Post-Operative Care Instructions – Temporomandibular Joint (TMJ) Arthrocentesis

BLEEDING

  • You may experience some bleeding from the surgical site. This would include a small amount of oozing and should easily be stopped with direct pressure over the area using a small gauze pad.
  • If there is blood in your ear, a rinse of half water, half vinegar put through a dropper three times a day would be helpful.

PAIN CONTROL

  • Always take medications with food or a glass of water to avoid stomach upset.
  • Take 200 – 600mg of ibuprofen (Motrin, Advil, etc.) as soon as possible and before the numbing wears off. Then, follow up with 500 – 1,000mg of acetaminophen (Tylenol) three hours later. Repeat this cycle every three hours for at least the first day. If you are unable to take ibuprofen or acetaminophen, please inform our staff, and we will create an alternative pain management plan for you.
  • If you find you require additional pain relief, you may substitute acetaminophen with your narcotic pain medication (if prescribed). Always take ibuprofen and choose either acetaminophen or the narcotic pain medication for the second dose.
  • If you find that you feel nauseated after taking the narcotic pain medication, discontinue use. If vomiting occurs, please contact our office for further assistance.
  • Make sure not to exceed 3,200mg of ibuprofen or 4,000mg of acetaminophen within a 24-hour period.
  • You will receive a prescription for pain relief, typically a narcotic analgesic such as Norco or Tylenol with Codeine, either in the ambulatory care unit or before the surgery. Additionally, a non-steroidal anti-inflammatory prescription like Naprosyn, Motrin, Indocin, Toradol, etc., may be provided alongside the narcotic pain medication. It is important to adhere to the prescribed directions when taking these medications.
  • Apply ice to the side of your face or through the dressing, 20 minutes on and 20 minutes off, during the first 72 hours (3 days) after your procedure. If you experience pain or swelling beyond 72 hours, you may switch to heat, following the same, 20 minutes on and 20 minutes off, pattern.
  • Swelling on the side where the surgery occurred may be observed, caused by the release of water from the joint space. This typically resolves within 24-48 hours.

DIET

  • You must follow a full liquid or non-chew diet for two weeks.

WOUND CARE

  • After the procedure, you will have a Jobst headwrap with gauze covering the incision site. It is advised to remove the dressing 6 to 8 hours post-procedure.
  • For the initial 72 hours after your procedure, apply an antibiotic ointment like Neosporin to the surgical site area twice daily.
  • You may shower, as needed, taking care to keep the surgical site dry for the initial two days.

PHYSICAL THERAPY AND EXERCISE

  • If a referral has been arranged for a physical therapist, it is advisable for the first appointment to take place ideally on the second or third day following your procedure.
  • Ideally, physical therapy sessions will be four to five times per week, or as advised by the physical therapist. The therapist may incorporate various modalities such as ice, heat, electrical stimulation, or ultrasound as necessary for pain relief.
  • Post-operative jaw exercises aim to enhance jaw mobility and restore normal function. Perform these exercises gently, avoiding force, to ensure they do not cause excessive pain. Begin these exercises the day after your surgery and continue until your first post-operative follow-up appointment with your surgeon. If any exercise causes discomfort, discontinue them for a brief period before gradually reintroducing them.
  • Begin with five repetitions for each exercise and gradually increase to ten to fifteen repetitions. Complete the entire sequence of exercises four times daily. Refer to the attached form for detailed instructions on the exercises.

SPECIFIC INSTRUCTIONS

  • If you have an occlusal appliance or splint, wear it full time unless instructed otherwise.
  • Follow-up appointments will be scheduled in the second and fourth weeks after your procedure. In case of complications before your initial visit, contact our office promptly.

Prescriptions: Any prescriptions will be sent electronically to your pharmacy. It may take up to 6 hours for your prescriptions to be ready. Please contact our office if it has been more than 6 hours.

Contact Our Office: If you have questions or concerns, please contact our office at (269)323-1527. We have a surgeon on call 24/7. For after-hours calls, our answering service will assist you. Please leave the patient’s name, date of birth, and a callback number. The on-call surgeon will contact you at the earliest opportunity.