Trismus: Interprofessional Assessment, Functional Implications, and Rehabilitation Strategies in Clinical Practice
Abstract
Background: Trismus is a clinical condition characterized by restricted mandibular mobility, often resulting from trauma, infection, temporomandibular disorders, or oncologic treatments. It significantly impacts mastication, speech, oral hygiene, and airway management.
Aim: To review the etiologies, functional implications, and management strategies for trismus in clinical practice.
Methods: A comprehensive literature-based analysis was conducted, synthesizing evidence on pathophysiology, epidemiology, diagnostic approaches, and therapeutic interventions.
Results: Trismus arises from diverse causes including trauma, dental procedures, infections, and radiotherapy-induced fibrosis. Acute cases typically resolve with conservative measures such as heat therapy, NSAIDs, and muscle relaxants. Chronic or refractory cases require physiotherapy, jaw motion devices, and occasionally surgical intervention. Early recognition and multidisciplinary care improve outcomes.
Conclusion: Timely diagnosis and tailored management are essential to prevent long-term disability and optimize functional recovery.
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References
1. Dhanrajani PJ, Jonaidel O. Trismus: aetiology, differential diagnosis and treatment. Dental update. 2002 Mar:29(2):88-92, 94
2. Tveterås K, Kristensen S. The aetiology and pathogenesis of trismus. Clinical otolaryngology and allied sciences. 1986 Oct:11(5):383-7
3. Garnett MJ, Nohl FS, Barclay SC. Management of patients with reduced oral aperture and mandibular hypomobility (trismus) and implications for operative dentistry. British dental journal. 2008 Feb 9:204(3):125-31. doi: 10.1038/bdj.2008.47.
4. Ogle OE, Mahjoubi G. Local anesthesia: agents, techniques, and complications. Dental clinics of North America. 2012 Jan:56(1):133-48, ix. doi: 10.1016/j.cden.2011.08.003.
5. Osunde OD, Adebola RA, Omeje UK. Management of inflammatory complications in third molar surgery: a review of the literature. African health sciences. 2011 Sep:11(3):530-7
6. Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral and maxillofacial surgery clinics of North America. 2007 Feb:19(1):117-28, vii
7. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia : an international journal of headache. 2017 Jun:37(7):692-704. doi: 10.1177/0333102416686302.
8. Beddis HP, Davies SJ, Budenberg A, Horner K, Pemberton MN. Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety. British dental journal. 2014 Oct:217(7):351-355. doi: 10.1038/sj.bdj.2014.862.
9. Ryan P, McMahon G. Severe dental infections in the emergency department. European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 2012 Aug:19(4):208-13. doi: 10.1097/MEJ.0b013e32834ddb68.
10. Honda K, Natsumi Y, Sakurai K, Ishikura R, Urade M. Mucinous adenocarcinoma of the temporal region initially diagnosed as temporomandibular disorders: a case report. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 2006 Oct:35(9):582-5
11. Kamstra JI, van Leeuwen M, Roodenburg JL, Dijkstra PU. Exercise therapy for trismus secondary to head and neck cancer: A systematic review. Head & neck. 2017 Jan:39(1):160-169. doi: 10.1002/hed.24366.
12. Dijkstra PU, Huisman PM, Roodenburg JL. Criteria for trismus in head and neck oncology. International journal of oral and maxillofacial surgery. 2006 Apr:35(4):337-42
13. Pauli N, Fagerberg-Mohlin B, Andréll P, Finizia C. Exercise intervention for the treatment of trismus in head and neck cancer. Acta oncologica (Stockholm, Sweden). 2014 Apr:53(4):502-9. doi: 10.3109/0284186X.2013.837583.
14. Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 1999 Sep:88(3):365-73
15. Fischer DJ, Epstein JB. Management of patients who have undergone head and neck cancer therapy. Dental clinics of North America. 2008 Jan:52(1):39-60, viii
16. Shires PM,Chow G, Trismus in the paediatric population. Developmental medicine and child neurology. 2015 Apr
17. Loh SY, Mcleod RWJ, Elhassan HA. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2017 Jul:274(7):2695-2707. doi: 10.1007/s00405-017-4519-6.
18. Marien M Jr. Trismus: causes, differential diagnosis, and treatment. General dentistry. 1997 Jul-Aug:45(4):350-5
19. Lund TW, Cohen JI. Trismus appliances and indications for use. Quintessence international (Berlin, Germany : 1985). 1993 Apr:24(4):275-9
20. Dijkstra PU, Kalk WW, Roodenburg JL. Trismus in head and neck oncology: a systematic review. Oral oncology. 2004 Oct:40(9):879
21. Wranicz P, Herlofson BB, Evensen JF, Kongsgaard UE. Prevention and treatment of trismus in head and neck cancer: A case report and a systematic review of the literature. Scandinavian journal of pain. 2010 Apr 1:1(2):84-88. doi: 10.1016/j.sjpain.2010.01.006.
22. Mu JW,Zhang MJ,Luan BQ,Wu J,Sun P, Quality of life in Chinese patients with laryngeal cancer after radiotherapy. Medicine. 2018 Jul
23. El Ç, Çelikkaya ME. Varied Clinical Presentations of Acute Dystonic Reaction Due to Metoclopramide. Pediatric emergency care. 2019 May:35(5):369-372. doi: 10.1097/PEC.0000000000001800.
24. Petrovic I, Baser R, Blackwell T, McCarthy C, Ganly I, Patel S, Cordeiro P, Shah J. Long-term functional and esthetic outcomes after fibula free flap reconstruction of the mandible. Head & neck. 2019 Jul:41(7):2123-2132. doi: 10.1002/hed.25666.
Authors
Copyright (c) 2025 Abdullah Mubarak Almughyirah, Samar Masnad Alanazi, Abdulelah Gaseem Hamali, Mohammed Hassan Faqihi, Ghalib Mohammed Abdu Arar, Latifah Eid Mashrouk Alshammari, Naseem Ageel Bashkor, Nawaf Hamoud Hamad ALHarbi , Maram Ahmed Saed Maqtary, Eman Owaidh Suayfan Al shallahi, Sara Jaber Aldafeeri, Muradi Basheer Alruwili
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