Causes and risk factors
Trismus occurs due to inflammation of soft tissue of mouth. Trismus can be caused due to various conditions ranging from local infection to tetanus. It is seen in submucous fibrosis. Certain malignancies also cause trismus. Additional conditions that can lead to trismus are dental – pericoronitis, extraction of lower wisdom teeth. Peritonsillar abscess can also lead to trismus. Radiation therapy of the face and neck leads to this condition. Diseases like temporomandibular joint [TMJ] dysfunction, bruxism, acute osteomyelitis, ankylosis of the TMJ, giant cell arteritis, mumps, seizures secondary to neuroleptic drug use, myositis, SLE, scleroderma. Burn, injuries, or trauma to musculature around joint can also cause trismus.
Clinical presentation
Patient presents with difficulty in opening the mouth, increased jaw pain, inability to open the jaw. There is a “spasm” sensation when attempting to open the mouth. Patient experiences difficulty in chewing, speaking, breathing, and brushing. Trismus reduces vocal quality. It presents as ‘lock jaw’ in tetanus.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Imaging studies are advised such as x-ray and CT scan of the TMJ to detect any damage to the TMJ and surrounding structure.
Treatment
Treatment depends upon the underlying cause. It involves treating the underlying cause with dental treatment, physical exercise, and devices to increase range of movement. Pain is managed using analgesics. Muscle stretching and neck exercises help in treating the disease. Warm compresses, muscle relaxants will also help in managing trismus. Further treatment consists of ultrasound waves and electrical stimulation.
Other Modes of treatment
The other modes of treatment can also be effective in treating trismus. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating trismus.
