From the Guidelines
To reduce a dislocated jaw, it is crucial to seek immediate medical attention from a healthcare professional, as they can perform the reduction procedure safely and effectively, minimizing the risk of complications and promoting optimal recovery 1.
Key Considerations
When medical help is unavailable and the situation is urgent, the following steps can be taken:
- The person with the dislocated jaw should sit in a low chair with their head supported.
- The helper should stand in front, place their thumbs on the person's lower molars (wrapped in gauze or cloth to prevent slipping), and fingers under the jaw.
- Apply steady downward pressure on the molars while simultaneously pushing the chin backward, which helps the jaw condyles slip back into their joint spaces.
Post-Reduction Care
Once the jaw is reduced, it is essential to:
- Immobilize the jaw with a bandage wrapped under the chin and over the top of the head for 24-48 hours.
- Eat soft foods for several days to avoid exacerbating the condition.
- Avoid wide mouth opening to prevent further dislocation.
Pain Management
Pain medications like ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours) can help manage discomfort, as recommended by recent guidelines 1.
Importance of Medical Evaluation
Jaw dislocations can occur due to trauma, yawning, or underlying joint laxity, and recurrent dislocations may require further medical evaluation to address any underlying conditions and prevent future episodes 1.
From the Research
Reduction Techniques for Dislocated Jaw
To reduce a dislocated jaw, several techniques can be employed, including:
- Anterior approach: This involves applying steady pressure over the prominent part of the coronoid process and anterior border of the ramus, which can be palpated easily over the cheek 2.
- Posterior approach: This method involves applying pressure intraorally, with the provider's elbows aligned with the patient's maxillary molars 3.
- Alternative approaches: Other techniques, such as the use of local anesthetic or sedation, can also be used to facilitate reduction 3, 4.
Use of Local Anesthetic and Sedation
Local anesthetic can be used to relieve muscle tension and reduce pain, thus facilitating successful TMJ reduction 3, 4. Sedation, such as midazolam, fentanyl, and propofol, can also be used to aid in the reduction process 3.
Importance of Proper Diagnosis and Timing
Delayed diagnosis of TMJ dislocation can lead to long-term sequelae for the patient 5. It is essential to test for normal mandibular excursion in every patient after surgery in the postoperative care unit to prevent delayed diagnosis 5.
Key Considerations for Reduction
When attempting to reduce a dislocated jaw, it is crucial to consider the following: