21480 Closed treatment of temporomandibular dislocation; initial or subsequent

Name of the Procedure:

Closed Treatment of Temporomandibular Dislocation
Common Name: TMJ Closed Reduction
Technical/Medical Term: Non-Surgical Temporomandibular Joint Reduction

Summary

This procedure involves manually realigning a dislocated jaw (temporomandibular joint) without surgical intervention, either for the first time or for recurrent dislocations.

Purpose

The procedure addresses temporomandibular joint (TMJ) dislocations. It aims to reposition the jawbone back into its correct place, restoring normal function and relieving pain.

Indications

• Jaw pain and discomfort
• Inability to fully open or close the mouth
• Visible or palpable jaw misalignment
• Recent trauma to the jaw area

Preparation

• No specific fasting required
• Patients should provide a full medical history, including any previous jaw dislocations
• Diagnostic imaging (e.g., X-rays) may be conducted to assess the dislocation

Procedure Description

1. The patient is seated comfortably.
2. Local anesthesia or a mild sedative may be administered to ease discomfort.
3. The healthcare provider places their thumbs inside the patient's mouth, alongside the lower molars, with fingers positioned on the lower jaw.
4. Gentle downward and backward pressure is applied to guide the jaw back into the correct position.
5. Once the jaw is repositioned, the patient is advised on how to avoid future dislocations.

Tools and Equipment:

• Gloves
• Gauze pads
• Anesthetic agents (if necessary)

Duration

The procedure typically takes about 15-30 minutes.

Setting

It is usually performed in an outpatient clinic or emergency room setting.

Personnel

• A dentist, oral surgeon, or emergency physician
• Nurses or medical assistants for support

Risks and Complications

• Pain or discomfort during the procedure
• Swelling or bruising
• Risk of re-dislocation
• Rarely, damage to teeth or surrounding tissue

Benefits

• Immediate pain relief
• Restoration of normal jaw function
• Non-surgical, minimally invasive approach

Recovery

• Patients are advised to avoid hard or chewy foods for a few days
• Follow-up appointments may be recommended to monitor healing and prevent recurrence
• Over-the-counter pain relief may be provided if needed

Alternatives

• Open surgical reduction (in cases where closed reduction fails)
• Physical therapy
• Use of a mouthguard or splint

Patient Experience

• Some discomfort or pain during the procedure, which can be managed with anesthesia.
• Post-procedure soreness is possible, typically manageable with pain medications.
• Overall, most patients experience relief soon after the procedure.