Date: Dec 2023

Oral & Maxillofacial Surgery - TMJ Arthrocentesis: Information for patients

Introduction

This leaflet includes information for those who have been recommended by an Oral and Maxillofacial surgeon to have a Temporomandibular Joint (TMJ) arthrocentesis. Inside you will find what this procedure is, why you need it, what will happen on the day of the procedure and what to do afterwards. Please speak to your surgeon or nurse in the Oral and Maxillofacial surgery department if you have any questions or need advice.

What is a TMJ arthrocentesis?

Arthrocentesis is a wash out of the joint space. Usually carried out while patient is asleep under a general anaesthetic. In some cases a camera can be used to facilitate the process, this is called Arthroscopy.

Why do I need a TMJ arthrocentesis?

Washing out is thought to clean and remove any loose material in the joint. These could be the result of a degenerative process. During the procedure, the mouth will be opened and closed a few times to allow thorough wash out.

What happens during the procedure?

The procedure is usually done under a general anaesthetic which means you will be fully asleep. Two needles are inserted into the joint space, one of the needles will flush the joint with a sterile solution, and the other will allow the water/debris to flow back out. If a camera is used, it will incorporate the first needle.

Sometimes the lower jaw is moved around or manipulated to encourage better position of the joint disk against the condyle (head of the lower jaw).

What happens after the procedure?

Usually you will be discharged home the same day. In some cases, you might need to stay in hospital overnight.

After discharge

After having a general anaesthetic, you will not be able to drive, work, operate heavy machinery or sign legal documents for 48 hours. You will also need someone to collect you and be with you for 24 hours after the anaesthetic.

You can eat and drink straight away, but it is better to maintain a soft diet for the first 5 days. This can be increased to normal diet and function by day 7 to exercise the joint. You can take over the counter pain relief, such as Paracetamol or Ibuprofen, as you need it.

Mouth opening exercises are generally encouraged to improve mouth opening if this is limited. Heat applications prior to exercises may be helpful. Your surgeon will discuss this with you in advance.

General risks and side effects

Like many other surgical procedures, there are some risks involved with TMJ arthrocentesis. These include: 

• Pain
• Bruising
• Swelling
• Infection
• Bleeding
• Blood clots

Specific risks and side effects

Your jaw may be stiff making it difficult to open your mouth which will subside after a few days. There is a small risk to your facial nerve and the ear canal next to the joint. These are usually temporary and resolve without intervention.

TMJ arthrocentesis is not always successful in improving function or pain. Its success varies depending on many factors.

Authors: Ghaly A Ghaly, Barbara Gerber, Athanasios Kalantzis