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Post Operative Instructions for TMJ Surgery
The surgical site following temperomandibular joint surgery will often swell. This swelling is very firm to the touch, and minimal drainage will occur from incision line. Swelling can take 2-3 weeks before it starts to settle down and soften.
Ice packs are recommended for the first 72 hours following surgery on 20 minute intervals. Moist heat is then recommended for symptomatic relief until the swelling improves.
Antibiotics may be prescribed to prevent infection, if they are prescribed take them until finished.
Pain medication will be prescribed to control pain and should be used during the post operative period as prescribed.
A liquid only, moving to a soft diet is recommended for the first 3 months after surgery. After 3 months you may slowly expand your diet. Avoid foods that hurt your jaw, such as raw vegetables, and whole apples. You should avoid practices such as cracking nuts, chewing on ice, gum or food that causes discomfort or repetitive motion. remember, no matter the type of TMJ management, “Once you have TMJ pain, you will most likely always be susceptible to TMJ issues”.
The dressing can be removed 48 hours following the surgery and you can bath or shower as desired providing the wounds are not placed DIRECTLY under water or shower head. Do not be concerned about the small incisions. The wounds can become a little damp but should be carefully pat dry with a clean towel following your shower. A small amount of watery drainage, bruising, and redness may be noted. Keep a thin coating of antibiotic ointment on the surgical sites. (Polysporin, Bacimyxin).
The side/sides of the TMJ surgical site will be numb permanently. This location is approx. 3cm in front of the ear up to the height of the hairline. This is a known risk of open TMJ surgery and is predictable to occur post surgery.
If you have sutures; you may clean the sutures only with a solution of ½ hydrogen peroxide and ½ water. Sutures, if not dissolvable, will be removed in 7-10 days following surgery.
It is highly desirable that you do not smoke for at least 2-3 weeks following the surgery, please be aware that smoking has a systemic effect and a history of smoking can jeopardize the overall success of your surgery.
Avoid strenuous physical activity until instructed.
It is not uncommon for the occlusion or “bite” to feel slightly “out”. This will gradually settle over about ten days and relates to swelling within the joint. For patients who have undergone joint replacement surgery it may be necessary for elastics to be used to hold the jaws together for a few days to help the bite settle. You will be supplied with small cutter and clips to help insert and remove the elastics. For patients who have had a TMJ diskectomy bite changes may be more pronounced and sometimes permanent.
Patients may occasionally notice some deafness in the ear on the operated side. This is usually related to some fluid/blood clot in the ear canal and also some swelling following the surgery as the surgical incision involves dissection near the ear canal. This deafness will gradually subside over 10-14 days and if it persists notify the doctor.
Please call our office if you have any problems or concerns. Notify your doctor if you have an increase in pain, swelling or bleeding. You will be generally given a follow up appointment approximately 10 days after your surgery.
The first 3 months are the most critical to reestablish range of motion and pain control. Maintaining your physical therapy management is another “key” area to your overall surgical success. You have been prescribed a “Therabite device” to aid in physical therapy, please use as instructed.