So before I began radiation I was told STERNLY, that I must constantly stretch my muscles that open and close my mouth throughout treatment, no excuses. Also that for a few months after treatment I must continue the process. It was not fun, but today I have full ability to open and close my mouth to pretty much what it was before treatment. ( I think perhaps that some wish that I had less ability to open it so often�) Anyway, the exercise was simple. Go to the drug store and buy a box of wooden tongue blades, usually about $5.00 for 250 or more of them. They are just pine, giant popsicle sticks really. Before treatment I was able to stack 15 of them between my upper and lower front teeth, so that was my normal full open that I was hoping to maintain. It all seemed so simple the first week of radiation, but then it started to become very difficult to open enough to get just 14 in. Painful really. By then end of month 3 of treatment, I was down to 12 max. I needed to try at least 5 times a day, and once before bed, to stack those things in there and I can tell you that it was painful. Once in place I need to hold them there for 5 minutes or longer. You can feel the muscles finally relax after about 5-10 minutes.

So what is actually happening? Radiation treatments cause scar tissue to form between the fibers of the muscles, in particular the masseter muscles that are in your cheeks, but in all of them. Scar tissue is not elastic at all. When it become thick and well developed, there IS NO WAY TO REVERSE THE SITUATION. As a non elastic tissue, you cannot stretch the muscles to open your mouth any longer. I know patients that did not do these stretches, or were poorly compliant as they felt to sick, depressed or whatever to care or comply, and today they can open their mouths maybe a half an inch. They cannot eat properly, talking is difficult, cleaning the inside of their mouth with a toothbrush is problematic, the resulting dental decay is horrible and hard to get to to fix, and on and on. Solid foods? Forget it, blender drinks for the duration.

So when you force yourself to stack the maximum number of wooden blades in there you are tearing the tissues, literally. Micro tears form in the scar tissue, and flexibility remains mostly intact. But you cannot skip days, or not hold the stretched muscles open for the proper time and have success, trismus that is difficult to overcome will set in. When the radiation damage has ceased happening every day, and a couple of months of healing has taken place, you can abandon the exercise. Don't engage in this and you will probably have reduction in vertical dimension of opening, and if the scar tissue gets thick enough I have never seen a person get it reversed successfully. And no, you cannot surgically cut through it as you will also be cutting the muscle fibers you need to contract your mouth. I hope this is simple to understand and the importance of it communicated. There are fancy devices like the Therabite and others that you can buy for several hundred dollars that do a similar motion for our jaw, but everyone that I now that has used the 5 dollar sticks has had success, without the insurance issues to get a device or the out of pocket costs. Hope this helps. Sorry it took so long to come back and post, with everything going on at OCF these days and a short staff, I've been running to try and get to it all.