In lockjaw, the opening of the mouth is partially or completely impaired. This condition can have a number of very different causes, but is generally easily treatable and reversible. However, lockjaw can cause severe pain.
What is lockjaw?
In lockjaw, the opening of the mouth is partially or completely impaired. This condition can have a number of very different causes, but is generally easily treatable and reversible. Lockjaw is classified into three different degrees, depending on the remaining mobility of the lower jaw. Grade I means a slight restriction, grade II a maximum mouth opening of 10 mm and grade III a maximum of 1 mm. The decisive factor here is the so-called cutting edge distance, i.e. the distance between the upper and lower incisors. This degree classification is also used to monitor the progress of the disease. Lockjaw is differentiated from lockjaw, in which the closing of the mouth is impaired.
Causes
The causes of lockjaw are varied, but are usually in the muscles or nerves of the jaw itself. Common causes include spasms of the masticatory muscles, inflammation of the mouth and jaw, or disc prolapse, a type of herniated disc in the temporomandibular joint. Spasms of the masticatory muscles can be caused by a wide variety of underlying diseases, such as meningitis, epilepsy, tetanus, amphetamine abuse or tumor diseases, but can also occur in response to pain when opening the mouth. In most cases, this pain stems from the eruption of wisdom teeth or their surgical removal. In this case, the spasm of the masticatory muscles is purely a protective reflex. In most cases, both the muscles that open the mouth and the closing muscles spasm. However, the latter is much more pronounced, so that if the entire musculature on the lower jaw spasms, the mouth remains closed. In rare cases, a mandibular fracture can also cause lockjaw by, for example, bone fragments restricting or preventing the mobility of the lower jaw.
Diseases with this symptom
- Meningitis
- Tumor
- Epilepsy
- Herniated disc
- Tetanus
- Parotitis
Diagnosis and course
Diagnosis of lockjaw is usually made by the dentist. However, it can also be determined by the general practitioner, general surgeon or oral surgeon. Diagnosis is based on symptoms, that is, that the mouth can no longer be opened. To confirm the diagnosis, a conduction anesthesia of the lower jaw can be performed: Here, the nerve pathways that caused the spasm of the masticatory muscles as a protective reflex are switched off and the mouth can be opened again. To exclude a mandibular fracture, an X-ray can be taken, depending on the course of events. The course after diagnosis depends entirely on the particular cause of the lockjaw. Depending on the underlying disease, it can be eliminated by the doctor within a few minutes, or a lengthy treatment with medication and physiotherapy may be necessary. In the vast majority of cases, lockjaw is completely curable and remains without secondary damage.
Complications
As a rule, a lockjaw is easily treatable. Consequential diseases do not occur according to current knowledge. Lockjaw is very often the result of local inflammation in the temporomandibular joint during impeded wisdom tooth eruption. It disappears in the vast majority of cases after the inflammation has ceased. Very rarely, however, a slight lockjaw may remain even after the inflammation of the jaw has passed. Even in these cases, with the help of relaxation exercises, complete healing is possible. However, lockjaw may exceptionally be associated with serious diseases. In this case, it usually occurs as a symptom. Complications as a result of lockjaw are not known. However, there are diseases in which a generalized muscle spasm of the jaw muscles can occur. In this case, the mouth is closed spasmodically and can no longer be opened. In this case, a muscle spasm, which can also manifest itself in the form of a lockjaw, is one of the many complications of these diseases.These conditions include tetanus, meningitis, calcium deficiency in the blood, abscesses in the palatine tonsils, neurological disorders, generalized epileptic seizures, skull base fractures or tumors of the parotid gland. In tetanus (lockjaw), lockjaw is even one of the main symptoms. If left untreated, tetanus always leads to death due to respiratory paralysis. This disease is among the most severe complications in which lockjaw plays a role.
When should you go to the doctor?
Lockjaw is a complete or limited inability to move the mouth opening, caused by a frozen jaw. A diagnosis of lockjaw is made by a dentist, general practitioner or oral surgeon. Depending on the cause, the patient can be cured within a few minutes. In extreme cases, treatment may take several months and may be accompanied by physical therapy. As a rule, a doctor should be consulted as soon as possible in case of lockjaw. To provide short-term relief from the pain, heat is suitable to relax the oral muscles. Painkillers can also provide short-term relief, but should never be combined with drugs or alcohol. The causes can be of different nature. Frequently, lockjaw occurs when the jaw muscles are tense. In this case, it is recommended to visit the oral surgeon to complete the diagnosis and, if necessary, to be referred to a physiotherapist. Particular disorders also occur during swallowing and are associated with the risk of aspiration. The condition can be very painful in some circumstances, or at least uncomfortable for the individual. If it is not clear where the pain is coming from, it is advisable to consult the general practitioner to rule out other reasons for the discomfort.
Treatment and therapy
In principle, in the case of lockjaw, the underlying cause must always be treated. This means that depending on the previous condition, the treatment of a lockjaw can look very different. If there is a simple spasm of the masticatory muscles, local anesthesia of the nerve pathways may already be sufficient. However, if the spasm is caused by a disease such as meningitis or tetanus, this disease must be treated, because when the anesthesia wears off, the masticatory muscles would otherwise spasm again. If an inflammation is the cause, this very inflammation must be fought. A single treatment at the dentist is often sufficient for this. If the lockjaw is triggered by pain stimuli, a painkiller can provide relief. If the patient has a seizure disorder with repeated seizures, a neurological examination must be performed to determine whether therapy with antiepileptic drugs is appropriate. In the case of a fracture of the mandible, surgical treatment may be necessary. Surgical reduction can also be performed in the case of a discus prolapse, but often a mandibular splint is sufficient in this case. Depending on the severity of the lockjaw, physical therapy may be appropriate: This consists of various exercises to stretch the masticatory muscles to regain the full opening angle of the mouth. One option is to stretch the mouth to its maximum opening with wooden mouth spatulas and then insert another mouth spatula. Each day, one more mouth spatula is used until the original mouth opening is achieved. However, it is imperative that this exercise be done under the guidance of a professional, otherwise overstretching can damage the muscles. In addition, mouthwashes with warm water and irradiation of the jaw with red light can be helpful, as the muscles relax due to the influence of heat.
Outlook and prognosis
In most cases, lockjaw can be treated relatively well. Since it can have many different causes, there can also be different courses of disease in lockjaw. The affected person must see a doctor in any case, because the lockjaw can not be solved without medical help. If the teeth or gums have also been damaged as a result, a visit to a dentist is usually also necessary. This can prevent pain or consequential damage. Sometimes those affected also suffer from pain and swelling of the jaw. If an ulcer develops, a doctor must also be consulted. For the patient, complications can occur in the form of shortness of breath if the lockjaw persists for a long time and is severe. A malposition may also develop, which must be treated.The solution of the lockjaw itself takes place without complications. Further complaints on the teeth or in the oral cavity are generally treated by a dentist. In most cases, a positive course of the disease is established.
Prevention
There is little a patient can do to prevent lockjaw. If one has already suffered a lockjaw once, it is crucial to control the underlying condition causing it well to avoid its recurrence. If the lockjaw occurs frequently, the doctor may prescribe an antispasmodic medication to help control the symptoms. In healthy people without a history of this condition, there is virtually no risk of lockjaw anyway, except for accidents involving the lower jaw.
Here’s what you can do yourself
In the event of a lockjaw, a doctor should be consulted in any case. However, there are self-help options that can alleviate the symptom. If the lockjaw also causes pain in the jaw, these can be combated for a short time with the help of painkillers. However, the patient should be careful not to take them for a long period of time and also not with alcohol and other drugs. To relax the muscles during lockjaw, heat is suitable. Thus, a hot water bottle or heating pad can be warmed up while holding it to the affected area. This can lead to relaxation of the possibly tense muscles. It is advisable not to leave the heating pad or hot water bottle on the affected area for too long to avoid burns. Cold is just as effective against the pain. Ice cubes or a cooling pad are suitable for this purpose. The cooling objects should be wrapped in a cloth to prevent frostbite. The cold treatment can be applied directly after the heat treatment. In the case of lockjaw, heavy physical activities and efforts should be avoided. In general, a doctor or dentist should also be consulted in case of lockjaw. Exclusive treatment with home remedies is not recommended.
