Child Jaw Dislocation: Causes, Symptoms, and What to Do

Can a child dislocate their jaw?

Yes, while less common than in adults, children can indeed dislocate their temporomandibular joint (TMJ), though the mechanisms and presentation may differ slightly due to their developing anatomy.

Anatomy of the Jaw: The Temporomandibular Joint (TMJ)

The temporomandibular joint (TMJ) is a complex, bilateral synovial joint that connects the mandible (lower jawbone) to the temporal bone of the skull. It is unique in that it functions as both a hinge joint (for opening and closing the mouth) and a gliding joint (allowing forward, backward, and side-to-side movements).

Key anatomical components include:

• Mandibular Condyle: The rounded upper end of the mandible that articulates with the skull.
• Articular Fossa (Glenoid Fossa): A depression in the temporal bone where the condyle rests.
• Articular Eminence: A bony protrusion anterior to the articular fossa. During normal wide opening, the condyle glides forward and down, often resting just beneath this eminence.
• Articular Disc: A small, oval-shaped piece of cartilage located between the condyle and the fossa, acting as a shock absorber and facilitating smooth movement.
• Ligaments: Several ligaments provide stability to the joint, including the temporomandibular ligament and accessory ligaments.
• Muscles of Mastication: Muscles like the masseter, temporalis, and pterygoids control jaw movement and contribute to stability.

In children, the bones are still developing, and ligaments can sometimes be more lax, which can influence the susceptibility to or presentation of a dislocation compared to a mature adult joint.

Jaw Dislocation in Children: The Possibility

While less frequent than in adults, a child's jaw can dislocate. A jaw dislocation occurs when the mandibular condyle moves out of its normal position within the articular fossa, typically gliding forward and getting "stuck" anterior to the articular eminence. This is known as an anterior dislocation and is the most common type. Other, rarer types include posterior, lateral, or superior dislocations.

The developing nature of a child's skeletal structure means that the forces required to cause a dislocation might differ, and their greater ligamentous laxity in some cases could make them either more resilient or, conversely, more prone to certain types of joint instability.

Common Causes of Jaw Dislocation in Children

Jaw dislocations in children are usually acute events caused by specific actions or trauma. Common causes include:

• Trauma: This is the most frequent cause.
  • Falls: Especially falls that result in a direct impact to the chin.
  • Sports Injuries: Contact sports can lead to direct blows to the jaw.
  • Accidents: Any impact that forces the jaw beyond its normal range of motion.
• Excessive Jaw Opening:
  • Prolonged Wide Yawning: While less common to cause dislocation in children than adults, an uninhibited, wide yawn can, in rare cases, lead to the condyle passing the articular eminence.
  • Forceful Crying or Screaming: Sustained, wide-mouth activity can be a factor.
  • Dental Procedures: Extended periods with the mouth held wide open during dental work can sometimes result in dislocation, particularly if the child is uncooperative or has pre-existing laxity.
• Medical Conditions:
  • Connective Tissue Disorders: Conditions like Ehlers-Danlos Syndrome (EDS) or Marfan Syndrome, which cause generalized joint hypermobility and lax ligaments, can make a child more susceptible to jaw dislocations.
  • Seizures: Involuntary muscle contractions during a seizure can sometimes lead to a jaw dislocation.
• Vomiting or Gagging: Violent or prolonged episodes of vomiting can exert unusual forces on the TMJ.

Recognizing the Symptoms

Recognizing a jaw dislocation in a child is crucial for prompt treatment. Key symptoms include:

• Inability to Close the Mouth: This is the most characteristic sign. The child's mouth will be stuck open, often with the lower jaw protruding.
• Pain: Significant pain around the jaw joint, often radiating towards the ear.
• Speech Difficulty: The child will likely be unable to speak clearly, if at all.
• Drooling: Due to the inability to close the mouth and swallow saliva effectively.
• Misalignment of the Jaw: The jaw may appear visibly shifted forward or to one side.
• Swelling: Localized swelling around the TMJ area.
• Clicking or Popping Sounds: While not a direct sign of dislocation, these sounds might indicate underlying TMJ dysfunction that could predispose to dislocation.

What to Do if a Child's Jaw is Dislocated

A jaw dislocation is a medical emergency that requires prompt professional attention.

• Remain Calm and Reassure the Child: A dislocated jaw can be frightening and painful for a child. Your calm demeanor will help.
• Do NOT Attempt to Reduce the Jaw Yourself: Attempting to force the jaw back into place without proper medical training can cause further injury to the joint, surrounding tissues, or even fractures.
• Seek Immediate Medical Attention: Take the child to the nearest emergency room or urgent care clinic.
• Support the Jaw: While en route to medical care, you can gently support the child's jaw with your hands or a soft bandage to minimize movement and discomfort.
• Apply a Cold Compress: A cold compress to the affected area can help reduce swelling and discomfort.
• Avoid Giving Food or Drink: The child will likely be unable to swallow properly, and attempting to eat or drink could pose a choking hazard.

Prevention Strategies

While not all dislocations are preventable, especially those due to unexpected trauma, certain measures can reduce the risk:

• Protective Gear in Sports: Ensure children wear appropriate mouthguards and head protection during contact sports or activities with a risk of facial impact.
• Educate About Wide Opening: Teach children, especially if they show signs of joint hypermobility, to avoid excessively wide or prolonged opening of their mouths (e.g., during yawning or screaming).
• Manage Underlying Conditions: If a child has a diagnosed connective tissue disorder or generalized hypermobility, work with their healthcare providers to understand specific precautions and management strategies.
• Safe Environment: Ensure play areas are safe and reduce tripping hazards to prevent falls that could lead to jaw impact.
• Dental Awareness: Inform dental professionals if your child has a history of jaw issues or hypermobility so they can take extra precautions during procedures requiring extended mouth opening.

Conclusion

While jaw dislocations are less common in children than adults, they are a distinct possibility, often stemming from trauma or, in some cases, underlying medical conditions. Understanding the anatomy of the temporomandibular joint, recognizing the signs of a dislocation, and knowing how to respond are crucial for any parent, caregiver, or fitness professional. Prompt medical attention is paramount for safe and effective reduction of the dislocation and to prevent potential long-term complications.