WHAT IS JAW DISLOCATION OR FRACTURE?
Dislocation of the jaw occurs when the lower jawbone (mandible) becomes displaced from one or both of the joints connecting it to the base of the skull (temporomandibular joints). Because these joints tend to be unstable, they are the ones most commonly dislocated, and recurrences are likely following an initial incident. A jaw fracture is a break in the mandible, usually due to a forceful blow. A severe jaw fracture warrants emergency care.
WHAT CAUSES JAW DISLOCATION OR FRACTURE?
- Automobile crashes, industrial accidents, and falls are the most common causes of jaw injury. Sports injuries and physical assault are also common causes.
- Some people have especially weak temporomandibular joints, so that opening the mouth very widely—for example during yawning or eating a large sandwich—may cause the jaw to dislocate.
SYMPTOMS OF JAW DISLOCATION OR FRACTURE
- Inability to close the mouth normally
- Difficulty opening the mouth widely
- Bite that feels crooked or "off"
- Painful, swollen, or numb jaw
- Swelling and bruising around the jaw
- Tenderness over the dislocation
- Abnormal appearance or lump of the cheek or jaw
- Forward protrusion of the jaw
- Limited movement of the jaw (with severe fracture)
- Pain in the face or jaw, located in front of the ear on the affected side, that gets worse with movement
- Stiffness of the jaw
- Loose or damaged teeth
- Misalignment of teeth or dislocation
- Speaking difficulty
- Emergency symptoms: breathing difficulty, heavy bleeding
- Paralysis or numbness in muscles of the face, jaw or neck due to pressure, pinching or cutting of blood vessels or nerves
- Wear seat belts in the car.
- Use a helmet if you ride a motorcycle or bicycle.
- Wear headgear with a jaw protector when playing sports.
- Patient history and physical examination.
- X-rays of the jawbone (mandible) and temporomandibular joints.
- CT (computed tomography) scans of the facial and skull bones.
HOW TO TREAT JAW DISLOCATION OR FRACTURE
- Medications to lessen pain and anxiety and to prevent infection before and after surgery, if indicated.
- A simple dislocated jaw often may be guided or manipulated back into place. However, recurrent dislocations warrant examination by a doctor.
- Get to an emergency room for more serious jaw injuries (fractures or very painful dislocations).
- The doctor or oral surgeon may insert a tube through the mouth and into the throat to ease breathing.
- The doctor will reset the jaw manually (for a minor dislocation) or surgically (for a severe dislocation or fracture). After it is reset, a fractured jaw is immobilized by wiring the upper and lower teeth together while the bones heal. Recurrent dislocations require similar treatment.
- More complicated fractures may require a surgical procedure to access and join the fractured segments.
- A liquid diet is necessary during recovery (a fracture may take up to six weeks to mend).
- Analgesics and muscle relaxants may be prescribed.
- During recovery from a dislocation, avoid opening your mouth too widely. For example, put your fist under your jaw when yawning, and try not to talk too much.
WHEN TO CALL A DOCTOR
- EMERGENCY See a doctor, oral surgeon, or call an ambulance if you sustain a serious jaw injury.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media