Abstract: Trismus, commonly known as restricted mouth opening, is a frequent condition in dental and medical practice. It is often associated with infections, trauma, inflammation, or as a complication of cancer therapies. This article reviews risk factors, causes, prevention strategies, and evidence-based treatments.
📌 Recommended Article :
Video 🔽 How to Reduce a TMJ Dislocation? ... Dislocation of the temporomandibular joint is a painful condition that occurs when the mandibular condyle becomes fixed in the anterosuperior aspect of the articular eminence.Introduction: Trismus is defined as a limitation of mouth opening, usually less than 35 mm, which interferes with eating, oral hygiene, and dental treatment. Its etiology is multifactorial, and its management often requires an interdisciplinary approach.
Advertisement
✅ Risk Factors
° Prolonged dental procedures
° Pericoronal infections
° Radiotherapy in the head and neck region
° Facial trauma
° Invasive oral surgeries
📌 Recommended Article :
Video 🔽 Massage Tutorial: Myofascial release for TMJ/jaw pain ... The temporomandibular joint can undergo some alterations that cause pain to the patient, and can limit the movements of the jaw. In this syndrome the muscles are also involved.✅ Main Causes
° Infectious: peritonsillar abscesses, pericoronitis.
° Inflammatory: temporomandibular arthritis, post-radiation fibrosis.
° Traumatic: mandibular or muscular fractures.
° Iatrogenic: intramuscular anesthesia, complex surgical extractions.
📌 Recommended Article :
Video 🔽 VIDEO: Signs and symptoms of TMJ disorders ... Temporomandibular joint syndrome is the lesion or localized pain that the patient presents in the joint.✅ Prevention
° Minimize trauma during dental procedures.
° Proper anesthetic techniques.
° Jaw exercise programs in oncology patients receiving radiotherapy.
° Early treatment of oral infections.
📌 Recommended Article :
Video 🔽 What Are The Causes Of TMJ Related Headaches? ... The chewing muscles and the joint are affected by TMD, and it prevents various actions such as: talking, yawning, eating and even breathing.✅ Treatment Options
° Pharmacological: anti-inflammatory drugs, muscle relaxants.
° Physiotherapy: progressive jaw exercises, mouth-opening devices.
° Surgical: scar release and reconstructive surgery in severe cases.
° Adjunctive therapies: local heat, therapeutic ultrasound.
📊 Comparison Table: Trismus — Causes, Risk Factors, Prevention and Treatment
| Category | Typical Causes | Risk Factors | Prevention | Treatment / Management |
|---|---|---|---|---|
| Infectious | Peritonsillar abscess, pericoronitis, odontogenic infections affecting masticatory muscles. | Untreated dental infections, delayed care, poor oral hygiene. | Early treatment of infections; patient education on hygiene and timely dental visits. | Antibiotics when indicated, abscess drainage, analgesics, early jaw physiotherapy. |
| Inflammatory / Arthritic | TMJ arthritis, inflammation, post-radiation fibrosis. | Systemic arthritis, prior head & neck radiotherapy, chronic parafunction. | Manage systemic disease; preventive exercises for radiotherapy patients; address parafunctional habits. | NSAIDs, steroid injections if indicated, jaw exercises, occlusal therapy. |
| Traumatic | Mandibular fractures, muscle contusion, penetrating injuries. | Facial trauma, high-energy injuries, delayed fixation. | Timely trauma management and appropriate fixation; early guided mobilization when safe. | Surgical repair if needed, progressive mobilization, physiotherapy, analgesia. |
| Iatrogenic / Surgical | Complex third-molar extractions, prolonged mouth opening during surgery, intramuscular injections into masticatory muscles. | Lengthy procedures, inadequate perioperative protection/exercises, poor technique. | Minimize procedure duration when possible; use protective positioning; provide post-op jaw exercises. | Progressive opening exercises, mouth-opening devices, pharmacologic muscle spasm control. |
| Oncologic (Radiation) | Radiation-induced fibrosis of masticatory muscles and TMJ structures. | High radiation dose to masticatory apparatus, lack of preventive exercise program. | Jaw exercise protocols before, during and after radiotherapy; tailor planning to spare muscles. | Long-term physiotherapy, passive/dynamic stretch devices; surgical release for severe fibrosis. |
💬 Discussion
Trismus significantly impacts patients’ quality of life, compromising nutrition, speech, and access to dental care. Recent literature highlights the importance of prevention in oncology patients undergoing radiotherapy and the benefits of combined therapies, where physiotherapy plays a pivotal role. Early recognition of risk factors is essential to avoid permanent functional limitations.
✍️ Conclusion
Trismus is a multifactorial condition requiring early diagnosis and multidisciplinary management. Preventive strategies in dental care and rehabilitation programs for high-risk patients are crucial for optimizing clinical outcomes and improving quality of life.
📌 Recommended Article :
PDF 🔽 What is temporomandibular disorder? - Concept, diagnosis and current treatment ... The etiology of temporomandibular disorders are complex and varied, and it is a challenge for the evaluation, diagnosis and management of this pathology.📚 References
✔ Dhanrajani, P. J., & Jonaidel, O. (2002). Trismus: aetiology, differential diagnosis and treatment. Dental Update, 29(2), 88–92. https://doi.org/10.12968/denu.2002.29.2.88
✔ Pauli, N., Fagerberg-Mohlin, B., Andrell, P., & Finizia, C. (2013). Exercise intervention for the treatment of trismus in head and neck cancer. Acta Oncologica, 52(6), 1065–1073. https://doi.org/10.3109/0284186X.2012.760846
✔ Bhrany, A. D., Izzard, M. E., & Wood, D. E. (2007). Trismus secondary to head and neck cancer: treatment strategies. Oral Oncology, 43(3), 252–260. https://doi.org/10.1016/j.oraloncology.2006.02.015
✔ Johnson, J., van As-Brooks, C., Fagerberg-Mohlin, B., & Finizia, C. (2010). Trismus in head and neck cancer patients in Sweden: incidence and risk factors. Medical Science Monitor, 16(6), CR278–CR282. PMID: 20512138
📌 More Recommended Items
► Myofascial Pain Syndrome in Dentistry: Clinical Impact and Modern Management
► Diagnosis of temporomandibular joint (TMJ) ankylosis in children
► Is there a relationship between headache and temporomandibular disorder?
