center duplicate the films and give you the copies or have them give you the scan on a CD. You are then to bring the CD or films to us at your next office visit. All this information will be reviewed at your second office visit.

After physical therapy and conservative treatment is performed for a few weeks, you will then be re-evaluated. If further action is required it will be recommended at that time. The procedure is performed as an outpatient procedure in a hospital or in our office under general anesthesia. It involves making a small puncture in front of your ear and a small probe inserted into your joint. When finished, a band-aid is applied. Usually, there are no stitches involved. Following the procedure, it is required that post-operative physical therapy begins within 24-48 hours.

An oral rehabilitation device may be recommended for you following your surgery. We usually recommend either a Therabyte or Dyna-Surg splint. These devices require pre-approval from most insurance companies and must be done so in advance of your surgery.

Post-operative appointments are usually at 1 and 2 weeks following arthroscopy. At those visits, measurements will be made of your jaw opening and side movements. Additionally, you will be asked to once again grade your pain on a zero to 10 scale.

Most patients are concerned about popping. This is a function of your disc within your temporomandibular joint. Not all noises are eliminated with surgery. Occasionally some popping persists.

If you have any further questions regarding this visit and treatment, please write your questions down. Remember to bring those questions to your office visit and do not hesitate to ask those questions to your treating doctor at the time of your visit.