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MANDIBULAR DISLOCATION

(DISLOCATION OF JAW, NOS)
Mandibular Dislocation

WHAT YOU NEED TO KNOW:

What is a mandibular dislocation? A mandibular dislocation is the separation of your mandible (lower jaw) from your temporomandibular joint (TMJ). When this happens, your lower jaw does not go back in place on its own.

What causes a mandibular dislocation?

  • Opening your mouth too wide: This may happen when you laugh, yawn, sneeze, take large bites, or vomit. Some open mouth or dental procedures may weaken the muscles around your TMJ and lead to dislocation.

  • Tooth problems: Teeth that are missing, worn, or not lined up correctly can prevent your jaw from working correctly.

  • Trauma: Mandibular dislocation may be caused by a blow to your chin while your mouth is open. This occurs most often in car, motorcycle, or bicycle accidents.

  • Unstable joint: This may be caused if your jaw muscles are weak or become too tight. Seizures and certain medicines may cause weak jaw muscles.

What are the signs and symptoms of a mandibular dislocation?

  • Dimpling in front of your ear

  • Drooling

  • Inability to open or close your mouth, or move your jaw from side to side

  • Pain and swelling in front of your ear

  • Teeth that do not line up

  • Trouble speaking, eating, or drinking

  • Unequal sides of your face

How is a mandibular dislocation diagnosed? Your healthcare provider will examine your jaw and face. He will ask about your other medical conditions and medicines you are taking. Tell your healthcare provider if your jawbone had been dislocated before. He will look for signs of a mandibular dislocation or other problems, such as a broken bone. You may also have any of the following:

  • X-ray: X-ray pictures will help your healthcare provider see your TMJ and check for swelling or broken bones.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your jaw. The pictures may show if your jaw is dislocated. You may be given a dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

How is a mandibular dislocation treated?

  • Medicines:
    • Anesthesia: This medicine puts you to sleep so you are comfortable while your jawbone is put in place. It may be a shot of numbing medicine or may be given through an IV. It may also be given as a gas that you breathe while you are asleep. Your healthcare provider will work with you to decide which anesthesia is best for you.

    • Muscle relaxer: These help to relax the muscles of your jaw.

    • Sedative: This medicine is given to help you stay calm and relaxed.

    • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask your healthcare provider which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

    • Sclerosing agent: This medicine is given as a shot into your TMJ. This helps tighten your jaw and prevents it from moving too much. You may need a fixation device after the use of a sclerosing agent.

  • Fixation devices: You may have wires or elastic bands to prevent you from moving your jaw.

  • Manual reduction: This is a procedure to put your jaw back into its normal position. You may need a fixation device after your manual reduction.

  • Surgery: If other treatments have not worked, you may need surgery. Surgery may be done to tighten the ligaments around your TMJ and make it more stable.

How can I manage my symptoms?

  • Support your jaw: For several days after your dislocation, try not to open your mouth widely, such as when you yawn. If you do, support your jaw. If your jaw has dislocated before, you may need a chin strap or bandage to help keep it from happening again.

  • Eat soft foods: You may need to eat only soft foods for some time after your jaw is put back in place. Soft foods include applesauce, baby food, bananas, cooked cereal, cottage cheese, eggs, gelatin, pudding, and yogurt.

  • Use ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it over your TMJ area for 15 to 20 minutes every hour or as directed.

  • Go to physical therapy: You may need physical therapy if you have had multiple jaw dislocations. A physical therapist will work with you to help make the muscles in your jaw stronger. This may help to stop your jawbone from dislocating again.

What are the risks of mandibular dislocation?

  • Surgery puts you at risk of dental or gum injuries, and stretched jaw ligaments and muscles. You may have pain, temporary nerve problems, ankylosis (joint stiffening), or bleeding in the jaw joint. Your top and bottom teeth may not line up correctly. Even after treatment, your jaw may dislocate again.

  • Without treatment, your mandibular dislocation may lead to further problems. Your pain may become worse and you may have trouble eating and talking. Scar tissue may form around your dislocated jawbone, which makes putting your jaw back in place more difficult. You may have facial nerve problems, hearing loss, and cranial (skull) injuries from the dislocated bone. If the dislocated bone goes into your skull, you may have life-threatening damage.

When should I contact my healthcare provider?

  • Your symptoms do not get better, or get worse.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

  • Your jawbone moves out of place again.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.