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Bilateral dislocation of the temperomandibular joints are rare in children. The classic signs of this condition, anterior open bite, protruded mandible, and drooling are all indistinct in this child until the dummy is removed. As a result she was initially diagnosed as having mumps because the subtle sign of the displaced mandibular condyle heads bulging in the pre-auricular region was misinterpreted as parotid swellings (arrowed in both pictures). Unwell children should have the orofacial region fully examined, which may require removal of the dummy. Not all pre-auricular swellings are parotid in origin.
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