What Is the Reduction of a Mandibular Dislocation?

A mandibular dislocation is a medical emergency. Delay in its correction may result in stiffness of the jaw joint due to abnormal joining between tissues of the mandibular bone.

A mandibular dislocation occurs when the temporomandibular joint (TMJ) is displaced on one side (unilaterally) or both sides (bilaterally) of the face.

A mandibular dislocation stretches the ligaments and muscles of the face, giving rise to extreme local oral and facial pain. You may not be able to open your mouth partially or completely.

The mandible with its connection with the skull above, on each side of the face (bilaterally), forms the TMJ.

The TMJ helps in opening and closing your jaw, and the mandible holds the teeth in place.

A mandibular dislocation is a medical emergency. Delay in its correction may result in stiffness of the jaw joint due to abnormal joining between tissues of the mandibular bone.

The main cause of a mandibular dislocation is trauma.

Most commonly, a mandibular dislocation happens during yawning and dental procedures where there is an excessive opening of the mouth.

Other instances when a mandibular dislocation can happen because of the opening of the mouth widely are as follows:

• Passionate kissing
• Eating
• Yelling
• Singing
• Endoscopy (insertion of a long tube into your mouth that goes into your stomach)
• Intubation (insertion of a tube into your mouth that goes into your windpipe)

Persistent muscle spasm in the jaw results in lockjaw (trismus) that can lead to a jaw dislocation. A previous mandibular dislocation also puts you at risk of repeated dislocations.

Your doctor will know that you have got a mandibular dislocation by taking your complete history and physical examination. He will confirm his diagnosis and rule out any jaw fracture by looking at the X-ray of your jaw.

Reduction of a mandibular dislocation is a procedure that aligns the mandible bone correctly—back to its original place—and corrects the temporomandibular joint (TMJ) by pushing or pulling the mandible.

Acute episodes of a mandibular dislocation can be managed with manual reduction (externally), whereas recurrent dislocations require a surgery.

The steps in manual reduction are as follows:

• Your doctor will give you painkillers and sedatives to ease your pain and local anesthesia into your jaw to numb it before the procedure.
• Your doctor or dentist will wrap his/her fingers with a gauze.
• Subsequently, they will put their thumbs inside the mouth on the lower back teeth and rest of the fingers around the bottom of the lower jaw.
• They will then press downwards on the back teeth and, at the same time, keep pushing the chin upwards until the mandible bone returns to its normal position.

• Your doctor or dentist may apply a Barton bandage (special bandage) for two-three days to limit the motion in your temporomandibular joint (TMJ).
• He will ask you for an X-ray of your jaw to confirm the success of the reduction procedure.
• You may have to wear a soft neck brace for some days.
• You can apply warm compresses to your jaw and take painkillers to ease the pain.
• You need to limit opening your mouth for six weeks during certain actions such as yawning and laughing and during dental procedures.

The possible risks that come with the reduction of a mandibular dislocation are as follows:

• Damage to dental hardware such as dental implants and braces
• Fracture of the mandible bone
• Injury to the adjacent nerves or arteries
• Problems due to sedation such as
  • low blood pressure,
  • irregular heart rate,
  • apnea (cessation of respiration) and
  • allergy.