Thursday, September 9, 2010

Trismus Prevention

Q: After having what I thought was routine crown-work on my lower back teeth, the following day I could barely open my mouth to eat. What did the doctor do to me?!!.........Phil in Canoga Park

A: Chill, Phil. You’re scaring me with those two exclamation points. One I can take, but two sends me to the shrink. Often after mandibular block injections, required to anesthetize the back lower teeth, the common side effect “trismus” occurs. (In your case, it’s “trismus in July”.) Often multiple injections are needed to numb these posterior teeth due to a tricky network of nerves that must be reached.  Limited opening, muscle spasms, stiffness and pain. This is caused by inflammation of the muscle fibers, hemorrhage into the muscles of mastication or low grade infection. This will all go away.  In the mean time, your dentist might recommend warm compresses, 800mg of Ibuprofen, muscle relaxants (Flexeril, Diazepam), salt water rinses, antibiotics, and in severe cases, a steroid such as Methylprednisone. Complete recovery can take several weeks.

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