Short answer: Arthrocentesis is a procedure performed under local anesthesia in which thin needles are inserted into the jaw joint space and the joint is rinsed with a sterile solution. It is usually considered for pain, closed lock and limited mouth opening that have not responded to conservative treatments. The aim is to flush out inflammatory substances and make joint movement easier. Whether you are a candidate is determined by the doctor after a detailed examination and, if needed, imaging.
Imagine your jaw catching at a certain point as you open your mouth, or feeling pain or locking just in front of your ear. Most jaw joint disorders ease with simple measures, but in some cases these measures are not enough. One of the methods that may come up at this stage is arthrocentesis, that is, rinsing the jaw joint with a sterile solution. Commonly known as a "jaw joint injection," this procedure is far more limited than surgery. In this article, we explain what arthrocentesis is, when it is considered and what to expect afterwards.
What is arthrocentesis?
Arthrocentesis is a procedure performed under local anesthesia in which thin needles are inserted into the space of the jaw joint (temporomandibular joint) and the joint is rinsed with a sterile solution. The aim is to remove inflammatory substances and pain-related by-products that have built up in the joint, reduce pressure inside the joint and help the joint surfaces glide more easily.
The jaw joint sits just in front of the ear, where the lower jaw meets the skull. Inside the joint there is a disc that acts as a cushion between the two bone surfaces. When this disc slips out of place, when the joint becomes inflamed or when the quality of the joint fluid deteriorates, complaints such as pain, clicking sounds, limited mouth opening and locking can appear.
During arthrocentesis, lubricating substances such as hyaluronic acid may sometimes be injected into the joint after the rinsing. This is why the procedure is commonly called a "jaw joint injection." The doctor performing the procedure decides whether any substance is needed and which one to use, based on the specifics of the case.
Which joint problems is it used for?
Arthrocentesis is usually considered for jaw joint problems that have not improved despite conservative treatment applied for at least several weeks. The first step is often non-surgical methods; arthrocentesis is a second-line option when these prove insufficient.
The main indications are:
- Closed lock: If the disc has slipped forward and does not return to its place, mouth opening can be markedly restricted. In this situation, arthrocentesis is one of the methods frequently chosen to improve mouth opening.
- Persistent joint pain: For joint-related pain that does not respond to methods such as splints, medication and exercises.
- Joint inflammation and degenerative changes: To relieve symptoms in conditions involving wear and inflammation of the joint surfaces.
- Sudden restriction of mouth opening: For restrictions that appear after a specific event and do not resolve on their own.
Not all jaw pain comes from the joint. For pain originating from the chewing muscles, complaints related to clenching and grinding, or pain originating from the teeth, arthrocentesis may not be an appropriate option. For this reason, a detailed examination is carried out before the procedure, and if necessary, imaging of the joint with magnetic resonance imaging (MRI) or computed tomography is requested.
How is the procedure performed?
Arthrocentesis is performed under local anesthesia by a doctor experienced in oral and maxillofacial surgery and is usually completed in thirty minutes to an hour. In general terms, the procedure follows these steps:
- Preparation: The area in front of the ear is cleaned and marked. Local anesthesia is applied around the joint.
- Placing the needles: Usually two thin needles are placed into the upper joint space. One is for the fluid to flow in, the other for it to flow out.
- Rinsing: Sterile saline or a similar solution is passed through the joint space. Meanwhile, the doctor may gently move the patient's jaw to help open up the joint.
- Additional application: If deemed necessary, a lubricating or anti-inflammatory substance is given into the joint at the end of the rinsing.
- Finishing: The needles are removed and the entry points are covered. Stitches are usually not needed.
Thanks to the anesthesia, the sensation of pain during the procedure is largely blocked; you may feel pressure or fullness. Due to the local anesthetic, temporary numbness of the facial muscles on the same side or slight weakness of the eyelid may occur for a few hours after the procedure. This effect disappears as the anesthesia wears off.
Recovery after the procedure
Most patients can go home the same day after arthrocentesis; recovery usually progresses noticeably within a few days. Mild swelling, tenderness and a feeling of fullness in the treated area are normal during the first days.
During recovery, the following recommendations are usually given:
- Soft diet: In the first days, foods that require little or no chewing are preferred; hard, sticky foods and large bites are avoided.
- Jaw rest: Movements that strain the joint, such as opening the mouth very wide, chewing gum and talking for long periods, are avoided.
- Cold and warm application: Depending on the doctor's advice, cold compresses in the early period and warm compresses afterwards can bring relief.
- Exercises: Simple jaw exercises recommended by the doctor or physiotherapist are done to maintain mouth opening.
- Medication: If necessary, the doctor may recommend pain relievers or anti-inflammatory medication; these should only be used as prescribed by the doctor.
Many patients notice an increase in mouth opening and a decrease in pain shortly after the procedure. However, every patient responds differently; in some people the procedure may need to be repeated or supported by other treatments. If swelling keeps increasing, or if there is fever, a marked change in hearing or facial numbness that does not go away for a long time, you should see a doctor without delay.
Alternative treatments
There are many non-surgical methods that can be used before or together with arthrocentesis for jaw joint disorders, and a significant proportion of cases can be brought under control with these methods. The main ones are:
- Education and habit changes: Simple steps such as not chewing gum, not biting nails or pens, and noticing and stopping daytime teeth clenching can noticeably reduce complaints.
- Occlusal splint (night guard): Especially when clenching and grinding are involved, a custom-made hard splint can help reduce the load on the joint and muscles.
- Physical therapy and exercise: Muscle-relaxing exercises, heat application and physiotherapy methods.
- Medication: Short-term pain relievers or muscle relaxants if the doctor deems them necessary.
- Intramuscular applications: In conditions related to overactivity of the chewing muscles, various injection methods may be considered based on the doctor's assessment.
- Arthroscopy and open surgery: In advanced cases that do not respond to other methods, including arthrocentesis, arthroscopy (examining the joint with a camera) or open surgery may be considered.
The relationship between bite problems and jaw joint complaints is still a scientifically debated topic. For this reason, orthodontic treatment is not considered a standalone treatment for a joint problem, but only as part of a comprehensive plan when the examination shows it is needed. You can find other common questions about the jaw joint and related treatments on our frequently asked questions page.
When should you see a doctor for jaw joint complaints?
If your mouth opening has suddenly become restricted, if your jaw pain has not gone away for several weeks, or if you have marked difficulty while chewing and speaking, an examination is recommended. At our polyclinic in Park Oran Ofis near Panora Mall in Çankaya, jaw joint complaints are evaluated; when necessary, the treatment plan is created together with the relevant specialties.
Frequently asked questions
Is arthrocentesis a painful procedure?
Because the procedure is performed under local anesthesia, what you usually feel during it is pressure or fullness rather than pain. After the anesthesia wears off, there may be tenderness and mild swelling lasting a few days. In most cases, these complaints are controlled with the methods the doctor recommends.
How many times can arthrocentesis be performed?
For many patients, a single procedure may be enough. In some cases, when the response is insufficient or complaints recur, the procedure can be repeated at certain intervals. The doctor decides whether a repeat is needed based on the examination findings.
When can I return to work after arthrocentesis?
Most people with desk jobs can return to their daily work one or two days after the procedure. In jobs that require talking for long periods, care should be taken in the first days to avoid straining the jaw. The doctor who performs the procedure determines the individual time frame.
Does a clicking jaw joint require treatment on its own?
A clicking sound heard only when opening the mouth, without pain or restriction, often does not require invasive treatment on its own. However, if the sound is accompanied by pain, locking or reduced mouth opening, an examination is recommended.
