Difficulty of Mastication

Dr. Mohamed Abdel-Monem Tawfik

Professor of Oral & Maxillofacial Surgery
Chairman of Oral & Maxillofacial Surgery Department
Mansoura University
 Welcome you all

Mansoura
Manchester
Dental Students
2018/2019
Difficulty of Mastication

Definition
Of
Mastication ?
 Definition

Mastication is a process of grinding

food into smaller pieces turning it into
a food bolus.
 Definition

This food bolus can easily swallowed

and then further digested as it goes
through the digestive tract.
 Mastication

Why mastication is important ?

 Importance

Mastication is the first step of

digestion.

It increases the surface area of foods

to allow more efficient breakdown
by enzymes.
 Masticatory muscles

1. Masseter muscle
2. Temporalis muscle
3. Lateral pterygoid muscle
4. Medial pterygoid muscle
Masticatory muscles
 Masticatory muscles

What is the role of the masticatory

muscles in the mastication process?
 Role of masticatory muscles

Masticatory muscles move the jaw

to bring the teeth into intermittent
contact, repeatedly occluding and
opening.
Role of masticatory muscles
 Role of masticatory muscles

Movements of the temporomandibular

joint (TMJ) are chiefly from the action
of the muscles of mastication.
Role of masticatory muscles

TMJ and muscles of mastication

Role of masticatory muscles
 Difficulty of mastication

What are the causes of difficulty of

mastication ?
 Difficulty of mastication

Problem in the masticatory muscles

And / Or
Problem in the temporomandibular
joint
Definition

Trismus
Trismus

Also called lock jaw

 Trismus

Trismus is reduced opening of the

jaws.

Or, limited mouth opening.

Trismus

Normal mouth opening

 Trismus

It may be caused by spasm of the

muscles of mastication or a variety of
other causes.
 Causes of trismus

Dental work that includes prolonged

mouth opening.

This will produce muscle fatigue.

 Causes of trismus

Injection of the local anesthesia into

the medial pterygoid muscle.
 Causes of trismus

Pericoronitis

Inflammation of the
gum around the tooth
crown.
 Causes of trismus

Pericoronitis

Commonly around the

lower third molar.
 Causes of trismus

Following surgical
extraction of the
lower third molar.
 Causes of trismus

Abscess around
lower molars

May produce facial

swelling.
 Causes of trismus

Trauma to the mandible

May produce fracture

of the mandible.
Causes of trismus

Condylar fracture
Causes of trismus

Mandibular angle fracture

 Causes of trismus

Tonsillitis

Inflammation
of the tonsils.
 Causes of trismus

Post tonsillectomy

Following surgical
removal of the
tonsils.
 Causes of trismus

Bruxism
Involuntary grinding of teeth against
each other mostly during sleep.
 Causes of trismus

Bruxism

Leads to jaw
stiffness in the
morning.
 Causes of trismus

Tumor at the region of parotid gland,

jaws, or TMJ can lead to trismus.
 Causes of trismus

Following radiotherapy

Radiation may produce fibrosis and

atrophy of the masticatory muscles or
TMJ leading to trismus.
 Causes of trismus

Drug therapy

Some drugs may cause trismus as a side

effect.
Most commonly, Succinyl choline and
Tricyclic antidepressants.
 Causes of trismus

Temporomandibular Joint Pain

 Causes of trismus

Causes of TMJ Pain

Psychological causes: stress and
anxiety.

Arthritis of the temporomandibular

joint.
 Causes of trismus

Other causes related to TMJ

TMJ Ankylosis

Bony union between the head of the

condyle and the mandibular fossa.
 Causes of trismus

Normal relation Ankylosis

Effects of trismus

What are the effects of trismus ?

 Effects of trismus

It impairs eating
with the resultant
weight loss and
gastrointestinal
disturbances.
 Effects of trismus

It interferes with oral hygiene

such as brushing
and flossing.
 Effects of trismus

It restricts access for dental

procedures.
 Effects of trismus

It affects the facial appearance

 Effects of trismus

It affects speech
 Effects of trismus

It effects the life style

“Thank You”