My BEST Dentists Journal

All Journal Entries

Limited Mouth Opening Problems

When you can’t open your mouth that is not normal. These problems can be treated without surgery.

Limited or restricted mouth opening can often be a difficult yet challenging problem to face. Decisions have to be made.  Understanding of the condition also has to be deciphered as well as history as to how the problem occurred (e.g., was it from an recent accident, fall, yawning a certain way…) or was it a sudden onset and one wakes up with “locked” restricted mouth opening in pain?

When condlyes are compressed up and back and the disc are displaced typically anterior and medially there will be a lot of pain behind the eyes, headaches, facial pain, temporal pain and it is miserable…pain is no fun! The mandible is being forced back because of the clamping muscles, yet at the same time the disc is being squished and traumatized because the vertical dimension of the bite specifically in the posterior region of the jaw due to insufficient vertical biting support to allow muscles to relax and condyles to decompress to improve normalized joint space of the disc to reposition over the condyles as they are intended to be positioned. The bite will naturally feel off because of these structural mal alignments of the lower jaw and joint bones.

Cases with limited range of mandibular movement are often due to either:


Disc displacement disorders

Chronic mandibular hypo-mobility problems from either contracture of elevator muscles

Capsular fibrosis from trauma issues, ankylosis and or

Coronoid hyperplasia issues.

To unlock this problem various methods have been used to reduce (unlock, recapture, normalize) the disc over the condyles.

Direct manipulation mechanically in an attempt to unlock jaw restrictions.

Some have used to gagging techniques to create an automatic mouth opening response to unlock the joints.

Pivot appliances over the back molars unilaterally or bilaterally have been used as an attempt to decompress the joints.

Injection therapy into the joint compartment to reduce inflammation.

Anti inflammatory medications can also be prescribed.

Surgical intervention under sedation to manipulate the jaw open (for patients who are anxious and want something done immediately).

Combination approach – muscle relaxation therapy (low frequency TENS combined with decompression techniques to increase condylar space to reduce the disc (the later is done non surgically), but takes cooperation, understanding and patience on the part of both patient and dentist to slowly unravel the hyperactive muscles that doing a tug and war on the cranio-mandibular joint and occlusal system.

Depending on the philosophy of the dentist or surgeons some may even recommend surgery of the joints in severely damaged disc problems to “repair disc damage” and reposition it.  (Remember there are always risks to any surgical procedure).

by Occlusion Connections TM

More Information:

Views: 59

My BEST Dentists Journal Headlines