Trismus is a spasm of the chewing muscles or their involuntary contraction. As a result of trismus, the jaws become closed and it is extremely difficult to open them. Usually the problem lies in impaired muscle function and tone, and this, in turn, can be associated with various diseases. It is very difficult to get rid of spasms of the jaw muscles on your own, so it is important to seek help from a dentist - he will assess the condition and refer you to specialists if necessary.
The mechanism of trismus occurrence
The chewing muscles set our jaw apparatus in motion. A sudden muscle contraction, accompanied by a strong closure of the jaws, limitation of the movement of the lower jaw, temporary loss of the ability to speak and eat, is called trismus. Strong clenching of teeth often causes breathing problems.
Excessive muscle tension leads to hardening. The disease can become a factor in a significant decrease in the quality of life and deterioration of the psycho-emotional background. A person’s appearance changes, the digestive tract organs suffer, so it is important to see a doctor as soon as possible. Without timely help, your general health may deteriorate, and it is also necessary to find out the causes of spasms.
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Signs of involuntary muscle contraction are:
- with bruxism – grinding of teeth during sleep, a feeling of overexertion in the jaws after waking up;
- with spasms of the head muscles - hoop-shaped pain in the temples, in the forehead, in the back of the head;
- pressing, pulsating, squeezing nature of pain;
- feeling of heaviness in the area of spasm;
- pain when pressing trigger points (try to palpate the area of the head when it hurts: when you press certain points, the pain increases significantly);
- nausea, vomiting, dizziness;
- painful reaction to light, loud sounds (infrequently).
When to see a doctor:
- headaches appeared suddenly and do not go away;
- you are experiencing muscle pain for the first time after 50 years;
- pain is accompanied by dizziness, weakness, numbness of the limbs;
- pain lasts more than two weeks in a row;
- painkillers either do not work at all or give an insignificant short-term effect;
- the pain is localized on one side of the head/neck.
Muscle spasms that provoke pain indicate a disruption in the healthy functioning of the body. To prevent the development of the disease, it is important to consult a doctor in time. We advise you to visit a therapist, neurologist, endocrinologist, who will prescribe detailed laboratory diagnostics for you. Based on the research results, specialists of another profile may be involved in your treatment: an orthopedist, a cardiologist, a chiropractor. Complex treatment may include taking medications, a massage course, and therapeutic exercises. A good doctor will definitely give you recommendations on nutrition and daily routine.
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Types of trismus and diagnostic methods
There are two main types of spasm of the masticatory muscles:
- Unilateral. Most often it is associated with an inflammatory process or injury to the mandibular joint and adjacent tissues. The result of unilateral pathology is a displacement of the lower jaw to the side when opening the mouth, as well as facial asymmetry.
- Bilateral. The cause of the disease is neuralgia and common infectious diseases. With this type of trismus, the jaws close together with a slight movement of the lower jaw back. There is an inability to open the mouth, difficulty speaking and eating.
To diagnose trismus, the doctor will find out information about previous diseases, operations, injuries, collect anamnesis, and listen to complaints. External examination is supplemented with radiography and other methods of clarifying the diagnosis.
Clinical picture
The first sign of trismus of the jaw muscles is compression of the upper and lower jaws, during which the person cannot make any movements.
Other characteristic symptoms:
- pain when trying to make a movement;
- swelling, compaction;
- limited mobility;
- facial asymmetry (with unilateral spasm).
The pain intensifies when palpated. In some cases, there is an increase in temperature and fever. Unilateral spasm most often occurs as a result of injuries and inflammation of the facial region, bilateral spasm occurs in pathological conditions of the body systems.
Trismus has three forms, which is determined by the degree of limitation of motor functions:
- with a mild form, the mouth may open up to 4 cm;
- with average – up to 2 cm;
- in severe cases - up to 1 cm.
The pathology is often confused with a dislocated jaw or arthritis of the joints, which is associated with similar symptoms, so professional diagnosis is necessary to determine the exact cause of the problem.
Causes of trismus
The problem of spasm of the lower jaw can be associated not only with damage to nerve endings and reflex contraction, but also with other factors:
- infectious and inflammatory diseases of the oral cavity;
- previous injuries;
- unsuccessfully performed anesthesia of the teeth of the lower jaw;
- arthrosis of the mandibular joints;
- pathologies of ENT organs;
- irritation, inflammation of the trigeminal nerve;
- purulent processes, etc.
In addition, trismus can be a consequence of pseudobulbar palsy, meningitis, epilepsy, calcium deficiency, etc. Symptoms may first appear after injury, temperature changes, or sudden hypothermia. Sometimes the jaw cramps after opening the mouth wide, for example, after removing a wisdom tooth.
Reasons for jaw reduction
Spasm of the facial muscles can be associated with internal or external factors.
Internal:
- physical condition of the body;
- diseases of organs and systems (oncology, musculoskeletal disorders, mental disorders, etc.).
External:
- pathological conditions of the oral cavity;
- consequences of unsuccessful dental treatment;
- jaw injuries (dislocations, fractures);
- arthritis of the jaw joint;
- neuralgia;
- inflammatory processes;
- abscesses;
- periosteum.
At risk are people suffering from bursitis, who are also exposed to constant stress and overstrain of the nervous system.
Symptoms and manifestations
Trismus of the masticatory muscles is accompanied by limited mobility of the joints responsible for closing the jaw. The inability to unclench them can be of a different nature - from partial to complete immobilization. The mouth may open 40, 20, or 10 mm or less, depending on the severity of the condition. Spasmodic contractions can worsen your overall health, cause headaches and other consequences.
One of the manifestations is inflammatory processes due to jamming of the jaws, in this case there is an alternating reduction of the sides of the face. Less commonly, trismus is associated with tumor processes, accompanied by a noticeable increase in formation and increased symptoms. With viral infections, elevated body temperature is often observed.
Treatment methods
Patients with hypertension should receive help as soon as possible, since trismus can accompany a hypertensive crisis. It is also important to call an ambulance if you suspect rabies and tetanus. In the absence of severe concomitant pathologies, you can consult a dentist.
Knowledge of how to relax the jaw muscles on your own is necessary for self-help directly during spasm - but in the future, examination and consultation with a specialist is necessary. A warm compress can help with spastic jaw closure. Its use is not recommended if there are foci of inflammation in the oral cavity, for example, with pulpitis, periodontitis, periostitis, or suspected abscess. A light massage of the muscles can also help to relax, but remember that the movements should be light, and in no case should you put any force on the muscles.
The approach to the treatment of trismus includes a detailed analysis of the condition and a search for the causes of the disease. To eliminate the causes, it may be necessary to remove the inflamed tooth or surgical treatment of purulent inflammation. In case of a fracture, the doctor will immobilize the jaw.
Physiotherapeutic methods are widely used as a supplement. Laser, ultrasound therapy, electrophoresis with the use of painkillers can be used.
Antibacterial therapy is used for the inflammatory nature of spasms, for example, inflammation of the trigeminal nerve.
Treatment of spasm of the masticatory muscles often includes the use of sedative medications if the pathology was caused by diseases of a neurological nature. However, a neurologist prescribes such drugs.
Also, if muscle tone disorders are suspected of being infectious, vaccination is mandatory. Infection with the rabies virus requires immediate attention.
Main stages of treatment
Step 1. Preparation for the procedure
A doctor, for example, an implant surgeon or an orthopedist, may refer you to the botulinum therapy procedure for comprehensive preparation before installing implants or dentures. But you can also contact your dentist yourself with complaints about the symptoms of dental bruxism. On the recommendation of a doctor, after consultation and diagnosis, you can begin the injection course.
No complicated preparation is required. 2-3 days before the procedure, it is advisable to eliminate alcohol and reduce the consumption of tea, coffee and energy drinks, as well as stop taking blood thinning medications and antibiotics.
Experienced doctors who follow safety precautions! Our specialists have undergone appropriate training, are certified and accurately calculate the dosage of the drug. We carry out treatment carefully, safely and with results!
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Step 2. Administration of the drug
The procedure itself takes on average 20 minutes. The doctor conducts a follow-up examination and marks points for drug administration.
The doctor takes the ampoule out of the refrigerator and opens the disposable syringe with the medicine in front of you - this way you will make sure that the storage conditions and sterility of the drug are observed. How many units of Botox are needed for bruxism? The specialist will calculate the dose individually, based on the severity of the symptoms, and divide it into 3-4 parts - that is, you will be given several small injections in different areas of the muscle. For injections, disposable sterile syringes with thin needles are used, so the procedure is almost painless. But for greater comfort, the injection site can be numbed.
Step 3. Rehabilitation period
The drug begins to act immediately, but gains maximum strength gradually - over about 10-14 days, during which the spasmodic area completely relaxes. At this time, it is undesirable to overheat and overcool the problem area: that is, you will have to limit physical activity, trips to the bathhouse and sauna, as well as to the pool.
It is also important in the first days to touch your face as little as possible and not to steam or massage the injection sites.
The effect of the drug lasts up to 7 months, but may weaken faster depending on individual characteristics. Your doctor will tell you at your follow-up appointment whether you need a repeat course.
Measures to prevent trismus
To prevent trismus, it is important to sanitize the oral cavity in a timely manner: remove teeth that cannot be restored, treat caries and inflammatory gum diseases. If prosthetics are necessary, you should contact only qualified specialists, and orthodontic structures should be replaced in a timely manner. The presence of neurological diseases requires constant monitoring by a neurologist.
If you have trismus, you can get advice from dentists at STOMA clinics. If pathology of the temporomandibular joints is detected, experienced specialists will prescribe an additional examination and give recommendations aimed at eliminating the causes of the disease. You can make an appointment for an examination by calling the specified phone number or using a special form on the website.
How to treat trismus of the masticatory muscle?
Treatment involves the following steps:
- jaw immobilization;
- elimination of the disease or condition that caused trismus;
- taking medications with a relaxing effect (neuropsychic stimulants);
- taking antibiotics;
- the patient takes sedatives;
- Physiotherapy is recommended.
If trismus is caused by an inflammatory process in the mouth, the dentist sanitizes the lesion (for example, opens an abscess), cleans the hole and, if necessary, removes the tooth along with the root.
