Trismus: Definition and Clinical Case with Dr. Tom Shackleton
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Dr. Thomas Shackleton is a general dentist in Calgary where he has been practicing for the past 20 years. He is a graduate of We sat down with Dr. Shackleton to discuss Trismus and why this common condition is important for practicing dentists to explore. This conversation includes a presentation for helping dentists work with their patients to treat Trismus and reviews the treatment story of single patient. Key discussion topics and case study details include:
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Read/download the transcript of the full conversation (PDF)
Additional Resource
How Do I Manage a Patient with Trismus?
Oasis Moment/Preview (1.11″)
Watch the full video (21.40″)
It would be nice to have seen some pictures of this case. One has to wonder if it was an accident waiting for a place to happen; i.e. worn teeth and other signs of occlusal disease. I’ve seen that happen a number of times, where TMD symptoms develop after dental procedures – not involving needle stick trismus per se. Some of these people with asymptomatic occlusal disease have even minor changes or trauma can push them over the edge.
People in chronic pain do go nuts. You can’t help it if you’re in chronic pain.
MRIs and “disc displacement” are a bit of a red herring IMHO and are not a significant aspect of management of TMD. The fact is in 30% of asymptomatic normals who have MRIs, you will find displaced discs. We’ve known that for a long time. For the most part, joint issues are simply secondary symptoms to the primary cause – which is the occlusion. That’s why joint surgery failed so badly in the 80s and 90s – because surgeons were operating on a symptom and not addressing the cause. And thus ended up creating a generation of chronic pain patients. What’s scary to me is that I’m starting to see hungry young surgeons operating on joints again (partially because the dentist doesn’t know what to do about TMD). Have we not learned from the lessons of the past, people??
Hi Mark. Her teeth were pristine, no abfractions, no incisal wear, no recession or fractured teeth. no history of pain or dysfunction. she had an injection and within 24 hours had pain and severely restricted opening, classic trismus due to myositis from a carpule of LA into a muscle. In cases like this, I prefer to apply the law of parsimony instead of looking for zebras.
Tom’s education and approach is a credit to our profession and a useful and important part of the Calgary dental community.