Differential diagnosis
Traditionally causes of trismus are divided into intra-articular (factors within the temporomandibular joint [TMJ]) and extra-articular (factors outside the joint, see table). Joint problems
Ankylosis
True bony ankylosis: can result from trauma to chin, infections and from prolonged immobilization following condylar fracture
Treatment – several surgical procedures are used to treat bony ankylosis, e.g. : Gap arthroplasty using interpositional materials between the cut segments. Fibrous ankylosis: usually results due to trauma and infection
Treatment – trismus appliances in conjunction with physical therapy. Arthritis synovitis
Meniscus pathology
Extra-articular causes
Infection
Odontogenic- Pulpal
Periodontal
Pericoronal
Non-odontogenic- Peritonsillar abscess
Tetanus
Meningitis
Brain abscess
Parotid abscess
The hallmark of a masticatory space infection is trismus or infection in anterior compartment of lateral pharyngeal space results in trismus. If these infections are unchecked, can spread to various facial spaces of the head and neck and lead to serious complications such as cervical cellulitis or mediastinitis. Treatment: Elimination of etiologic agent along with antibiotic coverage
Trismus or lock jaw due to masseter muscle spasm, can be a primary presenting symptom in tetanus, Caused by Clostridium tetani, where tetanospasmin (toxin) is responsible for muscle spasms. Prevention: primary immunization (DPT)

Dental treatment
Dental trismus is characterized by a difficulty in opening the jaw. It is a temporary condition with a duration usually not longer than two weeks. Dental trismus results from some sort of insult to the muscles of mastication, such as opening the jaw for a period of time or having a needle pass through a muscle. Typical dental anesthesia to the lower jaw often involves the needle passing into or through a muscle.
It is still perfectly possible to open the mouth. Submucous fibrosis. Fracture of the zygomatic arch. Other causes
Acute osteomyelitis
Ankylosis of the TMJ (fibrous or bony)
Condylar fracture or other trauma. Gaucher disease which is caused by deficiency of the enzyme glucocerebrosidase. Giant cell arteritis
Sympathomimetic drugs, such as amphetamine, methamphetamine, MDA, MDMA, MDEA, methylphenidate, ethylphenidate, and related substances. Infection
Local anesthesia (dental injections into the infratemporal fossa)
Needle prick to the medial pterygoid muscle
Oral submucous fibrosis. Radiation therapy to the head and neck. Tetanus, also called lockjaw for this reason
Malignant hyperthermia
Malaria severa
Secondary to neuroleptic drug use
Malignant otitis externa
Mumps
Peritonsillar abscess
Retropharyngeal or parapharyngeal abscess
Seizure
Stroke
Toothache

Diagnostic approach
X-ray/CT scan taken from the TMJ to see if there is any damage to the TMJ and surrounding structures. Treatment
Treatment requires treating the underlying condition with dental treatments, speech therapy for swallowing difficulty and mouth opening restrictions, physical therapy, and passive range of motion devices. Additionally, control of symptoms with pain medications (NSAIDs), muscle relaxants, and warm compresses may be used. Splints have been used. History
Historically, the term trismus was used to describe the early effects of tetany, also called "lockjaw". References


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