Mandibular Dislocation

WHAT YOU SHOULD KNOW:

• A mandibular dislocation is a movement of your mandible (lower jaw) out of its place. You will not be able to put it back on your own. Normally, your jawbones (upper and lower jaw) meet in front of your ears, at the temporomandibular joint (TMJ). This joint is like the hinge of a door that lets you open or close your mouth. Your jawbones are held together and supported by ligaments and muscles. With mandibular dislocation, one or both sides of your lower jaw may be away from the TMJ. Your lower jaw may have moved forward, backward, up or down, or to the side. A mandibular dislocation may occur suddenly and may become chronic (long-lasting) and happen again and again.
  
  
• You may get a mandibular dislocation with a blow (hit) to your chin. Your jawbone may also become dislocated if you open your mouth too wide. It may also happen if you have a problem with the bones, muscles, or ligaments in your TMJ. Tests, such as x-rays or a CT scan may be done to check if your jaw is dislocated. Treatment is done to put your jawbones back in place and keep them stable to prevent another dislocation. This may include manual reduction, use of a sclerosing agent, devices, and surgery. You may also be given medicine for your pain and tight jaw muscles. With early treatment, your jawbone will be put back into its normal position and serious problems may be prevented.

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.

RISKS:

• Medicines used to treat mandibular dislocation may cause an allergic reaction. If you have surgery, you may bleed or get an infection. Surgery also puts you at risk of having dental or gum injuries, and stretched jaw ligaments and muscles. With treatment, you may have pain, temporary nerve problems, ankylosis (joint stiffening), and bleeding in the jaw joint. You may also have a malocclusion where your top and bottom teeth do 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 damage that could become deadly. Talk to your caregiver if you have questions or concerns about your condition or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Oxygen:

You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

You may be given the following 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. It may also be given through your vein or as a gas that you breathe while you are asleep. Your caregiver will work with you to decide which anesthesia is best for you.
  
  
• Muscle relaxer: This is medicine to help your tight jaw muscles relax.
  
  
• Sedative: This medicine is given to help you stay calm and relaxed.

Tests:

You may need any of the following:

• Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your jaw. It may be used to look at your bones and muscles. You may be given dye before the pictures are taken to help your caregiver see the pictures better. The dye is usually given through an IV. An IV is a tube placed in your vein for giving medicine or liquids. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
• Jaw x-ray: This is a picture of your jaw. It is used to check your jawbones and tissues in your TMJ. A jaw x-ray lets your caregiver look for out of place or broken bones. It also allows your caregiver to see how your jaw is healing. You may need more than one x-ray of your jaw.

Treatment options:

• Fixation devices: Wires or elastic bands may be used to prevent you from moving your jaw.
  
  
• Manual reduction: This is a procedure to put your jawbone back to its normal position. Your caregiver will push down your lower back teeth while pulling your chin up. Remove your dentures if you are wearing any before having this procedure. You may need a fixation device after your manual reduction.
  
  
• Sclerosing agent: This is a special chemical 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.
  
  
• Physical therapy: This may be needed if you have had many jaw dislocations. A caregiver will work with you to help make the muscles around your jawbones stronger. This may help to stop your jawbone from dislocating again.
  
  
• Surgery: You may need surgery if other treatments have been tried and have not worked. It may also be needed if you have had your lower jaw out of place for a long time. Surgery may be done to tighten the ligaments around your TMJ and make it more stable. Changes in your jaw muscles may also be done to make them less tight. Your caregiver may cut or remove a part of your jaw to return bones to their normal position. Plates or screws may be used to hold your jawbones together.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Mandibular Dislocation (Inpatient Care)