Trismus

TRISMUS

Various types of tumors invading
the jaw bones, related muscles or the TMJ.

Trismus in simple terms, is an inability to open the mouth properly. It is not one disease, but maybe a manifestation of a group of many other conditions. This inadequate mouth affects the quality of life disproportionately because it hinders many basic aspects of daily life.

  • Inability to eat well – this affects not only nutrition, but also has psychological bearing.
  • Difficulty of speech – affects all daily interactions.
  • Difficulty in breathing – happens only in certain severe conditions and can be life threatening.

Why does it happen?

A myriad number of conditions may be responsible for causing trismus. Some of the common ones are

  • Infection starting in a decayed tooth or gums starting to cause pain and swelling in the muscles.
  • Erupting wisdom tooth causing irritation to the jaw and masticatory muscles.
  • Fascial spaces infetions affecting the masticatory muscles.

Temporomandibular Joint Disorders  precipitated due to stress, injury, bad chewing habits or bad posture of head and neck.

  • TMJ Ankylosis, which is another name for the joint getting stuck because of excessive bone formation within the joint cavity.
  • Oral Submucous Fibrosis. In this condition the cheek loses its suppleness and ability to stretch bvecause of excessive fibrous formations, hence restricting the ability to open the mouth. This is usually result of consumption of various irritants like tobacco, paan, areca nut and alcohol. Other milder irritants like excessively spicy foods, irritating beverarges etc also have a role to play.
  • Trismus may also result due to various types of tumors invading the jaw bones, related muscles or the TMJ.

This condition can lead to a lot of problems as mentioned earlier due to a variety of underlying conditions that can affect the muscles pertaining to mastication. Affecting the muscles can be due to a large variant of conditions that can cause muscles to fibrosis leading to tightening of the muscle which ends up in restricted mouth opening.

This can be due to improper technique of injections while anesthesia, spasm of the muscles as mentioned above temporomandibular joints etc. Once the muscle stiffens or restricts then it will take some time for the muscle spasm to recover and go back to the normal and requires intensive therapy and proper identification of the underlying cause.

scars or mark after surgery

Why is this condition severe?

How do you manage the cause?

Different treatment modalities are required for trismus and that needs expert consultation of the condition by an experienced oral and maxillofacial surgeon and that involves

  1. Removal of the infected cause (wisdom tooth or infection pertaining to the muscle)
  2. identifying whether it’s a cause arised from the tooth or bony deformities

3.examining the muscle and associated structures to rule out any cause pertaining to muscles of mastication

Treatment includes a several factors that are:

  1. medication with active muscle relaxants and home remedies
  2. mouth opening and Temporomandibular joint exercises to increase the mouth opening
  3. Physiotherapy and rehabilitation exercises to relax the muscles

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