TMJ Surgery in San Jose, CA
 TMJ surgery in San Jose, CA is a treatment option for temporomandibular joint disorders when conservative care has not solved the problem.
At South Valley Oral and Facial Surgery, we approach jaw joint surgery as a final step, not a first one. Most patients with TMJ pain do well with conservative TMJ treatment including occlusal splints, physical therapy, anti-inflammatory medication, and changes to clenching and grinding habits. Surgery enters the conversation only when months of consistent conservative care have not delivered relief, when imaging shows real structural damage in the joint, when the jaw locks or dislocates repeatedly, or when functional limitation has become severe enough to disrupt eating and daily life.
Our surgeons see patients from across San Jose, Gilroy, and Los Banos who arrive after years of conservative effort. Some are candidates for surgery. Many are not, and we will tell you that directly if it is true for you. Either way, you will leave the consultation with a clearer read of what your joint actually shows on imaging and what your realistic next steps are.
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When TMJ Surgery Is Actually Considered
 TMJ surgery is not the right first move for the vast majority of patients with jaw pain. The temporomandibular joint is a small, complex structure where the lower jaw connects to the skull, and most pain in that area comes from muscle tension, bruxism, joint inflammation, or a displaced disc that we can often manage without ever opening the joint. Conservative care that includes splint therapy, physical therapy, anti-inflammatory medication, and behavior change resolves symptoms for the majority of patients we evaluate, and our existing approach to bruxism and TMJ problems is to exhaust those options first.
Surgery becomes a reasonable consideration in a narrower set of cases. Imaging that shows clear structural damage in the joint (severe disc displacement that will not reduce, advanced arthritic changes, bony abnormalities) is one trigger. Chronic locking and dislocation, where the jaw catches open or repeatedly slips out of place, is another. So is severe functional limitation that has not improved after months of consistent conservative treatment with a clinician focused on TMJ care.
Muscle pain on its own usually does not respond well to surgery. If your symptoms are primarily tightness, headaches, and soreness with no clear joint pathology on imaging, we will likely steer you back toward conservative options before considering a surgical path.
Signs that a surgical evaluation may be appropriate:
- Persistent Joint Locking – The jaw repeatedly catches, locks open, or locks shut despite ongoing conservative treatment.
- Chronic Dislocation – The jaw slips out of the joint and requires manual reduction.
- Imaging-Confirmed Structural Damage – CT, CBCT, or MRI imaging shows real anatomic changes such as disc displacement, bone changes, or joint degeneration.
- Severe Functional Limitation – Mouth opening is significantly restricted, chewing is compromised, or speech is affected even after months of conservative care.
- Failed Multidisciplinary Conservative Care – You have completed several months of splint therapy, physical therapy, medication, and habit changes without meaningful improvement.
If none of these apply, surgery is probably not the right next step, and we will say so at the consultation.
Surgical Options for TMJ Disorders
TMJ surgery is not one procedure. It is a range of techniques chosen based on what the imaging shows and what specifically is wrong with the joint. The least invasive option that addresses your problem is always the right starting point.
Arthrocentesis
Arthrocentesis is the least invasive of the surgical options. We place small needles into the joint space, flush the joint with sterile fluid, and sometimes inject anti-inflammatory medication. The goal is to break up inflammation, wash out cellular debris, and release pressure on a displaced disc. Many patients with acute joint inflammation or disc displacement that has not responded to splints find meaningful relief after arthrocentesis without ever needing a more invasive procedure.
Arthroscopy
Arthroscopy uses a small camera and miniature instruments inserted through tiny incisions near the joint. The surgeon sees directly into the joint, clears adhesions, repositions a displaced disc, and addresses inflamed tissue. Recovery is faster than open joint surgery, and most patients return to normal activity within a couple of weeks. We reserve arthroscopy for cases where arthrocentesis is unlikely to be enough but the joint anatomy does not require fully opening the area.
Open Joint Surgery
Open joint surgery, sometimes called arthrotomy, is used when there is structural damage that cannot be addressed through smaller approaches. This includes severe disc damage, scar tissue that cannot be cleared arthroscopically, or fractures and bony changes that require direct repair. The surgeon makes a larger incision to access the joint and reconstruct or repair what the imaging identifies. Recovery is longer and the procedure is more involved, but it can resolve problems that smaller approaches cannot.
Total Joint Replacement
Total joint replacement is reserved for the most severe end-stage cases where the joint itself can no longer function. The damaged joint components are replaced with a custom prosthetic. This is a major procedure with a long recovery, and it is appropriate only for a small subset of patients with advanced joint destruction. Most TMJ patients will never need this option, and we only discuss it when imaging genuinely supports it.
Your TMJ Surgical Team in San Jose
 Dr. Joseph McMurray, DMD, MBA, FACOMS, is a board-certified oral and maxillofacial surgeon with more than 35 years of surgical experience, including 11 years with the U.S. Navy as fleet oral surgeon aboard the USS Nimitz and as clinical department head at U.S. Naval Hospital in Naples, Italy. His full bio covers the training and operational depth that shape how he reads a TMJ case, including knowing when surgery is the right move and when it is not.
Dr. Arian Chehrehsa, DDS, ABOMS, NDBA, is dual board-certified in both Oral and Maxillofacial Surgery and Anesthesiology. That second board matters for TMJ surgery specifically: the same surgeon who plans the joint procedure also plans the anesthesia, which gives us flexibility in tailoring sedation to each procedure and to each patient's medical history. More on Dr. Chehrehsa's bio.
For the most complex TMJ cases, our surgeons work in coordination with regional TMJ specialists whose practice focuses on joint pathology. When a case warrants a second opinion or a specialized approach we do not deliver in-house, we will say so and refer accordingly rather than push you toward a procedure we are not best positioned to perform.
What to Expect During TMJ Surgery
TMJ surgery is planned around your specific anatomy and the specific problem the imaging identifies. The general arc looks like this.
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Comprehensive Consultation – We review your history, prior conservative treatment, current symptoms, and any imaging you bring with you. If you have not had advanced imaging yet, we arrange a CBCT or MRI as the case warrants.
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Joint-Specific Diagnostic Imaging – Plain X-rays do not show TMJ disc position or soft tissue. We rely on CBCT for bony anatomy and MRI for the disc and soft tissue. The imaging drives the surgical plan.
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Surgical Planning and Anesthesia Discussion – We walk you through the recommended procedure, what it will accomplish, what it will not, and what a realistic outcome looks like. With Dr. Chehrehsa's anesthesiology background, we tailor sedation to your procedure and medical history rather than handing off the anesthesia plan to a separate team.
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Day of Surgery – We typically perform arthrocentesis under IV sedation or general anesthesia sedation depending on the case. Arthroscopy and open joint surgery generally use general anesthesia. You are monitored throughout, and most procedures take less time than patients expect.
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Initial Recovery – Soft diet, anti-inflammatory medication, and rest for the first several days. Swelling and stiffness are normal and peak in the first 48 to 72 hours. Most patients return to non-physical work within a few days after arthrocentesis or arthroscopy, and longer after open joint procedures.
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Follow-Up and Continued Care – We see you back at scheduled intervals to monitor healing. Physical therapy is often part of the recovery plan, and continued use of a splint may be appropriate to protect the joint while it heals. |
Benefits of TMJ Surgery for the Right Patient
For patients who genuinely meet the surgical criteria, the right procedure can change what daily life feels like. The point is not that surgery is universally better than conservative care, but that for the narrow group of patients who actually need it, conservative care alone is leaving real problems unsolved.
Restored Range of Motion
Patients whose mouth opening has been progressively limited by disc displacement or arthritic changes often regain meaningful jaw range after surgery. We measure your baseline opening at the consultation and track it through recovery, so the improvement is documented in numbers rather than estimated. Eating without measuring every bite and yawning without locking are not small things when you have lost them.
Reduction in Chronic Joint Pain
When the source of the pain is genuinely in the joint structure, arthrocentesis or arthroscopy can break the cycle of inflammation and disc impingement that conservative care has not resolved. The candidates we typically see at our consultations have already completed splint therapy and physical therapy with imaging that confirms structural joint pathology, which is what makes surgery meaningfully effective for them rather than another step that does not solve the problem.
Resolution of Locking and Dislocation
Chronic locking and dislocation are functionally limiting and often frightening. Surgery directed at the specific anatomic cause typically stops these episodes outright in patients who are good candidates. Our consultations map your lock pattern against the imaging so the surgical plan addresses what is actually causing the episodes, rather than treating the joint generically.
Better Joint Function Long Term
Earlier intervention in cases of progressive joint damage often preserves more of the original anatomy. Waiting until the joint is destroyed limits the available surgical options and can push patients toward more involved procedures than they would have needed earlier. Some TMJ cases overlap with bite alignment issues that may also warrant orthognathic jaw surgery evaluation, which our practice handles in-house alongside TMJ work.
Why Patients Choose Our Practice for TMJ Surgery
The most useful thing we can offer a patient considering TMJ surgery is an honest read of their case. Our practice handles the full scope of oral and maxillofacial surgery, which means TMJ work sits inside a broader surgical practice that also covers orthognathic jaw surgery, facial trauma, and complex extraction work. Surgeons who handle that range every week have a different feel for what a TMJ case actually warrants compared to a clinician who only treats TMJ conservatively.
Dr. Chehrehsa's dual board certification in oral and maxillofacial surgery and anesthesiology is unusual and matters operationally. The same surgeon who plans your joint procedure also plans your anesthesia, which removes the handoff that exists at most surgical offices. For patients with complex medical histories or anxiety about sedation, that is the difference between a one-team plan and a two-team coordination problem.
We also see enough TMJ pathology across our three Bay Area office locations to recognize when a case does not actually need surgery. That negative answer is often the most valuable part of the consultation. You will not be pushed toward a procedure we do not believe is warranted, and if your case is genuinely outside our wheelhouse, we will say so and refer to a specialist who can serve you better.
TMJ Surgery Cost and Financing
Cost matters, and we will be straight with you about it. TMJ surgery cost depends on the specific procedure (arthrocentesis is the least expensive, open joint and total joint replacement are the most), the anesthesia involved, the facility, and any imaging or follow-up care that surrounds the procedure. A meaningful number is impossible to quote on a service page because the right number depends on what your imaging shows and what procedure your case actually warrants.
Insurance is more often involved with TMJ surgery than with conservative TMJ care. Medical insurance, rather than dental insurance, typically handles the surgical portion when the diagnosis and surgical indication are documented. Coverage varies significantly by plan, and we help patients understand what to expect once we know the carrier and the proposed procedure. More on our insurance and financing options, including CareCredit for any patient portion that remains after insurance.
A consultation gives us what we need to put a real number in front of you. If you bring prior imaging, even better. We use that consultation to confirm whether surgery is the right move at all, and if it is, to map out the procedure, anesthesia, and financial side together.
Schedule Your TMJ Surgical Consultation
If conservative TMJ care has not solved your problem and you are wondering whether surgery is the right next step, bring your history and any imaging to a consultation. Call us at 408-479-9449 or request an appointment online. We're at 5595 Winfield Blvd Suite 202 in San Jose, CA. You can find directions and office details for our San Jose office.
Frequently Asked Questions
Is TMJ surgery really necessary, or can I keep trying conservative treatment?
For most patients we see, the answer is keep trying conservative care, especially if you have not completed a full multidisciplinary trial of splint therapy, physical therapy, and habit change. Surgery becomes reasonable to consider when imaging shows structural damage, when the jaw locks or dislocates repeatedly, or when months of consistent conservative care have not delivered meaningful relief. Our consultation will tell you which group you are in and may recommend further conservative TMJ care before any surgical discussion.
How long is recovery from TMJ surgery?
Recovery scales with the procedure. Arthrocentesis often allows return to non-physical work within a few days, with residual stiffness resolving over a couple of weeks. Arthroscopy typically requires about two weeks before resuming most normal activity. Open joint surgery is more involved, with the bulk of healing taking 6 to 8 weeks and full joint adaptation continuing for several months. Total joint replacement has the longest curve and is reserved for end-stage cases.
Will TMJ surgery eliminate all of my jaw pain?
Often, yes, when the pain source is genuinely in the joint structure and the surgery addresses what the imaging shows. When part of the pain comes from muscle tension or bruxism alongside joint pathology, the surgery resolves the joint component, but ongoing muscle care (continued splint use, physical therapy, stress reduction) is usually still part of the long-term picture.
What kind of anesthesia is used for TMJ surgery?
Arthrocentesis is sometimes performed under local anesthesia with IV sedation, while arthroscopy and open joint surgery generally use general anesthesia. The anesthesia choice depends on the complexity of the procedure and your medical history. Because Dr. Chehrehsa is board-certified in both oral and maxillofacial surgery and anesthesiology, our general anesthesia and sedation plan is built in-house alongside the surgical plan rather than coordinated through an outside team.
Does medical or dental insurance cover TMJ surgery?
Medical insurance is more often the payer than dental insurance for the surgical portion, but coverage varies by plan and depends heavily on how the diagnosis and surgical indication are documented. We verify benefits during scheduling rather than asking you to guess from a summary, and our insurance and financing options cover what we accept and the financing path for any out-of-pocket portion.
How long should my pain be around before surgery becomes reasonable?
The trigger for considering surgery is what your joint actually shows on imaging and how much functional limitation you have, not how many months you have been hurting. Some patients manage symptoms for years before structural damage develops to a degree that surgery would help. Others have an acute injury or dislocation pattern where surgical evaluation makes sense within weeks.
What if my case turns out to be too complex for your practice?
We refer. Our surgeons handle a broad range of TMJ work, but the most complex joint pathology and reconstructive cases are sometimes better served by clinicians whose practice is focused specifically on those procedures. If your case warrants that kind of referral, we will tell you and connect you with a regional specialist rather than push the case toward a procedure we are not best positioned to deliver.
Can I have surgery at any of your three offices?
Consultations and follow-up care happen at any of our three Bay Area office locations across San Jose, Gilroy, and Los Banos, depending on what is convenient for you. Surgery itself is scheduled at the location best equipped for the specific procedure and anesthesia plan. We will confirm the surgical location at your consultation. |
