Q&A Topic: TMJ: Non-Surgical & Minimally Invasive Surgical Treatment
Benjamin Kur, DDS
Q. What is TMJ?
A. While the common term for the condition is TMJ, the more accurate term is TMJ Disorder or TMD (but most people refer to it as TMJ so we will, as well). It’s the next most common cause of facial pain after toothache. The temporomandibular joint (TMJ) is a delicate, intricate joint—one of the most complicated in the body—that attaches the lower jaw (mandible) to the temporal bone. It is supported by the facial muscles and enables us to chew, swallow, and yawn (a total of more than 10,000 movements per day!). The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disc, which keep the joint running smoothly.
Q. What are signs and symptoms of TMJ?
A. The temporomandibular joint comprises six main mechanisms. When one of these mechanisms isn’t working optimally, acute pain, or pain flare-ups may arise. Signs and symptoms of TMJ include clicking jaw, jaw pain or tenderness, locking of the jaw joint leading to difficulty opening and closing the mouth, earache or pain around the ear, tinnitus, migraine, sleep apnea, discomfort or pain while chewing, neck or shoulder pain, or facial throbs/twinges. It’s important to note that while some patients experience a clicking sound or grating sensation when opening the mouth or chewing, this in and of itself is not a symptom of TMJ. If there is no pain associated with the clicking, it’s likely you don’t have TMJ.
Q. Who is most likely to suffer from TMJ?
A. Anyone can suffer from TMJ. The exact cause is often difficult to establish. TMJ dysfunction may involve muscle dysfunction, a misaligned bite, and/or pathology such as cysts or tumors. The condition may be the result of a combination of factors, such as genetics, arthritis or jaw injury. It’s a myth that clenching or grinding teeth cause TMJ. Many “grinders” never develop TMJ disorders.
Q. What are the best nonsurgical options for treating TMJ?
A. TMJ pain can often be treated with physical therapy, acupuncture, night mouthguards, anti-inflammatories and, in some cases, Botox. We will take a careful history to assess the condition. This includes a pain questionnaire, history of trauma and oral habits such as teeth grinding and nail biting, as well as an MRI and X-ray.
Q. If nonsurgical options aren’t effective, what do you recommend?
A. When TMJ becomes chronic and patients don’t respond to more conservative treatments, we perform a minimally invasive procedure called TMJ Arthrocentesis, also known as joint aspiration. Similar procedures are regularly performed to alleviate pain in other joints including the knee, hip, elbow, wrist, ankle, etc. TMJ Arthrocentesis is an in-office procedure performed under IV sedation/ general anesthesia. A small catheter is inserted into the joint. Synovial fluid is removed and the joint is irrigated with sterile saline and steroids. The purpose is to remove tissue that’s broken down and reduce inflammation. Results are excellent and relief is immediate. We will monitor you monthly for six months following the procedure.
Dr. Benjamin Kur is devoted to serving the Westchester County community. From emergency surgery on a 10-year-old facial trauma victim to reconstructing the jaw of an 89-year-old patient with implants, Dr. Kur takes the time required to ensure that every patient receives personal attention and best-in-class care. Dr. Kur’s specialties include the reconstruction of the jaws for implant placement, wisdom teeth removal, maxillofacial trauma, pediatric maxillofacial surgery, and corrective jaw surgery. Dr. Kur is a specialist in diagnosing and treating patients with TMJ (temporal mandibular joint) pain. A graduate of Albert Einstein College of Medicine, Montefiore Medical Center in 2006, Dr. Kur received his Doctor of Dental Surgery from SUNY Stony Brook in 2002, and a BA from The University of Michigan in 1996. Upon completion of his surgical residency, Dr. Kur joined the medical staff at Montefiore Medical Center as a Clinical Instructor. Dr. Kur is also a Faculty Associate Professor of Surgery at New York Medical College/ Westchester Medical Center, Staff Surgeon at Phelps Memorial Hospital, Montefiore Medical Center and LIJ/NJUH. He is a Diplomate of the American Board of Oral and Maxillofacial Surgery and a Fellow of the American Dental Society of Anesthesiology. Dr. Kur resides on the board of American College of Maxillofacial Surgeons and serves as Regent. He frequently speaks on the topic of advances in oral surgery at major surgery conventions.
Westchester Oral and Maxillofacial Associates
19 Bradhurst Ave, Suite 2500n
Hawthorne, NY 10532