Trismus is a term used to describe limited mouth opening. There are a number of causes for this condition, such as trauma, surgery, and stroke, but most often it is caused by radiation.
Limited mouth opening can affect:
Oral hygiene Chewing and/or swallowing Speech Cancer surveillance
Pain, inflammation and degenerative joint changes are secondary effects of trismus. Early intervention is essential to minimize the effects of trismus.
Evaluation includes a thorough case history, a comprehensive oral examination, a clinical evaluation of swallowing, and a careful assessment of pain. Results of the evaluation are reviewed with the patient and treatment objectives are discussed.
Treatment objectives include:
Stretching connective tissue Strengthening muscles that have weakened Mobilizing the joint Reducing pain and inflammation
Manual mobilization can have some positive effect on mouth opening, however, passive motion has been demonstrated to be more effective and can be achieved using a commercially available device. This device gradually increases mouth opening at a rate that is dependent on the patient's tolerance. The patient is trained how to use the device and an independent home program is prescribed. Progress is monitored and a maintenance program is established when goals have been achieved.
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