| Surgical-Dentistry.Info |
| Prolonged Limitation of Mouth Opening (Trismus) |
This can be due to medial pterygoid contracture / spasm.
This spasm may be the result of injury of the medial pterygoid muscle caused by a
needle (repeated injections during Inferior Alveolar Nerve block) or by trauma of the
surgical field especially when difficult lengthy surgical procedures are performed.
Other causative factors are inflammation of the post-extraction wound, hæmatoma
and post-operative œdema.
This spasm may be the result of injury of the medial pterygoid muscle caused by a
needle (repeated injections during Inferior Alveolar Nerve block) or by trauma of the
surgical field especially when difficult lengthy surgical procedures are performed.
Other causative factors are inflammation of the post-extraction wound, hæmatoma
and post-operative œdema.
The management of trismus depends on the cause. Most cases do not require
any particular therapy. When acute inflammation or a hæmatoma is the cause of
trismus, hot mouth rinses are recommended initially and then broad-spectrum
antibiotics are administered.
Other supplementary therapeutic measures include:
any particular therapy. When acute inflammation or a hæmatoma is the cause of
trismus, hot mouth rinses are recommended initially and then broad-spectrum
antibiotics are administered.
Other supplementary therapeutic measures include:
- Heat therapy, i.e., hot compresses are placed extra-orally for approximately
20 min every hour until symptoms subside. - Gentle massage of the TMJ area.
- Administration of painkillers, anti-inflammatory and muscle relaxant (such as
sedatives) medication. - Physiotherapy lasting 3 – 5 min every 3 – 4 hours, which includes movements
of opening and closing the mouth, as well as lateral movements, aimed at
increasing the extent of mouth opening. - Administration of sedatives for management of stress which worsens while
trismus persists, leading to an increase of muscle spasm in the area
| Photos showing a Patient with Trismus and the Use of Spatulas to Ameliorate the Trismus |