TMJ Open Joint Surgery

Post-Operative Care instructions for TMJ Disc Removal and Disc Repositioning

  • You are going to have pain and swelling for a few days to a couple of weeks. Bruising is also likely.  This is normal.
  • You will likely be given a long-acting local anesthetic at the end of your procedure. This should help significantly with your pain but may also make areas of your face feel numb.  It can even weaken your ability to move certain muscles of your face (moving your mouth, raising your eyebrows, and closing your eyes tightly). This will subside as the anesthetic wears off but can persist for multiple days.
  • Feeling as if there is fluid or pressure in your ears with decreased hearing is also normal for a few days. You may also note dried blood or other debris in your ear for days to weeks.
  • Your incisions must remain clean and moist. Scabbing and debris will only delay healing and increase scarring.  Place antibiotic ointment on these areas 3-5 times a day for the first 5 days.  After that, use Vaseline or Vitamin E based lotion to keep these areas moist. Your sutures will either dissolve on their own or be removed at your 1 week post-operative visit.
  • Pain Medications:

The following medications are part of a regimen we recommend for most patients.  However, due to specific health conditions, allergies, or other medications you take, this plan may be altered to fit your specific needs.  If the plan discussed with you at your appointments differs from below, please stick to the plan discussed at your appointment and use the following only as reference. 

You will typically be prescribed multiple medications to assist in pain control while attempting to limit opioids or other medications that have addictive potential or undesirable side effects. Please take the medications listed below.  THEY ARE LISTED IN ORDER OF IMPORTANCE/PRIORITY, HOWEVER, THE FIRST THREE SHOULD BE TAKEN ON THE DEFINED SCHEDULE LISTED AND THEN “AS NEEDED” THEREAFTER.

  • Ibuprofen (600 or 800mg depending on what is prescribed for you) every 8 hours with food for 1 week unless G.I. symptoms arise. Alternatively, you may be prescribed Meloxicam or Naproxen. Take on an as needed basis after the 1st
  • Acetaminophen (Tylenol) 1000mg every 8 hours as needed.
  • Lyrica (Pregabalin) 80mg if liquid (75mg if pill form) every 8 hours for the first 5 days. As needed thereafter.
  • Oxycodone 5mg every 4-6 hours. This is ONLY FOR EXTREME PAIN NOT MANAGED BY THE OTHER MEDICATIONS.  This is an Opioid Pain medication.  You may be prescribed a different opioid based on certain factors.  Please take as directed if needed.
  • Early mobilization and physical therapy are key to improving your condition. If you do not do this, you cannot expect to have long-term improvement.  No one can do this for you.
  • PLEASE FOLLOW ONE OF THE TWO REGIMENS BELOW BASED OFF OF WHAT PROCEDURE WAS PERFORMED!
  • FOR TMJ DISK REMOVAL:
  • Diet and Activity:
    • Days 1-7:
      • Simply open and close your mouth (but don’t bite hard), move it side to side, and forward and back multiple times a day.
      • DO NOT CHEW. Liquids and soft foods that can be swallowed whole or pushed with your tongue against the roof of your mouth only.
  • Week two until normal mouth opening is achieved:
    • You may now bite/chew what you feel comfortable eating. Start slow and move to normal.
  • Perform the following movements 5 times a day, performing 5 repetitions each time.
    • Opening maximally to a point where it does not hurt but feels like you are starting to stretch your jaw. At this point, use your fingers to gently stretch a little further and hold for 10 seconds.  This should not be very painful but you should feel a good stretch and slightly uncomfortable.
  • Move your jaw side to side (left to right) as far as you can and hold for 5 seconds at each side. This should not be very painful, but you should feel a good stretch and slightly uncomfortable.
  • Move your jaw forward as far as you can as if sticking out your lower teeth and chin and hold for 5 seconds.
  • FOR TMJ DISK REPOSITIONING:
    • Diet and Activity:
      • Weeks 1-3:
        • YOUR DISC IS HELD IN PLACE BY SUTURES. LIMITING MOUTH MOVEMENT, STRETCH AND FORCE IS CRUCIAL THE FIRST WEEKS TO AVOID COMPLICATIONS.
        • Limit your mouth movement only to what is needed to drink, eat soft foods (no chewing), and speak. Nothing more.
        • DO NOT CHEW. Liquids and soft foods that can be swallowed whole or pushed with your tongue against the roof of your mouth only.
  • Week THREE until normal mouth opening is achieved:
    • You may now bite/chew what you feel comfortable eating. Start slow and move to normal. STILL AVOID LARGE MOUTH OPENING.
  • Week FOUR until normal mouth opening is achieved:
    • Continue to progress diet and start opening your mouth more based on comfort and feel.
    • Perform the following movements at least 5 times a day, performing 5 repetitions each time.
      • REMEMBER, YOU CANNOT DO THIS TOO OFTEN (MORE THAN 5 TIMES IF YOU WISH) BUT YOU CAN DO IT TOO HARD/AGGRESSIVELY
      • Opening maximally to a point where it does not hurt but feels like you are starting to stretch your jaw. At this point, use your fingers to gently stretch a little further and hold for 10 seconds.  This should not be very painful, but you should feel a good stretch and slightly uncomfortable.
  • Move your jaw side to side (left to right) as far as you can and hold for 5 seconds at each side. This should not be very painful, but you should feel a good stretch and slightly uncomfortable.
  • Move your jaw forward as far as you can as if sticking out your lower teeth and chin and hold for 5 seconds.

If there are any questions or concerns, please call us anytime during business hours at 480-896-0600 or after hours at 602.492.3177 if there is an urgent/emergent issue.