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Trismus is a partial, temporary or complete inability to open the mouth as a result of the reflex contraction of the muscles of the temporomandibular joint – including the masseter, temporal muscles and pterygoid muscles. It may be caused by the presence of inflammatory changes in the area of the temporomandibular joint, in the throat or teeth. Trismus is a symptom, not a disease, so there is no specific treatment.
What is trismus and what are its causes?
Trismus is the inability to partially or sometimes even completely open the mouth as a result of involuntary contraction of the muscles of the temporomandibular joint. It is a very troublesome condition that affects patients of all ages, making it difficult to eat, speak, and engage in other activities involving the mouth. The most important thing is to find out the cause of this condition.
Trismus may be caused by inflammatory changes in the temporomandibular joint (inflammation of the muscles and / or joint, infections), in the mouth, teeth and throat, or as a consequence of trauma or tooth extraction (especially molars). It also accompanies certain diseases of the nervous system. It can be, among others a symptom of increased nervous tension, epilepsy, nerve paralysis, tetanus or the manifestation of some neoplastic tumors of the central nervous system.
Other possible causes of trismus:
- brain abscess,
- stroke,
- tooth eruption disorders,
- pharyngeal abscesses,
- throat inflammation
- hysteria,
- actinomycetes,
- taking drugs or overdosing on drugs (especially amphetamines can cause trismus),
- bruxism (frequent teeth grinding),
- oral floor phlegmon,
- meningitis,
- changes in the temporomandibular joint, e.g. congenital stiffening of the structures of this joint.
Symptoms accompanying trismus
Trismus symptoms may suggest a cause for this condition. Patients often complain of:
- hoarseness
- sore throat,
- redness of the throat
- high temperature,
- ear ache,
- change of voice timbre (sometimes),
- peritonsillar abscess (trismus occurs due to pus accumulated in the area of the throat and tonsils),
- headaches and neck pains (in these patients there is a problem with temporomandibular dysfunction; there is teeth grinding due to chronic stress,
- crackling and jumping of the lower jaw to the side when talking or eating.
The most obvious symptom with trismus is the inability to open your mouth.
Trismus – diagnosis
It should be emphasized once again that trismus is not a disease but a symptom of another ailment. To find it, it is enough that we observe the inability to open or close the mouth. It is very important to carry out proper diagnosis, because trismus may result from common pharyngitis, but also from other more serious disease, such as cancer. The basis of diagnostics is to conduct a medical interview with the patient, thanks to which it is possible to make a decision regarding further tests. In order to find the cause of trismus, the most common tests are:
- neurological (an EEG is performed to rule out the presence of epilepsy),
- ENT (to exclude inflammation or injuries in the joint),
- dental (to exclude inflammation in the teeth),
- imaging (computed tomography, magnetic resonance imaging, X-ray examination – allowing to diagnose not only a defect of the temporomandibular joint, but also to identify a possible brain tumor or abscess),
- laboratory (usually performed when inflammation is suspected).
Only after detecting the cause of the trismus, it is possible to take further steps.
Treatment of trismus
In a situation where trismus was caused by an infection (bacterial, viral or fungal), appropriate pharmacological measures are implemented to eliminate the infection. If the symptom is caused by problems with the teeth – the patient goes to the dentist and removes or treats the problem teeth.
Trismus related to the dysfunction of the temporomandibular joint is treated with special occlusive splints, which are placed on the upper dental arch. They should be worn about eight hours a day. Thanks to their action, the pain is significantly reduced and the mobility of the joints is improved. In addition, the splints reduce muscle tension, which allows them to relax. This is possible thanks to the appropriate arrangement of the teeth and articular surfaces in relation to each other, which prevents clenching of the teeth and constant tightening of the masseter muscles.
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Text: SzB
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