Alternatives to TMJ Jaw Surgery in St. Louis, MO

Explore non-surgical TMJ care before you make a decision that can’t be undone.

Being told you might need jaw surgery for TMJ can feel overwhelming. You may be worried about the procedure, the recovery, the cost, or all three. Before you decide, it helps to know that surgery is not meant to be the first step, and that there may be alternatives to jaw surgery worth exploring first.

According to the National Institute of Dental and Craniofacial Research (NIDCR), many jaw joint and muscle problems are temporary. Experts recommend starting with conservative care and avoiding treatments that permanently change your jaw joints, teeth, or bite.

At Gateway Center for Sleep Apnea & TMJ Therapy, Dr. Kevin Postol takes a conservative, minimally invasive approach to TMJ therapy whenever possible. Because our practice focuses on non-surgical TMJ care, your visit is about one thing: understanding what is causing your jaw pain and finding the least invasive path to relief.

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When Is TMJ Surgery Needed?

Surgery can be the right answer for some people. According to NIDCR, surgery should only be considered when:

There is destruction of the joint that cannot be fixed with other procedures, or
You have severe symptoms, such as pain or difficulty opening your mouth, despite trying other treatments.

If surgery has come up, you may hear about procedures like these:

Arthrocentesis: a needle is used to push liquid into the jaw joint.
Arthroscopy: an instrument with a tiny video camera is inserted into the jaw joint.
Open joint surgery: the joint is reached through an incision next to the ear. NIDCR notes there are no long-term research studies on its safety or on how well it relieves symptoms.
TMJ implants: artificial devices that replace part or all of the jaw joint.

NIDCR advises that before you consider an irreversible treatment like surgery or a TMJ implant, you talk through the potential benefits, risks, and alternatives with your doctor or dentist. If you haven’t tried conservative care yet, or haven’t had a thorough evaluation of what is causing your symptoms, that conversation is the right place to start.

Non-Surgical TMJ Treatment Options to Explore First

Every treatment plan begins with a comprehensive consultation and evaluation to find the root cause of your symptoms. From there, Dr. Postol tailors your plan, which may combine several of these TMJ alternative treatments. You can read more about each one on our TMJ treatment page.

Custom Oral Splints and TMJ Orthotics

Custom-fitted oral appliances, sometimes called bite guards, are designed to reposition your jaw. A daytime splint fits discreetly over your lower teeth, and a nighttime splint fits your upper teeth to protect against grinding while you sleep. NIDCR describes these appliances as ones that do not change your teeth or bite.

Platelet-Rich Fibrin (PRF) Therapy

PRF uses healing components from your own body. A small blood sample is drawn from your arm, spun in a centrifuge to concentrate the platelets and growth factors, and then injected into the affected jaw joint or surrounding tissues. PRF is designed to support tissue repair while reducing inflammation. Learn more about PRF therapy for TMJ.

Trigger Point Injections and Botox

If your jaw muscles are tense or in spasm, trigger point injections deliver medication directly into the muscle to ease pain and help your jaw relax. Botox can temporarily calm overactive jaw muscles to reduce clenching and grinding.

Physical Therapy, Heat Therapy and Medications

In more complex cases, Dr. Postol may refer you to a physical therapist experienced in orofacial pain for guided exercises, posture training and manual techniques. In-office moist heat therapy and, when appropriate, anti-inflammatory pain relievers or muscle relaxants can also be part of your treatment plan.

At-Home Care

A few simple habits can support your treatment: eating soft foods, applying heat or cold to your jaw, doing gentle jaw stretches, and cutting back on habits like gum chewing or clenching. These match the first steps NIDCR recommends for early jaw discomfort.

What a great experience! EVERY ONE was so friendly and kind. It’s so wonderful that Dr. Postol takes real one on one time for each patient. It makes you feel comfortable and heard. I appreciated that so much!

Sasha R.

TMJ Surgery vs. Non-Surgical Care at a Glance

	TMJ surgery	Non-surgical care at Gateway
When it’s used	Only when the joint is damaged beyond repair or severe symptoms continue despite other treatments	Where experts recommend starting
Changes to your jaw	Makes permanent changes to your joint	Oral appliances do not change your teeth or bite
Who provides it	An oral and maxillofacial surgeon	Dr. Postol, in our Twin Oaks office
Operating room or hospital fees	May apply, depending on the procedure	None
If it doesn’t help	Surgical changes can’t be undone	Surgery remains an option to discuss with a surgeon

Trying conservative care as an alternative to jaw surgery doesn’t close the door on surgery later. If your symptoms don’t improve, you can still talk with a surgeon, and you’ll go into that conversation knowing what you’ve already tried.

Considering a Second Opinion Before TMJ Surgery?

NIDCR recommends getting second opinions from qualified medical or dental specialists before having surgery or another irreversible procedure for TMJ. If you’ve been told you may need jaw surgery, a consultation with Dr. Postol can help you understand whether non-surgical care is worth trying first. If you have imaging or reports from another provider, bring them with you.

How Dr. Postol Evaluates Your Jaw

Dr. Postol uses a comprehensive diagnostic process, including a physical examination, imaging, and bite analysis, to find out whether your pain comes from muscle fatigue, cartilage wear, or a structural imbalance. At your consultation, he will:

Talk with you about your symptoms and any treatment you’ve already tried
Assess your jaw movement, bite alignment, and overall oral health
Walk you through your options, including what to try first

Dr. Postol has cared for patients in the St. Louis area since opening his practice in 1995, and he was named one of St. Louis Magazine’s Top Doctors for 2025. Meet Dr. Postol.

Questions to Ask Before Agreeing to TMJ Surgery

NIDCR encourages you to talk through the benefits, risks, and alternatives before any irreversible treatment. These questions can help you prepare for that conversation:

What is causing my symptoms, and how was that diagnosed?
Which procedure are you recommending, and can it be reversed?
What are the potential benefits and risks for me?
Which non-surgical treatments should I try first, and for how long?
What happens if surgery doesn’t relieve my pain?
What will recovery involve, and how much time will I need off work?
What will it cost, and how much will my insurance cover? Can I get that in writing?

Frequently Asked Questions

Do I need TMJ surgery?

Not necessarily. Surgery is meant for specific situations, and NIDCR notes that signs and symptoms of TMJ disorders go away without treatment for many people. The best way to know where you stand is a thorough evaluation of what is causing your symptoms.

When is TMJ surgery needed?

According to NIDCR, surgery should only be considered when there is destruction of the joint that cannot be fixed with other procedures, or when severe symptoms, such as pain or difficulty opening your mouth, continue despite other treatments.

Can TMJ be treated without surgery?

Yes, for many people. Non-surgical options include custom oral splints and TMJ orthotics, PRF therapy, trigger point injections, Botox, physical therapy, and at-home care. Dr. Postol will recommend a plan based on what is causing your symptoms.

How much does TMJ surgery cost?

The cost depends on the procedure, the facility, anesthesia, and your insurance coverage, so ask your surgeon and your insurance company for a written estimate. Non-surgical care in our office does not involve operating room or hospital fees, and our team can walk you through the cost of your treatment plan at your consultation.

Is TMJ surgery covered by insurance?

Coverage varies from plan to plan. Call your insurance company, ask whether TMJ surgery and non-surgical TMJ treatment are covered, and ask for the details in writing.

What if non-surgical treatment doesn’t help?

Surgery remains an option. If your symptoms don’t improve, Dr. Postol will talk with you about next steps, including whether it’s time to see a surgeon.

Do you perform TMJ surgery?

No. Our practice focuses on non-surgical TMJ care, so your consultation is about finding the least invasive path to relief.

Schedule a TMJ Consultation in the St. Louis Area

You don’t have to live with jaw pain, and you don’t have to make a decision about surgery on your own. Schedule a consultation with Dr. Postol to learn what is causing your symptoms and which non-surgical options may help.

Our office is at 1338 Big Bend Road in Twin Oaks, and we welcome patients from across the St. Louis area, including Ballwin, Manchester, Chesterfield, Grover and Ellisville.

Schedule a TMJ Consultation