(An Old Lady is getting her jaw locked with mouth open frequently for last 36 years .The jaw joint is becoming displaced when she yawns or open mouth wide but she is good in “unlocking” it or putting it back in its joint space. what she does is place two fingers on her jaw right next to her ears then just push to one side and push to the other side as you can see in the video clip.)
Mandibular dislocation resulting in lock jaw with open mouth usually occurs while yawning, during dental procedure or opening mouth wide like while eating a large sandwich mouthful.
People prone to dislocation may have naturally loose temporomandibular joint (TMJ) ligaments. Patients present with a wide-open mouth that they are unable to close. Pain is secondary to patients’ attempts to close the mouth.
Self manipulative reduction:
First of all, don\’t panic…
Take your two pointer fingers and stick them in your mouth and grab your farthest back teeth, one side with each hand. Wrap your thumbs around your jawbone. Press down firmly with your pointer fingers sort of down and back while relaxing your jaw. Hopefully it will reset itself. The quicker you set it the better.
How to reduce it
If the mandibular midline deviates to one side, the dislocation is unilateral. Although rarely used, a local anesthetic (e.g., 2% lidocaine to 5 mL) injected into the ipsilateral joint and into the adjacent area of insertion of the lateral pterygoid muscle may allow the mandible to reduce spontaneously.
Manual reduction may be necessary.
Mandibular reduction after giving sedation is tried.
The patient’s head is stabilized. The operator’s thumbs are placed on the external oblique line of the mandible (lateral to the 3rd molar area) or, after wrapping the thumbs in gauze, on the occlusal surface of the lower molars. The other fingers are curled under the mandible. The patient is asked to open wide, as if yawning, and the operator then applies downward force on the molars while applying upward force over the chin until the mandible reduces.
Barton bandage may be needed for 2 or 3 days. Most importantly, the patient must avoid opening the mouth wide for at least 6 wk. When anticipating a yawn, the patient should place a fist under the chin to prevent wide opening. If the patient suffers from chronic dislocations and more conservative treatment modalities have been exhausted, an oral and maxillofacial surgeon may be consulted.