TMJ Surgery

Do you struggle with jaw pain that never seems to go away? Does your jaw lock, click, or feel stiff despite months of treatment? Have you been told you might need TMJ surgery and aren’t sure what that means?

You’re not alone. Most people with TMJ disorders improve with conservative, non-surgical treatments. However, in rare cases where the joint itself is severely damaged, surgery may be considered.

At Advanced TMJ Maxillofacial Pain & Sleep Center in Seattle, we specialize in helping patients find relief through non-surgical care first—and guiding you if surgery ever becomes necessary.

Do All TMJ Pain Patients Need Surgery?

The short answer is no. The vast majority of people with jaw pain, clicking, or locking improve with conservative care such as oral appliances, physical therapy, medications, injections, or laser therapy.

At Advanced TMJ Maxillofacial Pain & Sleep Center in Seattle, our focus is on minimally invasive, advanced evidence-based treatments. Surgery is considered only when there is a clear structural problem in the joint and other treatments have not helped.

When Is TMJ Surgery Considered?

TMJ surgery may be recommended if you have:

Severe or persistent jaw locking with pain that does not improve
Advanced severe arthritis or joint degeneration
Ankylosis (fusion of the joint)
Jaw joint tumors or trauma or other joint pathologies
Failed conservative therapy over many months - if the source is the TMJ joint

In these cases, you may be referred to have a surgical evaluation with TMJ Surgeon.

What are the types of TMJ Surgery

Depending on the diagnosis, several surgical procedures may be considered:

1. Arthrocentesis

A minimally invasive procedure where fluid is used to wash out the joint, reduce inflammation, and release adhesions. Often performed as an outpatient.

2. Arthroscopy

A small camera is inserted into the joint space. This allows the surgeon to see inside the TMJ and perform minor repairs such as smoothing cartilage or releasing scar tissue.

3. Open-Joint Surgery (Arthrotomy)

In more complex cases, the joint is surgically opened to repair or remove damaged tissue, reposition the disc, or address bone changes.

4. Modified Condylotomy

A procedure on the lower jawbone near the joint, used for chronic dislocation or disc problems, without opening the joint itself.

5. Joint Replacement (Alloplastic Prosthesis)

In rare, severe cases, the damaged TMJ is replaced with an artificial joint. This is considered only after all other options have been exhausted.

What are the risks of TMJ Surgery?

Like any surgical procedure, TMJ surgery has risks. These may include infection, facial nerve injury and weakness, facial scarring, or persistent post-surgery pain. Importantly, surgery does not always guarantee relief, especially if the pain is muscle-based or neuropathic rather than structural.

Hence, it is important to rule out the source of pain before ANY intervention is planned.

Our Approach: Conservative First, Collaborative Always

Before specializing exclusively in Orofacial Pain management, Dr. Hemamalini Chandrashekhar trained and practiced extensively as an Oral & Maxillofacial Surgeon. Her surgical experience includes performing complex procedures such as TMJ ankylosis release, and jaw resection surgeries, often for patients with advanced TMJ pathologies or facial tumors.

This background gives Dr. Chandrashekhar a unique perspective: she understands when surgery is necessary, but also knows that most TMJ disorders can—and should—be managed conservatively. Today, she uses her surgical insight to guide accurate diagnosis, avoid unnecessary operations, and collaborate effectively with other maxillofacial surgeons when true surgical cases arise.

Takeaways:

Most TMJ disorders do not need surgery.
Surgery is reserved for structural problems OR don’t respond to other treatments, ONCE THE SOURCE OF THE PAIN IS IDENTIFIED.
Our clinic provides a comprehensive evaluation and conservative care first, and we connect you with surgeons only when necessary.