If you feel like you might have Trismus or lockjaw, it is important that you visit an ENT hospital. They might refer you to a dental surgeon and an orthopedician, based on the severity of the condition.
Symptoms include the reduced range of motion you experienced, pain or cramping in the jaw that occurs with or without movement, and pain or difficulty when exerting pressure, as when eating. Whether or not your jaw problem is due to TMD or trismus, we urge you to see your doctor or a TMD specialist for diagnosis.
Physiotherapy treatments may be required to establish normal function (exercises will include neck stretching, chin tuck, massaging of masticatory muscles, and other jaw stretching). Mandibular opening devices might be considered in some cases, but most likely provided by a physiotherapist or dental specialist.
Most cases of trismus resolve following symptom-directed treatment with heat therapy and NSAIDs. Refractory chronic trismus may require physiotherapeutic interventions.
Treatment for lockjaw starts with a dentist examining the patient to determine the cause of their problem. Getting treatment early on can be the difference between getting a permanent solution to your problem or dealing with chronic TMJ issues for the rest of your life.
But when the patient experiences these symptoms all of a sudden, they need treatment there and then. Acute TMD treatment involves manipulation (direct massage contact to the muscle by the dentist or assistant) or of direct-to-the-joint application of an injection of local anaesthetic or even saline.
In many cases, lock jaw treatment involves a combination of muscle relaxants and physical therapy. Muscle relaxants are used to provide relief from the painful muscle spasms that commonly cause lock jaw. Depending on the nature of the lock jaw, oral muscle relaxants or injected muscle relaxants will be used.
Generally, trismus is gradually alleviated or disappears within approximately 1 to 2 weeks post-operatively; however, in very rare cases, trismus persists for >1 month.
One simple test is the 'three finger test'. Ask the patient to insert three fingers into the mouth. If all three fingers fit between the central incisors, mouth opening is considered functional. If less than three fingers can be inserted, restriction is likely.
Whatever the cause, treating jaw stiffness – first with ice packs, then heat, then physical stretching – you can correct the trismus sooner and return more quickly to pain-free laughing and living.
Patients need to know that trismus that occurs 1 year after treatment will be permanent and that there is no good surgical or medical therapy. Aggressive encouragement will lead to good compliance with trismus exercises and a low incidence of severe trismus, even after surgery and radiation.
The diagnosis of trismus is clinical.
In endentulous patients, the measurement is from the alveolar ridge of the edentulous maxilla/mandible incisor to the opposing side. Trismus is diagnosed when mouth opening is less than 35mm.
They may need long-term physical therapy. Most people develop trismus after treatment for head and neck cancer. Overall, jaw spasms may seem like a minor issue compared with cancer and cancer treatment side effects. But left untreated, trismus can affect people's ability to eat and regain strength after treatment.
Trismus caused by inflammation resolves by itself in due course, without need of any intervention. Whereas, when there is infection, trismus persists for a prolonged duration and it may even aggravate. This can be controlled by prescribing antibiotics.
Common causes
Pericoronitis (inflammation of soft tissue around impacted third molar) is the most common cause of trismus. Inflammation of muscles of mastication. It is a frequent sequel to surgical removal of mandibular third molars (lower wisdom teeth).
Long-term or permanent trismus can dramatically impact a patient's quality of life and require the routine practice of jaw range of motion exercises for life. However, therapeutic options are available to minimize or eliminate the difficulties associated with long-term trismus.
Restricted mouth opening (RMO) and trismus are terms commonly used in oral oncology in instances where there is difficulty in mouth opening. The term trismus in oral oncology is mainly used to indicate the radiation-induced fibrosis of the muscles of mastication.
The word trismus comes from the Greek word trismós meaning “gnashing.” Trismus is technically defined as a tetanic spasm of the jaw muscles, causing them to close rigidly. Restricted mouth opening (RMO) is a condition in which the mouth opening is restricted owing to any cause.
The causes of limited mouth opening include trauma, infection, temporomandibular joint disorders (TMDs), neurological disorders, rheumatoid arthritis, drugs, tumors, hyperplasia of the coronoid process, etc. This condition can interfere with various medical treatments that require access to the oral cavity.
Trismus constitutes an important immediate postoperative complication of surgical removal of impacted tooth, which is caused by the edema and swelling associated with surgical trauma.
One of the most significant challenges for individuals living with trismus is maintaining proper oral hygiene. If you cannot open your mouth wide enough to insert a toothbrush, a cotton swab may be used to clean your teeth. Antibacterial mouth rinse can help minimize the bacteria in areas that are not accessible.
Sugar free chewing gum may be helpful to keep your jaw moving.
When to see a doctor. Seek medical attention if you have persistent pain or tenderness in your jaw, or if you can't open or close your jaw completely. Your doctor, your dentist or a TMJ specialist can discuss possible causes and treatments for your problem.
You'll probably first talk about your TMJ symptoms with your family doctor or dentist. If suggested treatments don't provide enough relief, you may be referred to a doctor who specializes in TMJ disorders.