Arthrocentesis of the temporomandibular joint (TMJ)

TMJ arthrocentesis is a minimally invasive procedure used to treat disorders of the temporomandibular joint (TMJ), which connects the jawbone to the skull. The procedure involves flushing the joint with sterile fluid to reduce inflammation, relieve pain, and improve movement.

At Penn Medicine, our oral surgeons, oral medicine physicians, and oral rehabilitation experts work together to provide expert care in the treatment of TMJ disorders.

Arthrocentesis of the temporomandibular joint is usually recommended for people who:

• Have conditions like TMJ disc displacement or joint inflammation
• Experience jaw pain or limited movement
• Have not improved with nonsurgical treatments

Before the procedure, you’ll receive local anesthesia with sedation or general anesthesia. Local anesthesia with sedation is typical for TMJ arthrocentesis and involves numbing the joint area and providing medication to keep you calm and comfortable throughout the procedure. For some cases, the surgical team may opt to use general anesthesia, which puts you in a sleep-like state.

During the procedure, you’re seated and tipped back at a 45-degree angle. Two needles are carefully placed in the joint using anatomical landmarks. A sterile fluid is then injected through one needle and drained through the other to flush out the joint. Sometimes, additional medications like corticosteroids are added to aid healing.

Most people are able to return home on the day of the procedure or after a brief overnight stay.

Recovery after TMJ arthrocentesis involves gradually resuming normal activities and eating. Follow your surgeon’s instructions and attend all follow-up visits.

• Postoperative care: Your care team may recommend applying ice packs for the first 24 hours. Be sure to take any prescribed medications and start gentle jaw exercises as directed.
• Pain: Pain and swelling may persist for two to three days. A squishing sound in the ear is normal and tends to resolve quickly.
• Diet: Soft foods like pasta, cottage cheese, or egg salad may be recommended for two to six weeks. You may be advised to avoid chewy foods like steak or pizza for several weeks.
• Recovery timeline: Full recovery may take two to three weeks, with many people resuming normal activities sooner.

Although generally safe, the procedure has some potential risks or side effects, including:

• Temporary swelling near the joint
• Temporary misalignment of the bite
• Bleeding, infection, or injury to nearby structures like nerves or the ear canal

Experienced care for TMJ pain

The oral and maxillofacial surgeons at the Penn Center for Temporomandibular Joint Disease are internationally known and have extensive experience performing TMJ procedures. Our TMJ experts are actively involved in research on treatment outcomes, prognosis projections, and prevention of TMJ disorders.