What is Open Lock of TMJ?
April 15th, 2015
An open lock is when the jaw or mouth gets stuck wide open and will not close. The medical term for open lock is subluxation. You may have heard the medical term “subluxation” and wondered what exactly that means. Understanding the subluxation of TMJ means knowing the level of pain, urgency of reduction, technique of manually reducing it, and how to prevent or manage open lock.
Subluxation occurs when the round ball of a joint comes out of the socket and is stuck in front of the socket of the joint. The ball (condyle) is stuck out in front of the socket of the Temporomandibular Joint (TMJ), pulling and stretching the ligaments that hold the disc (cushion) close to ball. The discal ligaments behind the ball and on the side of ball become overstretched and then tear. Like any subluxation, the ligaments behind and on the side of the joint are so overstretched that some even tear, creating significant pain. This cruel pain begs for help, but as anyone who has had open lock will tell you, the ERs, PCPs, and even most dentists do not know how important it is to treat open lock as soon as possible to reduce the tearing of joint ligaments. Not only is the urgency of the reduction not understood, but even the technique to reduce the joint is not in the training that most doctors or dentists receive.
First, know that the quicker the open lock is reduced, the less tearing that will occur to the ligaments holding the disc in place on top of the condyle. Second, you need to know that the only board certified and residency trained doctor who knows how to perform the reduction technique is an orofacial pain doctor. Unfortunately, there are only a few of us in each state. Third, you need to determine who can best help you to prevent or manage any future open locks or subluxations. The best place to start the conservative management or prevention of your open lock is with an orofacial pain specialist.
There are three levels of subluxation prevention, starting with the most conservative and least costly. If the conservative method is not successful, then a moderate conservative technique is used to stop the person from opening wide enough to cause an open locking. The last technique is surgery which is rarely ever performed, and only in the most extreme cases.
The open lock is not a highly prevalent event and can occur only in about 6% of the population. Even though an open lock itself can cause tearing of the ligaments to the TMJ discs, it is the painful panic that most people exhibit that tears the most ligaments. Panic causes a person to forcibly try to close the ball back into the socket, but the anterior bone of the socket is in the way, which does not allow the ball to return to the socket. This pits the ligaments against bone and the ligaments lose the battle.
We want to caution you not to panic if open lock occurs. There is a way to reduce it painlessly and there is a doctor to see you immediately to help you reduce the amount of tearing of the ligaments of the TMJ. If you tear enough ligaments, you will have jaw pain or chewing pain. As Ben Franklin said, “an ounce of prevention is worth a pound of cure.”
Raleigh Facial Pain Center Providing Relief for Subluxation
To prevent functional loss of these joints, it is important that your nervous system and structures are free from any subluxations. Board certified and residency trained Dr. Keith A. Yount and the team at Raleigh Facial Pain Center can help get your body back in sync. Reach out to us today at (919) 781-6600 or contact us online to make an appointment.