TMJ Disorders

TMJ stands for “temporomandibular joint”, which is the joint that connects the lower jaw (mandible) to the skull. It plays a crucial role in jaw movement, allowing for activities such as chewing, speaking, and yawning.

TMJ disorders (sometimes referred to as TMD, for temporomandibular disorder) are a group of conditions that affect this joint and the surrounding muscles and other tissues.

TMJ problems manifest themselves often as pain, dysfunction, or deformity.

Before any treatment it is important to obtain a precise diagnosis. For this a specialist is often required.

Mr Carls has seen and treated more than 10.000 patients with TMJ problems over his long career. He was head of the TMJ clinic at Zurich University and as such was clinical lead for all junior doctors. He was responsible for obtaining the correct diagnosis (including use of CT, MRI and arthroscopy) and setting up the treatment plan. 

During this time, Mr. Carls published several peer reviewed publications on TMJ arthroscopy.

The usual treatment consists of exercises, physical therapy, splints, or medications.

Recently a new method was introduced in the form of very advanced and sophisticated Radiofrequency.

Most of the time surgery of the TMJ can be avoided! Contrary to mainstream opinion Mr Carls experience led him to avoid surgery even in the following circumstances:

Severe pain: Chronic and intense pain that doesn't improve with routine treatments.
1) Jaw misalignment: If the TMJ is not functioning properly, it may lead to a misaligned jaw, affecting both appearance and function.
2) Joint damage: This could include structural damage or degeneration of the TMJ from arthritis, injury, or other conditions.
3) Limited jaw movement: When TMJ dysfunction makes it difficult to open or close the mouth fully.

An invasive procedure, but not really surgery are injections of medication into the joint.

This actually needs a high degree of experience, which Dr Carls has after having performed more than 300 arthroscopies.

Rarely proper TMJ surgery is necessary. Exceptions are obviously benign tumours (extremely rare are malign tumours) and so-called overgrowth of the condyle (head of the joint).

Types of TMJ Surgery:

1. Arthrocentesis: A minimally invasive procedure where fluid is injected into the joint to clean it out and reduce inflammation.
2. Arthroscopy: A minimally invasive procedure that uses a small camera and instruments inserted through small incisions to treat the joint, remove damaged tissue, or smooth out rough surfaces in the joint.
3. Open Joint Surgery: In rather severe cases, a surgeon may need to open the joint to repair or replace damaged tissue, bone, or the disc inside the joint.
4. Jaw Surgery (Orthognathic Surgery): If the issue involves significant misalignment or deformity of the jaw (such as an overbite or underbite), corrective jaw surgery may be needed to realign the bones of the upper and lower jaw, often in combination with TMJ surgery.
5. TMJ Replacement: In extreme cases, where there is severe degeneration or damage, the entire TMJ may be replaced with a prosthetic joint, though this is very rare.

We would like to stress that all forms of surgery very often can be avoided, however it is important to obtain a precise diagnosis and therefore precisely treat the condition you may have specifically.