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Post-Operative Instructions:
TMJ Arthroscopy

After TMJ Arthroscopy

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. Acute pain management should always start with over-the-counter pain medications, such as acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). If your surgeon approves these medications for you, you should take them as directed on the pill bottles, or by your surgeon. If you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Precede each pain pill with a small amount of food, and chances for nausea will be reduced.

The effects of pain medications vary widely among individuals. For severe pain, you may take your prescription opioid (narcotic). Do not take more opioid pills, or more often, than prescribed by your surgeon. If prescribed, Vicodin® / Norco® may be taken every 4-6 hours for pain. DO NOT USE TYLENOL. If you notice that the pain medication is not providing comfort for long enough, alternate the Vicodin / Norco and Ibuprofen throughout the day (ex: take 1 Vicodin, then 2 hours later, take ibuprofen…2 hours later another Vicodin / Norco). If you are unable to achieve a comfortable state, please call us for further advice. Do not drive or drink alcohol while you are taking opioids. Do not use opioids with benzodiazepines, sleeping medications, or other depressants. If you have any questions, ask your surgeon or any pharmacist before using these medications together as they can increase your risk of an accidental overdose.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling in front of the ear and sides of the face is very common. This is the body's normal reaction to surgery and a normal sign of healing. The swelling will not become apparent until 1-2 days following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Baggies filled with ice, or ice packs should be applied to the side of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of gentle moist heat to the sides of the face is beneficial in reducing the swelling and stiffness. Sleep with your head elevated on two pillows for the first week.

Wound Care

There will be two small stab-like incisions with one to two sutures each. Once the head wrap has been removed on the second postoperative day, clean the incision with a 50% peroxide and water mixture and apply Neosporin ointment. The sutures will be removed one week after surgery.

Exercises

Your surgeon will give you personal instructions regarding the use of a TheraBite® device or other techniques for exercise. It is imperative that you initiate the mouth opening exercises following your procedure as soon as possible.

Diet

Drink plenty of fluid and eat nutritious soft food on the days following your procedure. You can eat normally as soon as you are comfortable. It may only be comfortable to eat soft or pureed food for a few days following surgery, however, push yourself to drink plenty of fluids to avoid dehydration.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

Give us a call with any questions or concerns at (805) 648-5121.

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