Long-term tonic involuntary cramps of chewing muscles are called tris. This pronounced muscular tension without relaxation reduces the jaws and limits the motor function of the temporomandibular joint.
Spasm affects all muscles involved in the chewing process. Normal chewing food becomes impossible. In addition, the chewing muscles participate in the reproduction of speech and in the process of swallowing, and a jaw spasm leads to a violation of these functions.
When palpating the site of the lesion, the muscular tissue becomes more dense, and its volume increases. Any touch causes a sharp facial pain.
Tonic spasm of the chewing muscles arises as a result of direct( reflex) irritant action on the motor part of the trigeminal nerve, innervating them, or due to internal diseases.
Trigeminal nerve with its damage provokes triasm
Seizures happen different
Trisus of chewing musculature is of two types - one-sided and two-sided, which is also called bilateral. The name indicates the defeat of spastic masticatory muscles of one or both sides of the facial part of the head.
Especially dangerous is the bilateral trismus. It is a manifestation of some infectious and neurological diseases. At the same time, teeth and jaws are so tightly closed because of a lack of movement in the temporomandibular joint, that there is absolutely no speech and the opportunity, naturally, to eat and drink.
One-sided spasm is expressed on one side of the face. The lower jaw is pulled up to the strained muscles so that its skewness occurs, which increases when the mouth is opened.
More often diagnose bilateral trismus, one-sided occurs against the background of injuries, inflammatory and deformative diseases in the temporomandibular joint and in the presence of inflammation in the oral cavity.
Basic provocateurs
The causes of jaw trism are divided into general and local.
To the common causative factors provoking manifestations of trism, include a number of internal diseases of a neurological or infectious genesis( origin): 
- malignant and benign neoplasms in the brain;
- intracranial hemorrhage;
- meningitis;
- mental health disorders( stress, depression, hysteria);
- tetanus;
- rabies.
Local factors are some of the maxillofacial diseases and injuries:
- osteomyelitis of the lower jaw( inflammation of the bone tissue);
- abscesses and phlegmon in the lower jaw area;
- pericoronaritis on the lower jaw( inflammation in the soft tissues around the wisdom tooth);
- periostitis of the lower jaw( inflammation in the periosteum);
- consequences of mandibular( mandibular) conductive anesthesia in dentistry;
- fractures, cracks, dislocations in the lower jaw;
- is affected by arthritis or arthrosis of the temporomandibular joint.
Non-treated inflammatory processes in the mouth can also lead to a trisus of masticatory muscles. Its cause can be one strong blow to the jaw, pouring ice water and more.
Symptomatic manifestations and severity of
The main sign of tonic spasm of the masticatory muscles is the complete or partial restriction of movements in the temporomandibular joint, and accordingly in opening and closing the oral cavity.
Also with trisme other symptoms are expressed:
- Muscle tightness to hardness;
- increase in muscle volume( swelling);
- painful nibbling, chewing and swallowing food or the inability to perform these processes;
- soreness with any effect on the muscles;
- violated the reproduction of speech;
- clenched teeth with bilateral spasm;
- skewed face with unilateral spasm.
Symptoms of breathing disorders, nervous tension may be observed. Prolonged spasm leads to a sharp loss of weight, digestive problems and the work of the digestive tract due to lack of adequate nutrition.
In the development of trismus, three degrees of progression of the disorder are noted, which are determined by the distance between the upper and lower central incisor when opening the oral cavity:
- Light .Opening of the mouth reaches 4 cm.
- Average .Opening of the mouth - no more than 2 cm.
- Heavy .Mouth is slightly opened up to 1 cm or less.
Treatment methods
Treatment of tonic spasm of masticatory muscles begins after diagnosis and identification of the causes that caused it. Light trimester, not associated with inflammation and trauma, can be treated at home.
Specialists, in such cases, recommend an easy and cautious massage of the chewing muscles. This should be dominated by stroking movements. Rubbing and kneading should be such that it does not cause pain. The purpose of the procedure is muscle relaxation.
Apply alternating cold and warm compresses, which will help to remove pain. Meditation and relaxation techniques will also be useful.
Trimeses caused by local causes, treat dentists - therapists and surgeons, injuries of the lower jaw - traumatologist.
When dislocated in the temporomandibular joint - it is corrected, fixed, prescribed rest and physiotherapy. Can appoint electrophoresis, heat, UHF.
Before analgesia, anesthesia is performed. To do this, use Botox or Novocaine. Botox is not used by all doctors, there are opponents of its appointment in this case.
In the presence of purulent foci in the lower jaw area, dentists open, clean, drain, apply intensive antibacterial treatment with drugs of the Penicillin group, antibiotics - cephalosporins, metronidazole, sulfonamides. The cure of these problems leads to the disappearance of trism.
If the cause of spasm is the destruction of the temporomandibular joint by arthritis or arthrosis, non-hormonal anti-inflammatory drugs are prescribed. It can be Ibuprofen or Naproxen. They also have a good analgesic effect. Acetaminophen, Paracetamol is used to reduce pain in tonic spasm of muscles.
In the course of treatment of trism, prescribe muscle relaxants - drugs of central and peripheral action that reduce 
muscle spasm( Sirdalud, Midokalm, Flexeril, Pankuroniy, Ditilin and others).These drugs successfully reduce muscle tension.
Infectious and neurological diseases, manifested by trismus, are treated in a comprehensive and compulsory way in a hospital by doctors in the directions.
The method of emergency care for the first suspicion of tetanus is the introduction of tetanus antiserum, and rabies vaccine - with the alleged infection of the virus with the disease.
Stresses, depression and hysteria leading to spasm of the chewing muscles are treated with Valerian and bromide preparations - sodium bromide and potassium bromide. These drugs, in addition to sedative properties, also have an anticonvulsant effect. In severe cases, stronger means are used.
Successful treatment of internal diseases leads to a gradual reduction and complete disappearance of the spasm of masticatory muscles. In this case, the patient is prescribed special exercises to restore the mobility of the lower jaw.
Such patients are fed with a probe and intravenous injection of special preparations to support the body.
Prognosis for recovery and prevention
Trismus of chewing muscles of local origin has a good prognosis for complete recovery. Properly selected and timely treatment of pathology relieves muscle tension and restores the motor function of the temporomandibular joint in a period of 1 to 3 weeks.
For internal diseases, it is more difficult to predict recovery. Infection with rabies virus in humans, most often, ends with a fatal outcome. There is a risk of mortality and tetanus.
Preventing the occurrence of spasm of the masticatory muscles will be the timely treatment of inflammatory processes in the oral cavity.
Vaccination against rabies and tetanus will not only prevent trismus, but also help save the life of the patient.
It is necessary to protect mental health, avoid injuries in the lower jaw.
Dehydration of the body also contributes to the occurrence of trismus, so you should consume at least 1.5 liters of water daily.
Proper nutrition will provide the body with a norm of nutrients, vitamins and trace elements. A healthy lifestyle, physical education and sports will help strengthen the muscles and prevent tonic spasm of the chewing muscles.
