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You are here: Cancer information / Diagnosis and treatment / Managing side effects / Trismus

Trismus

Causes

Symptoms

Management

 

Trismus is difficulty opening the jaw. In the case of cancer, it occurs when scar tissue forms in the jaw muscles or jaw joint (temporomandibular joint or TMJ) or when the muscles or joint is damaged.

Causes

Trismus may be caused by disease (for example, tetanus), cancer or cancer treatment. Treatment-related causes are radiation therapy and surgery for head and neck cancers. If a person receives both of these treatments, there is a greater risk of developing trismus.

 

Trismus develops slowly after treatment has finished, over a period of 12 to 18 months. Once trismus develops, it is irreversible.

 

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Symptoms

The signs and symptoms of trismus may include:

  • stiff jaw
  • inability to open the mouth wide
  • pain when trying to open the mouth

 

A person's quality of life can be affected by trismus. It can lead to problems with:

  • speaking
    • If a person cannot open the jaw properly, their speech may be difficult to understand.
  • eating
    • If the jaw cannot be opened properly, a person may only be able to put a very small amount of food in the mouth, leading to problems with nutrition.
    • People with trismus may only be able to swallow liquids.
  • oral health
    • The limited opening of the mouth may make it difficult to brush and floss the teeth and to maintain good oral hygiene.

 

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Management

Because trismus is irreversible, the focus is on prevention. Trismus is managed by regular exercises:

  • opening and closing the mouth
    • Open the mouth against gentle pressure by pressing one hand underneath the lower jaw.
    • Place a finger of one hand on the top front teeth, a finger from the second hand on the bottom teeth and pull the mouth open as wide as possible.
  • using tongue blades (stacked blades) or specialized devices (TheraBite and corkscrew) to help to maximize mouth opening
  • yawning
    • Open the mouth as if yawning. Keep it open for 2 minutes.

 

It is important that the exercises be done every day, 20 to 30 times a day. Pain medication may be prescribed by the doctor if it is painful to do the exercises.

 

Exercises may be started during radiation therapy. After surgery, the doctor may recommend when to start the exercises. This is usually after the tissues have healed, about 4 to 6 weeks after surgery.

 

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References

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