Re: TREATMENT MODALITIES FOR POST EXTRACTION TRISMUS

Trismus can be due to medial pterygoid contracture / spasm.

This spasm may be the result of injury of the medial
pterygoid muscle caused by a needle (repeated injections
during Inferior Alveolar Nerve block) or by trauma of the
surgical field especially when difficult lengthy surgical
procedures are performed. Other causative factors are
inflammation of the post-extraction wound, hæmatoma and
post-operative Å“dema.

The management of trismus depends on the cause. Most
cases do not require any particular therapy. When acute
inflammation or a hæmatoma is the cause of trismus, hot
mouth rinses are recommended initially and then broad-
spectrum antibiotics are administered.

Other supplementary therapeutic measures include:

Heat therapy, i.e., hot compresses are placed extra-
orally for approximately 20 min every hour until
symptoms subside.

Gentle massage of the TMJ area.

Administration of painkillers, anti-inflammatory and
muscle relaxant (such as sedatives) medication.

Physiotherapy lasting 3 – 5 min every 3 – 4 hours,
which includes movements of opening and closing the
mouth, as well as lateral movements, aimed at
increasing the extent of mouth opening.

Administration of sedatives for management of stress
which worsens while trismus persists, leading to an
increase of muscle spasm in the area
Dr. Santosh Patil