28/08/2025
TMJ dislocation reduction:
When a patient has a TMJ dislocation, the lower jaw slips forward and gets stuck in front of the articular eminence. The patient can’t close the mouth, and it looks and feels very uncomfortable.
To put the jaw back, here’s the step-by-step idea:
1. Patient relaxation
First, the patient must relax as much as possible. If they’re tense, the muscles will resist and reduction becomes very difficult.
2. Head support
The head needs to be stable—either against a headrest or braced firmly—so the force you apply goes into the mandible, not into moving the whole head.
3. Hand positioning
Put on gloves.
Your thumbs: either place them on the hard bone ridge just behind the molars (external oblique ridge) or on the biting surfaces of the lower molars (with gauze to protect your thumbs).
Your fingers: curl them under the jaw, around the mandible, with index fingers behind the rami for control.
4. Forces applied
The key sequence is:
Downward pressure: Push down firmly at the back of the jaw (using your thumbs). This pulls the condyle down and away from the articular eminence.
Upward support at the chin: At the same time, your other fingers rock the chin slightly upward.
Posterior pressure: Once the condyles are freed downward, guide the whole mandible backward so the condyles slip back into the socket.
Think of it as “Down first… then back.”
5. Result
If done properly, you’ll often feel or hear a “snap” as the condyles slide back into their normal position.
👉 The most important principle for you to remember is: never jerk suddenly. Use steady, firm, continuous force. The danger is if you rush, you could injure the TMJ or get bitten.
