Osteoradionecrosis and unable to open mouth

by Julia
(Portsmouth )

Hello. I have osteoradionecrosis of the jaw that is getting slowly worse. I had an infection in the jaw and now cannot open my jaw more than a few millimeters. I am in a lot of pain which is managed constantly and my consultant is considering jaw replacement in the damaged area of jaw bone. I need help to open jaw please.

Hello Julia,
I'm sorry to hear all this; nasty time you've had.

The question is what is inhibiting you opening the jaw, and there are many factors; the infection may be in the joint itself, the radiation may have affect the hyaline cartilage, or meniscus or bone in the joint, or perhaps just the muscles from all the trauma to your jaw.

I would suggest starting to do some deep massage on the masseter and temporalis muscles; find them at our TMJ page. Do it then whilst gently opening and closing the jaw, trying to very gently stretch those muscles.

Then, and this may be extremely painful so do it very gently, slide your finger, pulp facing outwards into the 'pterygoid pocket' and locate the 'external pterygoid muscle'. Like I said I'll bet it's very tender and do the same but only a few times; you may find the pain radiates right into your head and eye if that muscle has an active trigger point.

Alternating ice and heat over the jaw joints and those external muscles before and after the massage would help.

Talk to your consultant about this, and see what he thinks. He will be able to help you locate the pterygoid pocket; Dr Google also provides information. And I think it's on one of our TMJ pages.

Then there are our TMJ exercises; again start very slowly and gently. I expect there are some chiropractors in your area who do a lot of TMJ work; really it's a specialisation within our profession, so perhaps a call to the state association.

I wonder if a chicken bones bouillon might help?

Even if this gets only a 10 or perhaps 50 percent increase in your opening it would all help. Let me know how you get on.

Any idea what caused the cancer?

Dr B

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