The management of TMJ dysfunction can be arduous and fraught with difficulty. Often patients have seen multiple clinicans without satisfaction and continuing problems. The biggest hurdle is often attaining a workable diagnosis.
Surgical procedures for TMJ dysfunction are indicated only in strict circumstances and must satisfy a regimented criteria prior to embarking on treatment. Prior to any surgical treatment, patients must understand that TMJ surgery bears a degree of risk and may not be 100% satisfactory. In most cases, a significant improvement of function and pain can be expected. There are a minority of cases where no improvement occurs or even worsening of symptoms.
TMJ problems are often not cured but rather "managed" like any other disease process and once a patient is deemed a surgical candidate will often need continuing input from non-surgical clinicians.
Developing a Treatment Plan involves the surgeon and takes into account patient preference and personal values.
This concept is "SHARED DECISION MAKING".
CONCEPTUAL DIAGRAM OF POSSIBLE TREATMENT ALGORITHMS
Our first choice clinician for non-surgical management is Anita Nolan. She is the only medically trained oral medicine physician in the South Island.
The first surgical step is often arthroscopy when a small camera is inserted into the joint which can then flush out "inflammatory mediators", remove adhesions, reposition discs and diagnose pathology.
Total Joint Replacement can be utilised in end stage disease when all other treatments are deemed inappropriate.
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