When the jaw literally drops
What you need to know:
- Temporo-mandibular joint dislocation is a dislocation of the hinged joint of the lower jaw and the temporal bone of the face, the bone that comes down from the temples on both sides. The lower jaw had slipped out from under the joint, dislocating forward.
- Though an uncommon happening, temporomandibular dislocation is more likely to happen from not-traumatic activities such as laughing, yawning, chewing, vomiting and even singing. It may also result from traumatic injury where it is more likely to be accompanied by fractures of the jaw bones, facial bones and even the base of the skull.
When the girls decided to party, nothing could rain on their parade. Chantal*, Raina* and Samara* could get wild when they chose.
Chantal had finally gotten her divorce concluded after three years in court, an experience she wouldn’t wish on her worst enemy. She felt like a huge weight had been lifted off her shoulders and she could finally breathe.
The process had definitely taken a toll on her and she was overjoyed to be able to put it behind her. Francis* had walked out of their marriage because Chantal couldn’t bear children but when she filed for divorce, he fought her every step of the way, dragging her through the mud for attempting to reject him.
Raina being Raina, decided this was worth a celebration. For Raina, a celebration meant a destination holiday. Being a travel agent, she called in a few favours and voila, the girls had a three-day getaway to an exclusive ranch in one of the local conservancies. They hopped into Samara’s off-road vehicle and drove into the wild, singing loudly into the savannah sunset, alongside the blaring stereo, even when none of them could sing to save their lives.
The three days were blissful as they relaxed, taking in the wonders of nature and soaking up the sun at the poolside. They drank cocktails on the balcony of their cottage, watching the animals drinking from the watering hole below them. They had relaxing massages from the hotel spa team and gossiped in the hot tub about what was happening in their lives.
On Monday morning, after blowing a hole in their wallets, they set off on their way back to the reality that was their lives; feeling refreshed but slightly hung over. Just on the outskirts of the city, they stopped for a bathroom break at a mall. They looked rather strange in their shorts and sandals at the beginning of the week when everyone else was dressed for work but they didn’t really mind.
As they pulled out of the mall, Samara, who was narrating stories of her many failed blind dates, made a remark that had them all laughing uproariously with tears streaming down their faces, when Raina suddenly pulled up on the highway shoulder and started screaming.
Being the quintessential drama queen, the rest laughed on for a while before they actually noticed there was a problem. Raina’s mouth hung open and she couldn’t seem to close it! She was drooling and couldn’t voice out her words properly. She was tearing up in intense pain.
The reality of what was going on suddenly hit Chantal and Samara and they both sprang into action. Samara took over the wheel while Chantal sat with Raina in the back seat wiping off the drool and trying to reassure a freaked-out Raina that she would be fine. In 15 minutes, Samara had pulled into the emergency department and was frantically yelling at the security officers to call for help.
A short while later, Raina’s pain was beginning to ease off after a morphine shot and the doctor was able to talk to them. They explained the suddenness of the onset of the symptoms and the fact that it was preceded by laughter. The doctor examined Raina delicately on the face especially the jaws and the area along the cheekbone.
He then sat across Raina and explained that she had suffered a condition called temporo-mandibular joint dislocation. This is a dislocation of the hinged joint of the lower jaw and the temporal bone of the face, the bone that comes down from the temples on both sides. The lower jaw had slipped out from under the joint, dislocating forward.
Though an uncommon happening, temporomandibular dislocation is more likely to happen from not-traumatic activities such as laughing, yawning, chewing, vomiting and even singing. It may also result from traumatic injury where it is more likely to be accompanied by fractures of the jaw bones, facial bones and even the base of the skull.
Repeat dislocations may point to an underlying anatomical abnormality such as a shallow joint; or to a congenital medical condition where the body’s supporting connective tissues are weak, providing poor joint support.
Raina, who couldn’t articulate her words due to the inability to close her mouth, could only nod in acceptance as the doctor explained the procedure he needed to perform, in an effort to reset the joint. Raina was lightly sedated at the emergency department’s procedure room and the doctor attempted to manually reduce the dislocation.
Everyone heaved a sigh of relief when they heard Raina swearing at him with distinct words, even though slightly slurred from the sedation. She was going to be fine! The doctor scheduled Raina for a follow-up review with a maxillofacial surgeon within the week, gave her written instructions on how to handle her jaw for the next few days, and absolutely forbade her from excessive laughter. She was to eat semisolid foods for the next two weeks and to support her chin whenever she yawned.
Chantal sighed in exaggerated relief, clutching her hand to her chest, thanking God for an upcoming peaceful week where Raina would give them all peace as she nursed her jaw back to health!
Dr Bosire is an obstetrician/gynaecologist