JAW (TEMPORO-MANDIBULAR) SPRAIN |
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General Information
DEFINITION--Violent overstretching of one or more ligaments in the temporo-mandibular joint. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. If the ligament pulls loose a fragment of bone, it is called a SPRAIN-FRACTURE. There are 3 types of sprains:
Mild (Grade I)--Tearing of some ligament fibers. There is no loss of function.
Moderate (Grade II)--Rupture of a portion of the ligament, resulting in some loss of function.
Severe (Grade III)--Complete rupture of the ligament or complete separation of ligament from bone. There is total loss of function. A severe sprain requires surgical repair.
BODY PARTS INVOLVED
Ligaments of the temporo-mandibular joint of the jaw.
Tissue surrounding the sprain, including blood vessels, tendons, bone, periosteum (covering of bone) and muscles.
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SIGNS & SYMPTOMS
Severe pain at the time of injury.
A feeling of popping or tearing inside the jaw.
Difficulty opening and closing the mouth.
Tenderness at the injury site.
Swelling around the jaw.
Bruising that appears soon after injury.
CAUSESStress that forces the jaw through a wider range of motion than ligaments normally permit.
RISK INCREASES WITH
Contact sports, especially boxing.
Previous temporo-mandibular joint injury or disorder.
Inadequate protection from equipment.
HOW TO PREVENTWear protective equipment, such as a face mask and mouthpiece, when appropriate.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis.
Bandaging or wiring of the jaw (sometimes).
Biofeedback training (See Glossary) during the healing phase.
Physical therapy (moderate or severe sprain).
Surgery (severe sprain).
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the jaw to rule out fractures or dislocations.
POSSIBLE COMPLICATIONS
Proneness to repeated jaw injury.
Inflammation at the ligament attachment to bone (periostitis).
PROBABLE OUTCOMEJaw sprains usually cause no permanent problems if allowed to heal sufficiently. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are:
Mild sprains--2 to 6 weeks.
Moderate sprains--6 to 8 weeks.
Severe sprains--8 to 10 weeks.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CARE
Continue using an ice pack 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the jaw. Use for 20 minutes at a time.
After 72 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort, you may use aspirin, acetaminophen or ibuprofen.
Your doctor may prescribe:
Stronger pain relievers.
Injection of a long-acting local anesthetic to reduce pain.
Injection of a corticosteroid, such as triamcinolone, to reduce inflammation.
Stool softeners if constipation results from a liquid or soft diet.
ACTIVITYResume your normal activities gradually after clearance from your doctor.
DIETA normal diet may be difficult, especially if the jaw is wired or bandaged. If so, eat soft or liquid foods and increase your protein intake to promote healing.
REHABILITATIONConsult your doctor or oral surgeon for rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of a moderate or severe temporo-mandibular sprain, or a mild sprain persists longer than 2 weeks.
Pain, swelling or bruising worsens despite treatment.
You feel numbness or coldness around the injury.
Any of the following occur after surgery:
Increased pain, swelling, redness, drainage or bleeding in the surgical area.
Signs of infection (headache, muscle aches, dizziness, or a general ill feeling with fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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