Mandible grip method

• prepare the patient as already described
• protect your thumbs with surgical gloves and a clean cloth such as a handkerchief
• stand in front of the patient with your thumbs on his back lower molars
• grip the mandible tight on the dislocated side(s) with your index finger behind the ramus and your other fingers beneath the mandible
• get the patient to brace his head against the back of the chair
• push the down and back suddenly and you should feel the 'clonk' as it goes back into place

Note:

• avoid the following / precautions (1) :
  • to get the thumbs bitten when the jaw snaps back into position.
    • firm, steady traction with gauze should be maintained to protect the thumbs .
  • putting pressure on oral prostheses that could cause them to break.
  • attempting to reduce a TMJ dislocation with the patient's jaw at the height of your shoulders or above.
  • trying to force the patient's jaw shut.

Reference:

• (1) Jaw dislocation. National center for emergency medicine informatics.2008