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The jaw sometimes dislocates after enthusiastic laughing, chewing or kissing.
Palpate to check there has not been a fracture.
Types of dislocation
- the mandible usually dislocates anteriorly, and subluxes when the jaw is opened wide
- other dislocations imply the presence of a fracture and require referral to a surgeon
Dislocation is often a chronic problem and associated with temporomandibular joint dysfunction.
If dislocation is not obvious, then consider other conditions, such as:
- fracture
- hemarthrosis
- closed lock of the joint meniscus
- myofascial pain.
Clinical features:
- severe pain at TMJ and over masseter muscle
- the jaw is pushed forward from its normal position
- the patient cannot bite the teeth together
- dislocation on one side only causes asymmetrical deviation of the chin
- bilateral dislocation causes the jaw to protrude
- the patient has difficulty speaking (2)
- severe pain anterior to the ear (2)
- a depression can be seen or felt in the preauricular area (2)
Reference:
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