Get temporomandibular joint (TMJ) surgery in Birmingham.
TMJ issues are very common. Some studies suggest that up to a third of people may experience some problems with the TMJ joints within their lifetime.
The TMJs are paired joints at either side of your head. Their movement enables common everyday functions such as eating, chewing, talking, yawning and laughing. With so many cycles of use over a lifetime, it is no small wonder that many of us develop issues with our TMJ joints.
People with TMJ issues experience symptoms including subtle aches and pains, aggravated by hard or chewy foods and activities such as yawning. People may commonly attribute the onset of symptoms to specific events such as an episode of trauma or a lengthy trip to the dentist. Often, bruxism, or clenching and grinding (which may be subconscious) may have a role to play in the development of issues with the TMJ.
At The Priory Hospital in Birmingham, Mr Elledge, oral and maxillofacial surgeon, sees a range of patients with TMJ issues. As a renowned and nationally recognised figure in the subspecialty of TMJ surgery, he is well placed to diagnose and treat the full spectrum of issues with this joint.
He is an expert in the field, being an accredited full member of the European Society of TMJ Surgeons (ESTMJS) and former national lead of the British Association of Oral and Maxillofacial Surgeons TMJ Subspecialty Interest Group (BAOMS TMJ SSIG). He is also TMJ section editor for the national journal.
Broadly speaking, people generally have a combination of the following issues:
People with internal derangement may experience issues with derangement of the articular disc. This is a cartilage disc within the joint that can get “stuck” and make it difficult and painful to open your mouth. The disc may become “displaced” within the joint and stuck forwards, which limits the movement of the joint. Patients complain of difficulty opening their mouth wide and pain as the joint impinges upon the more vascular and richly innervated tissue at the back of the disc.
Like any joint, the TMJ can wear out! Patients may have simple wear and tear arthritis (osteoarthritis), or less commonly inflammatory arthritis such as rheumatoid arthritis. Again, the complaints are limitation of movement, restricted dietary intake and pain at the joints themselves, although imaging will often demonstrate worn away joints at various stages of degeneration.
People who often clench or grind their teeth are essentially exercising their TMJs like elite athletes. Just like any other muscle can ache after an intense gym session, habitual bruxism (tooth grinders) can wake from sleep with aching pains around the jaw and accompanying headaches. The issues are not so much with the joints themselves, as opposed to the muscles around them. People often report much wider distributions of pain that tend to be worse in the mornings.
Simple measures such as self-directed physiotherapy, mouthguards, resting the joints, soft diet, warm compresses, ice packs and analgesia (pain relief) can go a long way to settling issues faced by people with milder symptoms and largely normal joints.
Sometimes, people may benefit from being referred to physiotherapists with subspecialty interests in TMDs. Mr Elledge works closely with physiotherapists who are members of the Association of Chartered Physiotherapists in Temporomandibular Disorders (ACPTMD) and have a dedicated practice in this area.
Interventional treatments may include the following:
Myofascial pain that cannot be treated with conservative measures such as physiotherapy can often be treated with botulinum toxin injections such as BOTOX® or Dysport®. This is a series of injections in outpatients that takes minutes to administer but can lead to months of lasting pain relief as muscles are taken out of spasm and allowed to relax. As an outpatient-based treatment it is very affordable with no significant down time.
Patients with arthritis who are unable or reluctant to undergo surgery can often have a spectacular response to a simple steroid injection in outpatients with DepoMedrone®. This takes less than a minute to do and can again yield months of lasting relief, improved movement and significant reduction in pain. As an outpatient treatment it has no significant downtime and an affordable cost.
Mr Elledge is one of a handful of surgeons nationally who can provide TMJ arthroscopy. This is a cutting-edge treatment whereby a tiny 1.9mm camera is introduced into your joint. This enables a visual inspection of the joint and permits lavage and intra-articular steroid injection. Mr Elledge has also attended training to enable him to provide advanced arthroscopic surgery including synovial biopsy and coblation. Arthroscopy can get painful joints moving, with improved mouth opening and reduced pain scores, translating into an overall improvement in quality of life. The surgery is day-case so patients can expect to be discharged the same day with a rapid recovery within one to two weeks and ongoing outpatient support from Mr Elledge and his time.
Patients who had significant findings on arthroscopy may fall into that tiny minority of candidates for open joint surgery. This involves a cosmetic incision in front of the ear and partially concealed within the hairline to access the joint enabling fixation or removal of the intra-articular disc, substitution with fat grafts and reshaping of the joint to enable reduced pain and better movements. It represents a viable alternative for patients who have advanced degenerative changes but do not meet the threshold for (or are reluctant to undergo) joint replacement.
Mr Elledge is one of very few surgeons able to provide this end stage treatment for the most advanced patients. Within his NHS practice he provides around one joint replacement every month and is one of an even smaller number of clinicians performing this surgery privately. He has published widely in this field and has even created a classification system named after him for extended temporomandibular joint replacements (eTMJRs).
The joints that Mr Elledge used are state of the art Stryker Ventura TMJ Concepts prostheses. These are made bespoke for each patient and have one of the strongest track records in terms of mechanical stability, longevity and outcomes. Mr Elledge has been performing this surgery for years as a Consultant within the NHS and is committed to enabling access to this in the independent sector at The Priory Hospital. The surgery takes only a few hours to perform and requires only 1-2 nights hospital stay in the relaxing and supportive environment of one of the inpatient wards at The Priory and daily reviews by Mr Elledge himself.
When you choose to go private with Mr Elledge at The Priory Hospital for your TMJ surgery you’ll benefit from:
If you have issues with painful TMJ symptoms, limited mouth opening, restricted diet and daily painful jaw joints then please get in touch today.
Reception: 0121 440 2323
Mon-Fri: 6am-9pm
Sat-Sun: 7am-6pm
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