I will be 18 mos. post TX on 12 January but it seems that one shoe after another keeps falling in my case. I had to have my lower right side wisdom tooth extracted back in early November due to damage from earlier radiation. It took several months post TX for it to start giving me problems but eventually did. The extraction went without incident. In fact, there was very little bone left around the roots of the tooth holding it in place at the time of the extraction. Now, starting about 4 weeks ago, I am experiencing a problem that sounds a lot like what is identified as Trismus and I am wondering if anyone else has had this problem? The most obvious symptom I seem to have is an inability to open my mouth very wide to eat. When I try to do that it feels as if someone is sticking a knife in my jaw, right below my right ear in the hinged area. Very painful to say the least but only when I try to open wide to even eat a sandwich.

This did not start to be a problem immediately after the extraction but more like 3 to 4 weeks following. I had one follow-up visit with my oral surgeon who extracted the tooth about a week after the extraction and he said all looked good at that time. This also followed a regimen of hyperbaric oxygen treatments of which I had 20 prior to the extraction and 10 following. I have an appt. to see the OS again in a few days but am trying to find out what I can at this point. I would appreciate hearing from anyone who has dealt with Trismus as I am almost convinced that this is what is going on.

Bill D.

Bill, sorry to hear you are having problems. have you called Dr. Chen and talked to her? I think that would be my first recourse. By the way, how was your trip out of town back at the end of October? We had a blast at the screening at the race track and did several screenings.

Bill, I have trismus but I don't get pain that sharp when I push against the limits of my jaw opening. It does hurt, though, for example when I need to yawn or anytime when I am really pushing--so it could be symptoms of trismus you are epxeriencing. If it is trismus you are catching it early and may have to push back against it by using your therabite, pain or no pain, to keep the jaw from tightening more.

Nelie

i was wondering does anyone else have ear aches not all the time comes and goes i had cancer in my right vocal cord stage1t1a
also hasd chemo and rad this is how i remember my first problems startingafraid it is back i got done with tx aug 13th is there any thing i can do about my ears and sometimes throat spasms im sure my smoking is keeping it irrated
just had a bout of broncitus.

Bill, I have some trismus, which is worse on some days than others. I also concur that yawning is a really bad idea. Besides the jaw, my neck really goes nuts when I yawn.

Is the trismus a sharp pain? Yes and no. On the one hand, it is not like the pain of breaking a bone, but it is more acute than an ache. I would describe it as a sort of burning\cramping type of sensation.

A couple of things that I do to help it. One is jaw exercises --just repeatedly opening, closing, and moving side to side. The second is making sure that my neck and shoulder muscles are as loose as possible. Difficult for me right now, due to aftereffects of bilateral neck dissection, and some residual from my cervical fusion, but when my neck and shoulders are looser, the jaw muscles also do not work as hard.

Hope you are feeling better soon.

The other thing that can help, especially if you are feeling real cramps in the jaw muscle--which I get and they are VERY painful--is to put some kind of heat pack on it. I have one of those neck wraps you can warm in the microwave and I've found it I drape it over the top of my head, the ends are right at the corner of my jaw on each side and the heat really seems to help ease the cramps--and a phsycial therapist told me that actually part of the muscles that control the jaw extend up to higher on your head anyway so I think I may be relaxing those muscles too when I use that wrap that way.

Nelie

Lolita,

I know you are a newbie to posting but it is better for you if you start your own post with your own question than to tag onto another poster's question.

Oh yeah, I've got trimus and had it since treatment ended. I don't do anything for it, but massage and stretch those muscles. I think the rad takes nice elastic tissue and turns it into shoe leather.

I've also got a significant hearing loss in one ear, and it feels plugged all the time, like it's full of water. My ENT says 'it's because you've been radiated', but that's no longer an acceptable answer.

I didn't have a ND but I did have 35 IMRT's. I also didn't have a Peg but I did have "lockjaw" for a few days after rad ended where I communicated with pad and pen. Since then I have had zero problems with anything close to trimus so I doubt it's a long term side effect of rad alone.

Bill,

Another possibility is that you have developed a TMJ problem. Heat, as Nelie said, can help you out for either. Moist heat is the best and I suggest soaking a wash cloth in warm water and keeping it on the area until it cools and then start all over again. You might also start taking 600 mg of ibuprophen 3-4 times a day and see if that helps.

Your surgeon should be able to diagnosis exactly what is going on.

Let us know how you make out.

Jerry

Thanks for all who responded regarding my question of Trismus. Seems I was mistaken following almost 3 hours at the oral surgeon's office today. I had an appt. for next week but got a call this morning that they could see me this afternoon, last minute, and I took advantage of it. I met with the oral surgeon who extracted the wisdom tooth in November and long story short, it seems as though I have the early stages of Osteoradionecrosis after all. Even after going through 30 hyperbaric oxygen treatments it seems that I have fallen into the "somewhat less than 5%" who still might contract the problem even with HBO treatments. Xrays were compared, today's with mid-November's, and the Doc pointed out to me the visible change for the worse in the bone structure where the wisdom tooth once lived. He went on to tell me that 8 of 10 oral surgeons would recommend 30 days on an antibiotic and then have another look but that he was one of the 2 of 10 who says let's attack it now. Bottom line, I am now scheduled for surgery next Tuesday for him to go in and do what has to be done.

It just seems that the "shoes keep falling" even after Tx but again I feel that all of this could have possibly been avoided if I had been screened orally last year prior to treatment. I would almost bet it would have been recommended that the problem wisdom tooth be removed at that time prior to treatment. For that reason I would again like to emphasize to everyone facing treatment to make sure that an oral/dental screening is done.

Bill D.

Bill: We can relate to your frustration...Buzz just lost one of his 'caps' from one of the FEW jaw teeth (on the opposite side from his surgery) he has left to chew his food...getting it fixed tomorrow morning...but, I wonder if this is going to be an ongoing problem because of the IMRT and chemo...we'll wait and see.
Keep us posted. We DO care!

Lois & Buzz

Just as an aside Jerry--is 600mg ibuprofen up to 4 times a day a usual dosing schedule??????????
I feel guilty taking 400mg up to 3 times a day!

Brenda

Brenda - until Jerry gets to you, when my son was taking Ibuprofen, (way more than 1200mg per 24 hours) I talked to the nurse at the doctor's office who said too much could damage the liver and suggested holding it down to 1500/24 hrs. I had to keep strict records of all the meds and had to hide the Ibuprofen in my car and just give him a small amount when I left at the end of the day! But you know, everyone is different so checking with a doctor would be best. You have a right to the best when it comes to pain management.

Brenda i have been taking 600 mg for years for my ankle injury.Recently when i hurt my back i was taking 800 at a time . my GP said 1600 per 24 hours was ok.

love liz

they told me anytime you have radiation this will be an ongoing issue for the rest of your life, the tissues will always try to tighten so you must be diligent with exercising your mouth daily - a few times a day to keep it moving. easier to keep it going that to get back what is lost.

mine this past week started to lock up some on me, so i am working to get it back and not let it do it again.

best wishes

Bill

Please don't beat yourself up with "should've & could've" over not getting a thorough oral screening. As I have posted elsewhere, I passed a through dental review by a specialist in oral cancer patients prior to radiation replete with. I regular and panoramic X rays, Yet the radiation fried the nerves and jaw on my left side in order to get the cancer that had spread to those lymph nodes. Nevertheless so far I have had to have 3 root canals, 3 crowns and am currently hoping that this last root canal on an old wisdom tooth that otherwise would have been extracted because it suddenly cracked works out. Plus I continue to get ear pain and a sense of "fullness" that is especially worrisome since those were the only symptoms I had of the cancer. Both my ENT and prothodontist say don't worry, that they've seen this same effect from max doses (72 GY )radiation on the jaw muscles and jawbone and it can get better with time. I do jaw stretching daily as otherwise my mouth does start to close up. So while I agree with you about the importance of getting an oral checkup, it is no guarantee of freedom from future dental and jaw issues. It sucks to keep having issues from treatment and I hope things get better for you.