Systemic Arthritic Conditions
rlorly in front of the articular eminence and becomes locked in that position (Fig. 30-16). Dislocation may be unilateral or bilateral and may occur spontaneously afteropening the mouth widely, such as when yawning; eating, or during a del}tal procedure. Dislocation of the mandibular condyle that persists for more than a few seconds generally becomes painful and is often associated with severe muscular spasms. Dislocations should be reduced as soon as possible. This reduction is accomplished by applying downward pressure on the posterior teeth and. upward pressure on
the chin, accompanied by posterior displacement of the mandible. Usual}Y’ reduction is not difficult. However, muscular spasms may prevent simple reduction, paricularly when the dislocation cannot be reduced immediately. In these cases, anesthesia of. the auricular temporal
nerve and the uscles of mastication may be necessary. Sedation to reduce patient anxiety and provide muscular relaxation may also be required. After reduction the patient should be instructed to restrict mandibular opening for 2 to 4 weeks, Moist heat and nonsteriodal antiinflammatory
drugs (NSAIDs) are also helpful in controlling pain and inflammation.