TMJ Problems & Surgery

TMJ problems and surgery are controversial.  We hope to be helpful to patients who want information and treatment options.  We respect a patient’s decision to have non-surgical or surgical treatment.  We feel only 10-15% of TMJ problems are surgical issues and use diagnostic radiographs, CT and MRI studies to identify a patient’s condition.

Dr. Cullens uses an orthopedic approach focusing on the condition and position of bone and cartilage.  Dr. Cullens background of mechanical engineering and 15 years of TMJ surgery is the foundation of this approach.  Some providers use a dental approach to TMJ issues and have good outcomes.  We believe that once an orthopedic injury or degenerative condition (arthritis) has damaged a joint the orthopedic approach is appropriate.

We have helped patients with short-term problems with non-surgical techniques and medication.  We do not continue non-surgical techniques beyond 60 days.  We can refer to providers for long-term non-surgical treatment if it has been successful and the patient wishes to continue.

A common situation for surgical patients is the failure of non-surgical techniques, chronic and increasing pain, lost ability to open mouth and/or lost ability to chew.  Many of the surgical patients have decreased quality of life due to chronic pain.  Our goal is to complete the diagnostic tests and present your condition to 10-14 days.  We know you need help and do not delay in our efforts.  You will receive a copy of the results so that a second opinion can be obtained if you or your insurance want one.

Dr. Cullens is FDA approved to purchase and surgically place three (3) prosthetic TMJ systems.  Most patients will not need a Total Joint Replacement of the TMJ but when it is needed it has a dramatic positive outcome for the patient.  The more common procedure is a reposition of displaced cartilage using orthopedic anchors similar to hand or shoulder surgery. 

We provide a new patient the opportunity to discuss outcomes with past patients.  We believe the input from a past patient can be very helpful.  We would ask patients to come for a consult about TMJ surgery with an open mind.  We are not going to push you toward surgery.  We want you to be sure it is right for you.  Our success is because we did the right surgery for the right patient.  Many patients have been told incorrect information from providers who do not provide the surgery.  Providers may be attempting to be helpful but they can’t be accurate if they don’t do the operation.