How the joint works and why it comes out of the fossa
The temporomandibular joint connects the lower jaw to the skull in front of the ear. It is more complex than most joints: the head of the jaw not only rotates, but also slides forward along the articular tubercle, which allows the mouth to open wide. If the mouth opens too much, the head jumps over the tubercle, and the muscles immediately contract and hold it in the new position - it can no longer go back on its own. This is facilitated by stretched ligaments, a flat articular tubercle, and previous dislocations.
- The head of the jaw slides forward when the mouth opens
- Jumping over the articular tubercle due to excessive opening
- Muscle spasm keeps the jaw in the wrong position
- Stretched ligaments make recurrent sprains easier
- Possible unilateral and bilateral dislocation
Why is this happening
The most common situation is wide opening of the mouth without injury: yawning, laughing, screaming, trying to bite off a large piece, vomiting. The second typical situation is medical procedures: long-term dental treatment, tooth extraction, gastroscopy, intubation. Less commonly, a dislocation occurs when there is a blow to the chin or the side of the face, and then a fracture must be ruled out. A separate group consists of people with increased mobility of joints and weakness of ligaments, in whom the dislocation recurs for no apparent reason and becomes habitual.
- Wide yawn, laugh, scream
- Biting off a large piece of food
- Long-term dental treatment and tooth extraction
- Endoscopic procedures and anesthesia
- Hit to the chin or side of the face
- Weak ligaments and increased joint mobility
How to recognize
With a bilateral dislocation, the mouth remains wide open, the person cannot close the teeth, speech is slurred, saliva flows out, and the chin is pushed forward. With a unilateral dislocation, the mouth partially closes, and the chin is shifted to the healthy side, the face looks asymmetrical. A depression is felt in front of the ear, and a displaced head is felt under the zygomatic arch. The pain is usually mild but constant and worsens when trying to close the mouth. The general condition does not suffer, there is no temperature.
- The mouth is open, the teeth do not close
- Slurred speech and drooling
- The chin is pushed forward or shifted to the side
- Retraction in front of the ear
- Joint pain
- Inability to chew and swallow food
What to do before the doctor and how to fix it
The main rule: do not try to straighten the jaw yourself and do not let others do it - you can damage the ligaments, disc and soft tissues. Before your appointment, support your jaw with a bandage over your head to reduce pain, do not try to eat or drink, and apply ice to the area in front of your ear. The doctor realigns the jaw using special techniques: with a certain movement, the head returns to the hole, usually immediately with a characteristic click. In case of severe muscle spasm or long-standing dislocation, local anesthesia or muscle relaxation may be required, and in some cases, intervention under anesthesia.
- Do not adjust yourself
- Supportive bandage and cold before appointment
- Do not eat or drink before reduction
- Manual adjustment by a doctor
- Pain relief for severe spasms
- X-ray after reduction to monitor position
After reduction and prevention of recurrences
Immediately after reduction, the jaw is fixed with a bandage for several days to allow the ligaments to recover. During this period, you need soft food, you cannot open your mouth wide, yawn without supporting your chin with your hand, chew hard things and gnaw hard things. If dislocations recur, the doctor understands the cause: prescribes therapeutic exercises for the muscles, if necessary, mouth guards, physical therapy, and in persistent cases discusses surgical methods. It is worth warning the dentist about a dislocation before long-term dental treatment.
- Fixing bandage for several days
- Soft foods and limited mouth opening
- Supporting your chin with your hand when yawning
- Therapeutic exercises and physiotherapy as prescribed by a doctor
- Mouth guards and orthopedic devices for habitual dislocation
- Warn the dentist about previous dislocations