A difficulty in opening the mouth or the complete inability to do so can occur due to a number of different reasons. These may arise from a systemic disturbance, or more commonly from a local pathology.
Some of the most common causes associated with this condition are:
- Tooth pain: Easily the most common cause on the list, this tooth pain can be from a wisdom tooth or third molar. This is the last tooth to erupt into the oral cavity. It is often impacted or partially impacted and thus gets infected causing pain and discomfort while opening the mouth.
Tooth pain can also be referred from other teeth which are decayed or cracked.
- Fractured Jaw: The temperomandibular joint, which is responsible for opening and closing the mouth, is made up of a number of different bones. The mandible, in particular, is susceptible to fractures when subject to direct trauma.
A fractured jaw is extremely painful and one of the more difficult fractures to heal as it can difficult to make it completely immobile.
- Tetany: A systemic condition in which there is a mineral imbalance, in particular a calcium imbalance, which can lead to severe cramps in muscles all over the body. The muscles of mastication and others which support the Temperomandibular joint are also susceptible to these cramps, making it difficult for patients to open their mouths.
- Oral Submucous Fibrosis (OSMF): This is a pre-cancerous condition which is associated with a heavy amount of tobacco intake. This could be in the form of smoked or chewed tobacco. The pathology behind this disease is related to a hyalization of the ligaments involved in opening and closing the mouth.
Patients often complain of a hardening of the soft tissues of the mouth as well as a burning sensation and inability to tolerate spicy food.
- Dental Abscess: Most commonly associated with a partially impacted tooth, however other posterior teeth in the maxilla or mandible could also be affected. There will be a painful swelling associated with the tooth, redness and bleeding of the overlying gingival and some amount of pus may be released into the mouth giving off a bad odor and taste.
The treatment for most of the above mentioned diseases is not very difficult and is cause related. More than one condition can exist in a patient and that can require separate treatment for all issues. Tooth pain, abscesses and fractured jaws are easy to diagnose and relief should be seen within days of commencing treatment.
Supportive antibiotics are to be expected to prevent any deep soft tissue abscesses from forming or any space infections from occurring. OSMF is a chronic disease and the treatment for this is quite difficult. The patient will have to commit to a complete cessation of tobacco usage as well as undergo minor surgery to relieve some of the hyalinized bands that may have formed.
Tetany can be a life-threatening situation and should be treated with immediate hospitalization and infusion of necessary fluids to restore the balance in the body.
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