Sir, I am a newly qualified dentist and recently experienced a patient dislocating their jaw whilst treating them in practice. This incident has compelled me to write to share my experience to highlight that this unexpected incidence can easily happen when you least expect it.

At university we were taught only briefly about TMJ dislocations with the main emphasis being that it was somewhat a rarity and most likely to occur when extracting wisdom teeth or if using excessive force. The reality of my situation was far from this. I was extirpating a lower premolar, using no force at all, my patient did not have his mouth open wide or for very long, he had no history of dislocating his TMJ and there were no other associated risk factors.

Having not previously seen or managed any TMJ dislocations I felt under-prepared for managing this incident. At university we were simply told to 'push back and down' and to be careful that you don't get your thumbs bitten. This sounds rather straightforward but the reality of my situation was not so. Even my experienced VT trainer and an associate – who has previously worked as a MaxFax SHO – were not able to relocate my patient's TMJ.

Although I am sure that this scenario is straightforward for someone with experience in this area, I found managing this incident was not as simple as I had been led to believe in my training at university.

My patient attended our local hospital and successfully had his TMJ relocated by the MaxFax team and has had no subsequent problems. I felt compelled to write to draw the attention to how a seemingly low risk patient can dislocate their TMJ during routine dental procedures, when one may least expect it, and how recent dental graduates have limited experience in this field.

1. London