I can often feel, and at times hear, the dysfunction in the joint. When severe, the TMJ can painfully "lock," and the person is unable to move their jaw until the joint is realigned, which can at times require surgery. These issues can occur in association with bruxism, excessive jaw clenching, jaw trauma, and at times without any clear cause.
A very common treatment for TMJ dysfunction is the use of a nightguard, which is a plastic mouthpiece that covers the teeth, and prevents enamel on enamel contact. A nightguard is usually fitted to the upper maxillary teeth.
In general, a dentist fabricates custom nightguards. Although usually more expensive, custom nightguards are a better choice than over-the-counter versions for a number of reasons. Custom night guards tend to be thinner and more comfortable. Although bruxism has never been a significant problem for me, I wear a nightguard to prevent enamel wear and shifting of teeth. After using a nightguard for a number of years, I tell patients that not wearing my nightguard is like not putting on my seatbelt after I get in the car.
It is a disruption in my routine, which can at times leave me feeling restless. Other treatments for TMJ dysfunction include injections directly into the joint and jaw surgery. One of the less invasive and less painful treatments is the use of botulinum toxin Botox. Cosmetically, Botox works by relaxing the muscles that, when overactive, can cause wrinkles. Similarly, when injected into jaw muscles, they relieve tightness, pain, and wear on the TMJ.
Two of my patients had very large jaw muscles from constant clenching over the years, and with Botox injections the contour of their faces changed. One of these patients said, "I hated having these big jowls. My jaw line is much smoother now, and my pain is essentially gone. Mathew, does injecting Botox in the jaw muscles cause any side effects?
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. You may benefit from wearing a mouth guard, especially if your jaw tightness is caused by clenching or grinding your teeth in your sleep.
There are several types of mouth guards available. You may need a specific type based on the cause of your condition. You doctor or dentist should be able to recommend an appropriate mouth guard.
This will help reduce wear and tear on the teeth. It may also help to eliminate jaw tightness and pain. Mouth guards for bruxism can be made of several materials, ranging from hard acrylic to soft plastics. There are many over-the-counter brands of mouth guards available, although it might be preferable to have one custom made to your mouth. Custom-made mouth guards are a more expensive option, but they allow for varying levels of thickness based upon the severity of your teeth grinding.
If you have a joint disorder, such as TMD, your dentist may recommend a mouth guard called a splint. Splints are made of hard or soft acrylic, and are usually custom made. This helps reduce the strain on your jaw bone and surrounding muscles. Your dentist may recommend you wear the splint 24 hours a day rather than just at night.
Treatment may last from months to years. Massaging your jaw may help increase blood flow and reduce muscle tightness. You can try this by opening your mouth and gently rubbing the muscles next to your ears in a circular motion. This is the area where the temporomandibular joints are located. Try this several times a day, including right before bed. Reducing stress and anxiety may help prevent jaw pain. Stress-busters to try include:. Avoiding excessive chewing and overuse of your jaw muscles may also help prevent jaw pain.
A tight, painful jaw can be caused by a range of conditions, including bruxism, TMD, and stress. Some at-home solutions may provide relief or prevent tightness and pain. These include stress reduction and behavior modifications, such as eating soft food and avoiding chewing gum. Mouth guards or splints may also help. In rare instances, your nerve or muscle can become permanently damaged from an infection.
If it does, you may be more likely to experience recurrent episodes of lockjaw. Some medications can affect nerve function and lead to lockjaw. The most common culprits are anti-nausea medications, such as Reglan metoclopramide and some antipsychotic medications.
More rarely, anesthetics can cause a rare complication called malignant hyperthermia. This complication is a severe reaction involving high body temperature and rapid heart rate. In addition, it can involve muscle spasms, including lockjaw. Cancer and some cancer treatments surgery, radiation can cause injuries to parts of the jaw that control movement. The following are risk factors for developing lockjaw:.
Tetanus occurs from exposure to a life-threatening neurotoxin released by Clostridium tetani, a bacterium commonly present in the environment.
Tetanus toxin can cause muscle spasms. These spasms may affect several muscles throughout the body, including:. Tetanus is a significant risk factor for lockjaw—so much so that those with tetanus almost always experience it. In fact, lockjaw used to be called tetanus. However, tetanus is extremely rare in most parts of the world because immunizations and booster shots that protect against the infection are routine.
Hypocalcemia low calcium levels is another common cause of lockjaw. This complication can sometimes occur during thyroid surgery. Sometimes, nerve or muscle diseases can cause muscle spasms.
For example, stiff person syndrome , a rare autoimmune disorder, can cause spasms in any voluntary muscle. You might think of how you get a "Charley horse" in your leg if you don't stretch before going on a run. The muscle spasm occurring with lockjaw is essentially the same thing, just in a different location and with a range of other possible causes and risks.
Doctors diagnose lockjaw based on your medical history and a physical examination. However, the effects of lockjaw can make it difficult for you to explain your symptoms to your medical team. Most people have to describe their medical history by writing it down. Typically, people can open their mouths between 35 to 55 millimeters mm or 1. However, if you have lockjaw, you may only be able to open your mouth as much as 35 mm 1. That's less than three fingers in width.
Your healthcare provider will measure how wide your mouth can open to see if you fall in or out of the typical range. In addition, if you have lockjaw, your doctor will look for the following:. If there is a concern that you could have an injury, infection, or tumor affecting your mouth, face, or jaw, you may need diagnostic testing. Imaging studies can often identify lesions in and around the jaw. They might include:. In some instances, you may need to have a piece of a tumor removed so that it can be examined more closely.
This is called a biopsy. Treatment for lockjaw often involves medication and physical therapy. Any underlying problems often require additional treatment. For example, if you also have an infection, your treatment will include antibiotics. Specialists who treat lockjaw include:. If medication caused your muscle spasm, your doctor will likely recommend discontinuing it.
However, never stop a drug without your healthcare provider's OK. Oral and injected muscle relaxants are typically helpful. Common examples of oral medications that relax muscles include:. These medications may cause side effects such as drowsiness. Targeted injections, including botulinum toxin Botox or anti-inflammatory steroids , can relax the muscle, relieving the spasm.
Injections do not cause the kind of body-wide side effects seen with oral medications. In addition to medical management, you may need physical therapy or speech therapy. Your therapist may also suggest at-home exercises so you can improve control of your jaw muscles. When you take part in at-home therapy, it is important to avoid pushing your exercises to a painful level.
They may ask about recent injuries or dental work and look for signs of cancer or abnormalities in the bones or tissues of the jaw. Trismus may also make it challenging for those wearing dentures to insert the dentures or remove them for cleaning.
If people cannot bite, chew, or swallow properly, there is a chance of malnutrition and dehydration. Many of the infectious and traumatic causes of trismus may also have associated complications. For example, an odontogenic infection that causes trismus may lead to further infection with facial cellulitis or mandibular osteomyelitis. If an infection is the cause of trismus, there may be associated complications, such as cellulitis.
Trismus is a painful condition involving a reduction in the size of the mouth opening between the jaws. Most cases are temporary, and medications, physical therapy, and other treatments can often effectively alleviate trismus and reduce or prevent complications. Early treatment typically provides the best outcomes. Individuals who have concerns about trismus or their risk of developing it should speak to their doctor or dentist.
Halitosis is a common condition and is most often caused by a buildup of bacteria in the mouth because of gum disease, food, or plaque. Many causes of…. Peritonsillar abscesses form around the tonsils. They usually occur as a complication of tonsillitis and are often caused by the same bacteria.
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