• Reference Number: HEY-141/2021
• Departments: Oral Surgery, Dentistry and Max Fax
• Last Updated: 14 May 2021

Introduction

This leaflet has been produced to give you general information about your treatment.   Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a jaw joint arthroscopy?

The procedure is performed under a general anaesthestic which means you will be asleep during the operation. The joint is initially filled with fluid and then a small cut 2-3mm long is made in the skin over the joint. The arthroscope (the telescope, put inside the joint) itself is very slender, being only 2-3mm in diameter.

Sometimes a second incision is made, if it is thought necessary to have a fuller examination of the joint or if the surgeon wishes to pass instruments into the joint, for example to clear away fibre which might be preventing the joint working properly.

Why do I need a jaw joint arthroscopy?

There are a number of situations where this can be necessary.

The most common of these is where the patient has long-term symptoms relating to the temporo-mandibular joint; in particular, pain on movement of the jaw and locking of the joint when attempting to open or sometimes on closing the mouth. The majority of patients with such symptoms get better as a result of resting their jaw and wearing a splint, which fits on the teeth. Some patients fail to improve with these measures.

A further group of patients may present with symptoms which have come on over a short period of time and are severe; such as sudden locking or a swelling of the tissues surrounding the joint.

The procedure to inspect the joint is in part diagnostic, to find out why the symptoms are present and in part therapeutic, as inside of the jaw joint is washed out.

Can there be any complications or risks?

A rare, but most serious complication is injury to the ear. This is something which your surgeon is aware. He will inspect the ear at the beginning and end of the procedure, and pack the ear during the procedure. A more common but very short-term complication is weakness to the muscles of your face. This only lasts a few hours. It occurs because of the effects of the local anaesthetic, which is given close to the nerve which powers the muscles of your face. The local anaesthetic paralyses the nerves which make your muscles move just as it numbs the nerves which allow you to feel touch and temperature. Movement and feeling return as the local anaesthetic wears off after a few hours.

There is a risk of infection being introduced into the joint. This is unlikely but you will be given a prescription for antibiotics to take to reduce the likelihood of this happening.

How do I prepare for the joint jaw arthroscopy?

Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this operation.

You will attend a pre-assessment clinic where the nurse will assess your medical health. She will give you the date, time and ward to attend for the operation. You will be able to ask any questions you may have at this appointment.

What will happen?

On the day of your admission the ward staff will meet you and show you round. You will be seen by a doctor and possibly an anaesthetist who will explain the treatment and gain your written consent. The type of anaesthetic you will have is called a general anaesthetic i.e. you will be asleep during the procedure. You will be prescribed pain relief post-operatively to manage any pain you may have.

What happens afterwards?

You will be kept in hospital until you have woken up fully and the effects of the anaesthetic have worn off perhaps until the next day. You will find that your jaw feels stiff and at first you will feel that you are unable to get your teeth together on the side which has been examined. This is because of the volume of fluid within the joint. This will be absorbed and the joint will be less swollen by the next day. Your jaw will feel stiff for another 2-3 days. At first you will feel numb in the area because local anaesthetic is put in to relieve any discomfort.

You should take the antibiotics and pain relief medication as prescribed and rest your jaw for the first 72 hours, taking care not to open the mouth too wide or to chew hard food. After this time, you should start to do gentle exercises to increase the range of movement of your jaw. Gentle movements from side to side may be more comfortable than attempting to open your mouth wide. You should continue with a soft diet until advised to revert to food which requires chewing.

It is important that you should wear the splint that has been prescribed for you soon as you are able to get it into your mouth following the surgery.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Maxillofacial Unit (01482) 463218

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.