Extra-Oral Reduction Technique for Anterior Mandible Dislocation
1. Place the patient in either sitting or supine position.
2. The provider should stand in front of the patient.
3. The provider places their thumb on the patient's cheek, on the mandibular ramus and coronoid process of the dislocated mandible, and applies persistent pressure posteriorly (figure 3).
4. The fingers are placed behind the angle of the mandible to stabilize the grip.
5. At the same time on the opposite side, the provider places their fingers from the other hand on the angle of the mandible and pulls, applying anterior force (figure 4). Note that this maneuver causes further anterior dislocation of the ipsilateral TMJ, rotates the jaw, and facilitates contralateral TMJ reduction.
For comparison purpose, here is the traditional method of repositioning dislocated temporomandibular joints.
Alternatively, you can try the hands-off syringe technique:
The patient bites down with their posterior molar teeth on a 5-10 cc syringe on the side of the dislocation. Ask patient to roll syringe back & forth. The syringe is rotated so that it pushes the posterior molars posteriorly. The direction of rotation is clockwise for a right dislocation, or counterclockwise for the left.