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Bilateral dislocation of temperomandibular joints in a child: easily missed with the dummy in
  1. L Cascarini,
  2. M Cameron
  1. Department of Maxillofacial Surgery, Queen Victoria Hospital, East Grinstead, UK
  1. Correspondence to:
 Mr L Cascarini
 Department of Maxillofacial Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK;

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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.

Figure 1

 (A) With the dummy in the only sign of dislocated TMJs is the pre-auricular swelling, arrowed; (B) with dummy removed, clearly showing the classic signs of dislocated TMJs.