Post TMJ

Post Operative Instructions for Patients Undergoing Tempromandibular Joint Arthrocentesis

Diet: You will be on a liquid-diet following your procedure. This can be advance to a pureed diet (Puddings, applesauce, oatmeal, or anything blenderized) usually by the second postoperative day. By the end of the first week you can usually be advanced to a soft diet (pasta, baked fish, and cooked vegetables) for about three to four weeks. The doctor will discuss the advancement of your particular diet during your postoperative visits.

Healing: You will experience soreness for 2 -4 days. Usually, no severe pain should be experienced. You may shower or take a bath and wash your hair when the drowsy effects of the anesthesia have worn off. The small bandages may be removed and the incision areas may be left uncovered.

It is not a problem if the injection areas get wet when you are bathing. It is uncommon, but possible, that you may have some numbness or muscle weakness in the areas of surgery. If this does occur, it should be temporary and resolve without treatment.

On rare occasion, you may experience fluid in the ears. This feels like a swimmer’s ear and can last for about 2 – 4 days. Also, on rare occasion, dizziness can accompany this situation. The feeling of fluid in the ears, if it does occur, will usually resolve itself without any definite treatment.

Some swelling in the area is expected. This is usually minor, but occasionally more pronounced swelling can occur. If this happens, it is usually a result of sterile irrigation fluid that has entered surrounding tissues, and most of the swelling will resolved within 24 – 36 hours. Ice may be applied to the area for the first 2 days after the procedure.

EXERCISES: The exercises that you are to perform after the surgery are critical for the success of the procedure. They are to be started within 24 hours after the surgery. The following set of exercises needs to be performed five or six times a day for 4 – 5 minutes each time:

  1. With the index finger of your right hand on the lower teeth in the left side of your lower jaw and your thumb on your upper front teeth, use firm finger pressure in a scissors-like fashion to increase the opening of your mouth. The best method is to open your mouth as wide as you can, then place your fingers in your mouth, as just described, and perform the exercise.
  2. Move your lower jaw as far to the right as possible. Then, move your lower jaw as far to the left as possible. Repeat this 25 times. You should be moving your lower jaw about 1/8 of an inch to each side by 2 days after the surgery and about 3/8 of an inch to each side by the sixth day after surgery. It may be necessary for you to apply pressure to the sides of your lower jaw with one of your hands to aid in doing this exercise.
  3. Move your lower jaw forward, and then return to the normal resting position of your lower jaw. Repeat this 20 times. By the second week after the surgery, you should be able to move your lower jaw forward, so that your lower front teeth are in front of your upper front teeth.

It must be stressed again that these exercises are critical for your surgery to be successful. You will experience soreness when you do these exercises; this is expected. You may want to take some pain medication or ibuprofen, if you have not had an adverse reaction in the past, about 20 – 30 minutes before performing these exercises.

Dental Hygiene: It is important to maintain excellent oral hygiene. After any meal, even full liquids, please rinse your mouth with warm salt water (1/4 teaspoon salt to 8 ounces of water). Use a soft toothbrush to brush your teeth.  

Please Note: Each person responds differently to surgery and you may have special circumstances that may necessitate changes from these printed guidelines. The doctor will discuss any modifications of your postoperative care, and should you have any concerns, do not hesitate to call our office at Old Town Alexandria Office Phone Number 703-299-4614.