FROM OUR EXPERTS
Alternative Names Dislocated jaw; Fractured jaw; Broken jaw; TMJ dislocation Symptoms Symptoms of a dislocated jaw include: Bite that feels "off" or crooked Difficulty speaking Drooling because of inability to close the mouth Inability to close the mouth Jaw that may protrude forward Pain in the face or jaw, located in front of the ear on the affected side, and gets worse with movement Teeth that do not line up properly Symptoms of a fractured (broken) jaw include: Bleeding from the mouth Difficulty opening the mouth widely Facial bruising Facial swelling Jaw stiffness Jaw tenderness or pain, worse with biting or chewing Loose or damaged teeth Lump or abnormal appearance of the cheek or jaw Numbness of the face (particularly the lower lip) Very limited movement of the jaw (with severe fracture)
Reader Question: What is Bisphosphonate-Associated Osteonecrosis of the Jaw (ONJ)? How common is ONJ, and what are its risk factors?
Not a day goes by when these questions do not come up. It appears that a significant amount of lawyers’ advertisements as well as newspaper and magazine articles have raised public opinion and thought on the matter. Recent news coverage focuses on new lawsuits against Merck, the maker of Fosamax (alendronate sodium) , for causing deterioration of the mouth and exposure of the jaw bone. Here is a summary of the information I have been telling my patients as well as what has been released by the American College of Rheumatology.
Intravenous Bisphosphonate There are 368 cases of bisphosphonate-associated ONJ published between 1966 and January 31, 2006. Sixty percent of cases occurred after oral surgery for dental extraction or other dentoalveolar surgery, whereas the remainder occurred spontaneously, some in patients wearing dentures. Most ...
Q: How do most patients get referred to a rheumatologist in the first place? Kremer: Usually, it’s the pain that’s perceived to be arthritis pain. Sometimes it’s muscle pain. Other times it can just be a nagging pain from anywhere that the primary care provider cannot diagnose. It’s more helpful to be referred to a rheumatologist when there are other symptoms along with the pain, such as early joint swelling. Q: What does the rheumatologist do when they see a referred patient? Kremer: We’ll take a history. Do you have morning stiffness? Fatigue? How long has this been going on? Do you have any family history of these same symptoms? After history, you do a physical exam looking for impaired joint movement, which joints are swollen, warm to the touch, difficult to move. Q: When do you take lab tests? And which tests do you start with first? Kremer: It depends on where the initial history and exams lead you. You many test for Rheumatoid factor (...
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