Temporomandibular joint (TMJ) dislocation occurs when the jaw condyle slips forward, displacing its functional position inside the glenoid fossa and posterior articular eminence. This causes acute orofacial discomfort by stretching the facial ligaments and muscles.
Dislocations of the TMJ can be either acute or recurring, with each type having distinct causes.
Mandibular dislocation typically develops in individuals with a previous history of the condition. Typically, it happens when the mouth is wide open (e.g., biting into a large sandwich during a wide yawn or a dental procedure).
The inability to close one’s mouth might be frightening and unpleasant, but it is readily treatable with the assistance of a dentist or dental professional. If you believe you may have dislocated your jaw, the following information is essential.
What is Jaw Dislocation?
Dislocation of the lower jaw occurs when it shifts out of its usual position. Typically, it heals well, although it may create future complications. If you have dislocated your jaw, get medical attention immediately. Never attempt to reposition a dislocation yourself.
Temporomandibular joints are the joints directly in front of each ear that link the jaw’s bottom portion to the skull (TMJ joints). The lower portion of the jaw becomes dislocated when it is dragged away from one or both TMJ joints. Even if it returns, it might still cause pain and other complications.
These are the symptoms of a dislocated jaw:
- inability to close the mouth
- an overbite or underbite
- facial or jaw discomfort
- misalignment of the lower jaw with the upper jaw
- stiffness and trouble moving the jaw.
A dislocated jaw can cause bleeding or breathing difficulties and must be addressed immediately. Restricting jaw movement as much as possible is essential until you can consult a medical professional.
Possible Causes
Sudden Impact
Anterior TMJ dislocation commonly follows the extreme opening of the mouth (such as while eating, yawning, laughing, singing, vomiting, or dental treatment) and less frequently following trauma. Dislocation can also be caused by dystonic medication responses, convulsions, or tetanus infection. In addition, iatrogenic dislocation during anesthesia induction and upper endoscopy has been described. Symmetric mandibular dislocation is most common, but unilateral dislocation with the jaw deviating to the opposite side can also occur.
Superior and posterior dislocations of the TMJ are very rare and usually associated with high-energy trauma. Superior dislocations occur in association with mandibular fossa fractures. Posterior dislocations may be associated with disruption of the external auditory canal or fracture of the temporal plate.
Patients prone to mandibular dislocation include those with an anatomic mismatch between the fossa and articular eminence, weakness of the capsule and the temporomandibular ligaments (e.g., patients with Ehlers-Danlos or Marfan syndrome), and torn ligaments. Patients who have had one episode of dislocation are predisposed to recurrence.
Mortality/Morbidity
Rarely is there significant morbidity associated with isolated mandibular dislocations. TMJ dislocations are frequently accompanied by mandible, maxillofacial, and orbital bone fractures.
Chronic recurrent dislocations, ischemic necrosis of the condylar head, traumatic injury to the articular disk, and mandibular osteomyelitis may be linked with mandibular dislocations. Chronic dislocations that go untreated might result in irreversible malocclusion. In situations of mandibular dislocation, mortality is typically caused by concomitant severe traumatic injuries and not by the dislocation itself.
How to Deal with TMJ Dislocation
Jaw dislocation Self Care
Immediately seek medical assistance if you suspect you have a dislocated jaw. On the drive to the hospital, use your hand or a loose bandage to hold the jaw in place. If you vomit, you should be able to remove the bandage without difficulty.
After the jaw has been repositioned, you may alleviate pain with medicines and a cold pack for 10 to 20 minutes every two to three hours. Consume soft meals to reduce the amount of jaw movement required to chew.
If you have TMD, you should avoid gum chewing and prevent clenching your jaw or opening your mouth too widely. You can wear a mouthguard at night to avoid teeth grinding and practice relaxation techniques to reduce tension. Occasionally, activities that strengthen the jaw might also be beneficial.
Procedures
At presentation, a professional should undertake a complete evaluation of the patient’s airway, breathing, and circulation (ABCs). If a comprehensive history, physical examination, and adequate imaging investigation indicate an isolated mandibular dislocation, a judgment must be taken regarding the appropriateness of closed reduction in the emergency department.
An oral and maxillofacial surgeon visit is recommended for individuals with dislocations linked with fractures and persistent dislocations. Many of these patients require an open reduction in the operating room due to the severity, displacement, and damage to related structures.
The muscles around the TMJ must relax for the condyle to resume its natural position. Some patients require an injection of local anesthetic in the jaw joint for this procedure. This may be followed with a muscle relaxant comparable to diazepam (Valium) to halt the spasms. A muscle relaxant is administered intravenously (into a vein in the arm).
A physician or dentist can reposition the condyle if the jaw muscles are sufficiently relaxed. To release the condyle, they will pull the lower jaw downward and tilt the chin forward. The ball is then guided back into place.
Rarely, the dislocation may need to be repaired in the operating room under general anesthesia. After the dislocation has been repaired, it may be necessary to wire the jaws shut or place elastics between the upper and lower teeth to restrict jaw movement.
After surgery, you should have a soft or liquid diet for many weeks. This decreases tension and jaw movement. Avoid chewy meals, including tough meats, carrots, hard sweets, and ice cubes. Also, avoid opening your mouth too widely.
Prevention
TMJ dislocation can persist in individuals with lax TMJ ligaments. Dentists recommend that individuals restrict the range of motion of their jaws to prevent this from occurring too often. When yawning, a person with this condition should hold a hand under the chin to prevent the mouth from expanding too far.
Surgical procedures that are less invasive can help prevent the condition from recurring. Some individuals have their mouths permanently wired shut. This causes the ligaments to become more rigid and limits their mobility. Talk to your dentist or dental professional about conservative surgical procedures that can help prevent the problem from recurring if recurrent dislocation remains a major issue. Rarely do some individuals have their jaws wired shut for a period of time, which causes their ligaments to tighten and limits their mobility.
With the assistance of a dentist or dental professional, your displaced jaw may likely be repositioned without difficulty. Your best chance is to remain calm and pay close attention to your jaw movement patterns. With a little more attention, your grin will be literally back on track.
In some instances, surgery may be required. An example of a procedure is eminectomy. It eliminates the articular prominence to prevent the joint’s ball from being caught in front of it.
Frequently Asked Questions
Is a Dislocated Jaw Serious?
The unhinging of the jaw joint is known as a dislocation. A broken, fractured, or dislocated jaw can cause extensive damage to the area’s nerves, tendons, and muscles and can also affect your ability to speak or eat. If you experience a dislocated jaw, it is important to seek medical attention immediately. Treatment typically involves surgery to repair the damage done to the bones and tissues in the area. Depending on the severity of your injury, you may also require physical therapy or speech therapy following treatment.
What are the Risk Factors for a Dislocated Jaw?
The most common risk factor for a dislocated jaw is participating in sports, especially contact sports or motorsports. Other risk factors include: being male, having a family history of dislocated jaws, and being obese.
Dislocated jaws can be extremely painful and may require surgery to correct. If you experience any of the following symptoms, please seek medical attention immediately:
- Pain in the jaw that is not relieved by taking pain medication.
- Inability to open the mouth more than a few inches.
- Facial swelling.
- Bruising around the eyes or lips.
Why is the Jaw Misaligned All of a Sudden?
While there are many reasons why your jaw hurts, it is often linked to stress, trauma (injury or blow to the face), or dental misalignment. TMJ can cause pain and discomfort in the jaw joint and surrounding muscles, headaches, ringing in the ears, and problems with opening and closing the mouth. If left untreated, TMJ can lead to more serious problems, such as arthritis of the jaw joint. TMJ treatment may include rest, ice packs, over-the-counter or prescription medications, physical therapy, or surgery.
How Do You Cure Joint Dislocation?
The standard treatment for acute TMJ dislocation is the reduction of the mandibular condyle back into the glenoid fossa. Reduction is performed by grasping and displacing the condyle anteriorly while applying traction to the head. This can be achieved with or without general anesthesia. Open reduction and internal fixation are indicated if reduction cannot be accomplished.
Read more: Can You Treat TMJ Disorder With Injections?
Consult Garza DDS to Learn More About What to Do about TMJ Dislocation
If you believe that you have dislocated your TMJ, visit your doctor, dentist, or hospital emergency room as soon as possible. The joint must be back in place quickly to avoid long-term damage. We hope this article has been helpful and informative. Please contact our office today for more information about TMJ dislocation or a consultation with Dr. Garza.