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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Consequences of jaw spasm
Trismus is unpleasant for a person not only due to pain. When opening and closing the mouth is painful, the normal process of eating is disrupted and the gastrointestinal tract suffers. When the jaw spasms, breathing is impaired, which leads to constant oxygen starvation of the brain and headaches. This affects the composition of the blood and the functioning of the cardiovascular system.
Trismus caused by infections or tumors causes serious health problems. In this case, long-term serious treatment is required. In the initial stages, pain is completely relieved. For systemic diseases, when trismus is a secondary symptom, complex therapy is necessary.
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.
Botulinum therapy as one of the methods for treating hypertension and bruxism
Botulinum toxin type A, which is used in medicine and cosmetology, is able to relieve spasms and relax overstrained muscles, specifically reducing their activity or immobilizing them completely. But not forever, but only for a certain period of time - during this time the body adapts to new circumstances and stops overstraining a certain area. That is, the therapeutic effect for a diagnosis such as “bruxism” lasts for a long time, which is confirmed by numerous reviews from patients.
How it works?
Botulinum toxin type A is a neurotoxin produced by the bacteria Clostridium botulinum. It blocks nerve impulses from the central nervous system to muscle fibers. That is, in fact, the drug paralyzes a certain muscle without transmitting motor commands from the brain to it.
In medicine and cosmetology, it is used in ultra-small and highly purified forms - that is, it is not poisonous or toxic to the body!
The drug is injected into clearly defined points in order to affect only a specific muscle and not affect the work of others. The dosages are harmless, and the blocking is reversible. Over time, the drug is completely eliminated from the body - usually this takes from 5 to 7 months. Gradually, neuromuscular conduction in the area is restored, and mobility returns to the muscle - but since it has “rested,” the spasmodic fibers are smoothed out, and the body adapts and normalizes the load.
Botulinum toxin only relieves hypertonicity and allows the muscle to relax. This is the basis of its well-known cosmetic effect - smoothing out wrinkles by blocking the work of facial muscles. That is, it is wrong to think that you can “pump yourself up” with botulinum toxin preparations - they do not in any way increase the volume of soft tissues.
To relieve excess tension in the masticatory muscles, we use the drug Botulax for intramuscular injection with 99% active substance content, thereby increasing the speed of onset and duration of the therapeutic effect. And thanks to the high degree of purification of the drug, the risk of adverse reactions is minimized. The dosage and course are selected by the doctor strictly individually!
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.
Why is botulinum therapy not enough to eliminate hypertension?
You need to understand that Botox treatment in dentistry, like orthopedic treatment of bruxism (that is, the manufacture of special protective mouth guards for teeth during bruxism), is only an additional, and not an independent method. Botulinum therapy protects against the consequences of muscle strain - that is, visible relief will actually occur after administration of the drug. The spasm will go away, the muscles will relax, you will stop involuntarily clenching your jaw and thereby injuring your teeth. But as soon as the effect of botulinum toxin wears off, the problem may return, albeit to a lesser extent.
Of course, if it was just a formed habit based on nervousness, and the causes of bruxism are psychosomatic or neurological, then during treatment you have a good chance to completely get rid of it. But if the source lies in other pathologies and disorders, then you also need to address them: take care of your posture, solve bite problems, restore damaged teeth, replace low-quality dentures, etc. And botulinum therapy will become an effective comprehensive measure.
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.
Diagnostics
Early cases of hemifacial spasm are sometimes difficult to distinguish from facial myokymia, tics or myoclonus, which may be caused by pathological processes in the cerebral cortex or brainstem. In such cases, neurophysiological testing is the most valuable diagnostic method.
Wide and variable synkinesis on eyeblink tests and high-frequency discharges on electromyography (EMG) with associated clinical manifestations are diagnostic criteria for hemifacial spasm. Stimulation of one branch of the facial nerve can spread and cause a response in the muscle innervated by another branch. Synkinesia is absent in essential blepharospasm, dystonia or epilepsy. Needle myography shows irregular, short, high-frequency burst potentials (150-400 Hz) of motor units that correlate with clinically observed facial movements.
Visualization methods
Magnetic resonance imaging is the diagnostic method of choice when there is a need to exclude compression effects. Angiography of the cerebral vessels is generally of little value in the diagnosis of hemifacial spasm. Ecstatic blood vessels are rarely identified, and these vessel findings may be difficult to correlate with nerve effects. Performing angiography and/or magnetic resonance angiography is typically used to perform surgical vascular decompression.
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.
Prevention of hypertonicity of the TMJ muscles
Preventive measures against hypertonicity of the lower jaw muscles will help prevent the disease with an integrated approach. It is much easier to follow the general recommendations of doctors than to face a painful spasm of the TMJ. Prevention includes the following activities:
- Preventive visits to the doctor every six months.
- Careful systematic oral hygiene.
- Treatment of caries at its first symptoms.
- Orthodontic treatment for malocclusion pathologies.
- Disinfection of food products.
- Antitetanus therapy for animal bites.
- A set of necessary vaccinations.
- Do not open your mouth wide (jaw dislocations often occur when trying to bite off a large fruit).
- Do not overuse solid foods and do not chew nuts with your teeth.
- Avoid stressful situations, react less to stress.
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 properly treat trismus of the masticatory muscle?
Treatment of the problem involves:
- immobilization of the jaw by applying a bandage or splint;
- eliminating the underlying cause of trismus (disease or specific condition);
- taking neuropsychic stimulants and sedatives;
- a course of taking muscle relaxants;
- a course of antibiotics (for inflammatory processes);
- physiotherapy;
- peace and release from physical work.
If the patient’s condition is severe, observation in a hospital is necessary under the supervision of a maxillofacial surgeon, neurologist, traumatologist, etc.
After eliminating acute symptoms, a person is recommended a special diet:
- plenty of fluid;
- chopped food;
- vegetables and fruits;
- natural juices.
If it is impossible to eat normally, food is supplied through a tube, and liquid is supplied through the skin.
To restore the functions of the masticatory muscle, the patient is recommended to perform special therapeutic and preventive exercises.
It is important to completely cure trismus, and not just suppress its symptoms. If the cause is not removed, the problem will reoccur. Spasms put a powerful strain on the teeth, gums, and nervous system. It is very important to contact an experienced dentist with a surgical profile, who will help cure the disease and tell you what to do in emergency situations. The 32 Dent network of clinics in Moscow employs specialists who will provide such comprehensive assistance for trismus of the masticatory muscle and other serious problems.
If you have a problem similar to that described in this article, be sure to contact our specialists. Don't diagnose yourself!
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Drug treatment for muscle spasms
There is no universal remedy for muscle spasms of the head and neck. If the pain is episodic, taking painkillers in combination with supplementation with vitamins and minerals may be enough. If we are talking about chronic involuntary muscle contractions, the patient may be prescribed antiepileptic drugs, muscle relaxants, antidepressants, and antipsychotics. The doctor may also recommend medications to strengthen blood vessels and normalize blood circulation.
All patients with muscle pain are advised to ensure sufficient physical activity, avoid alcohol consumption, reduce stress levels, eat nutritiously and get enough sleep.
What can you do at home if:
Head muscle spasms
To relieve spasm and pain, you can take aspirin, a painkiller tablet like Ibuprofen, or a painkiller in powder form (for example, Nimesil). Give yourself peace of mind. You can try pressing trigger points and stretching your earlobes.
Jaw muscle spasm
If trismus manifests itself, before the doctor arrives, you can self-massage the masticatory muscles, accelerating the blood in them, alternately pressing on the muscles constrained by spasm. It is also possible to use compresses (alternate warm and cold compresses, apply them to the lower third of the face).
Cervical muscle spasms
Make gentle rotational movements with your head, lower and lift it (without throwing it back too much), turn it right and left. You can try stretching your neck muscles with your hands. Warm compresses and rubbing are effective.
*Attention! The information is for informational purposes only and does not constitute medical advice.
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