Temporomandibular joint dislocation

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
• severe pain anterior to the ear
• a depression can be seen or felt in the preauricular area

Reference:

1. Sharma N et al. Temporomandibular joint dislocation. Natl J Maxillofac Surg. 2015 Jan-Jun;6(1):16–20.