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Trismus is a painful condition that tends to restrict normal mandibular function and movement. Generally, all conditions which can lead to the inability of opening the mouth within a normal range of 35 to 55 mm (40 mm average) may be addressed as Trismus. Several factors are responsible for this condition, ranging from a disturbance of the trigeminal nerve to life-threatening conditions such as tetanus.
Extraction of wisdom teeth (lower third molars) might also cause Trismus as a result of inflammation in the mastication muscles area or direct trauma to the temporomandibular joint (TMJ). However, it’s important to note that Trismus is not synonymous with tetanus (lockjaw) although they are closely related.
Can It Happen At The Dentist?
For the majority of dental practitioners, it is routine to administer local anesthetics almost daily. Normally, the anesthetic effect is achieved with no adverse effects. However, it is possible for complications, even serious ones, to happen.
Trismus can happen as a result of inflammation following dental surgery or due to jaw hyperextension during the procedure. This could be due to the prolonged mouth opening during the dental appointment. If the needle injecting anesthetic inadvertently causes damage to the surrounding tissues, Trismus could also result.
Several problems can arise that include difficulty speaking, problems eating and swallowing, and oral hygiene issues. Those patients who don’t get prompt treatment could end up developing Trismus and edema following dental surgery.
How Can It Be Avoided?
As noted above, Trismus is associated with jaw infections. Trismus complications after injecting local anesthetic are rare and they may be averted by using short needles when doing maxillary posterior injections. Additionally, avoiding multiple injections in a short span of time can help.
If any indication of infection appears, it is important that it’s addressed quickly. This includes swelling, pain, redness, and warmth in the affected area. The prevention of infection can help in preventing Trismus from developing. The prevention can be through the early institution of diverse treatment such as heat, exercises, analgesics, and muscle relaxants.
How Long Does It Last?
The most widely seen complication associated with local anesthesia is persistent pain at the injection site. Trismus is, however, more of a temporary complication rather than a permanent one. Nevertheless, the earlier treatment is started, the better are the chances for a faster and greater recovery.
A mouth that cannot open fully, is the trismus hallmark. If you are unable to fit 3 fingers that are vertically lined up between the bottom and top front teeth it could be another sign of Trismus.
Treatment options include:
- Using jaw-stretching devices
- Medical muscle relaxants
- Physical therapy – jaw massaging and stretching
- Applying heat to the affected area
- Soft foods until Trismus symptoms disappear.
Some patients suffering from severe Trismus may experience an element of muscle spasm that Botulinum Toxin injection can improve.
Conclusion
Most affected individuals will normally notice some relief from Trismus-associated pain after 48 hours, although cases have been reported lasting two weeks. The bottom line is that the earlier a person seeks and receives treatment, the better they can expect the outcome to be. Therefore, you shouldn’t hesitate to seek professional help straight away the moment you notice any of the symptoms associated with trismus. The prognosis, if treatment gets delayed, is certainly not as good.
Author: Peter Mayhew
Peter is a dental hygienist in the city of Chicago, IL. In his free time he likes to write blogs and product reviews on anything dental health related.
I am so upset & you have helped. I had 2 fillings done 9 days ago & she admitted she hit that nerve when I jumped in chair. Electrical pain shot in my ear and tounge that was unbearable, I felt like my ear exploded but couldn’t move & she continued shot. Not until she was done & I told her did she apologize. The shocks continued until I was numb & the two teeth needed numbing again as only my face & jaw were.She used another Med & needle u believe. I sat for hours as she did 2 deep fillings & strain keeping my mouth open. However I only felt fatigued for first 3 days after & thankfully no toothache. Now, for last 6 days I am in agony with ear & jaw pain. No fever, no tooth pain. I can barely open my mouth to eat s sandwich & no I can’t fit 3 fingers now. I called my dr 4 days ago who said if fever or worse go to Er. Said it was jaw lock not lock jaw. I called my dentist friend(didn’t do my work) said it was lock jaw & to take ibuprofen & make sure no fever. I am beside myself & tying to avoid the clicking, popping & pain that comes with opening my mouth beyond brushing my teeth. I am scared! Should I go to dentist? Er? Dr? Everyone’s saying it will pass & then I read all this. Please please respond to me, thanks
I’m having same problem and it been over a month ! Did u go to the er ? I have been to the dr twice and he also gave me steroids and and that didn’t work ! Told me to rest my mouth and use ice ! I am also beside myself !
Hi Nichole,
I was wondering if your feeling better or whether or not you got an answer. I am experiencing almost the exact same thing and am terrified it might be permanent. The first couple days after my filling I was fine, then approx 3-4 days later I started feeling some pain when I tried to eat, the next day my cheek was swollen and I couldn’t open my mouth, the following day I developed a bruise on my jaw. I went to urgent Care and all they did was give me was amoxicillin in case it was infected and told me to schedule an appt with my dentist asap. My dentist told me I didn’t have an infection and that they (urgent care) were just giving me something just to give me something. He prescribed something for inflammation and pain. The inflammation went down for a little while and now it’s back to being swollen
again. The procedure was done on the 16th and now I can barely eat and the pain meds do nothing because the pain is absolutely unbearable by my jaw area when I try to open my mouth.
Annabelle , I have the exact same thing as you going on right now ! My cheek is swollen on the inside and outside too ! I’ve been on muscle relaxers and prednisone also ! Nothing is really helping me at all ! It has been more then 2 months since this happened. I am getting ver y frustrated! Any advise will be greatly appreciated !
Beginning of September I experienced sharp pain. An old old filling was hiding a cracked tooth. I didn’t use my regular dentist as he wasn’t available for a few hours. I needed thecpain to stop. That was one of the worst decisions I’ve made. The dentist that that did the work did a mandible block. I didn’t feel a shock, but the injection didnt feel right. I have experienced deep intermittent pain at the injection site. They gave me motrin 800, but I can’t take that forever. It’s been a month of jaw, ear, throat and sometimes tooth pain. What is the remedy for this condition. My next move will be an OMFS.
I had the same thing happen to me. After about 2 weeks maybe 3 I couldnt eat or open my mouth more then the size of a straw. I thought maybe it was gone and didnt think much of it until I tried to open my mouth to bite a piece of apple. Now I am having that same pain in my ear and jaw. It’s back! I dont know who to call either. A doctor or a dentist that created this pain to begin with!!!!
I’m having this same issue. I had a temporary crown put on a Tues and the following Saturday I had issues opening my mouth. Pain and popping in my jaw. I called my dentist after a week and he prescribed steroids and ibuprofen. I’ve completed the steroids and am still taking ibuprofen but it still hurts. If I open my mouth very wide, my jaw catches and kind of clicks and pops and hurts pretty badly. I don’t know what else to do. It’ll be 3 weeks on Saturday. I have never had an issue like this before.
Did the trismus ever go away ? I have it over a month now and doesn’t seem to be getting any better
Hi everyone! It’s now October 4 and I am two weeks into trismus caused by a needle stick during a root canal Prednisone did not help. Have any of you gotten relief?