Lxtraction of teeth may result in trismus. or limitation in opening  the mouth. This is the result of inflammationinvolving the muscles of mastication. The trismus may be a result of multiple injections of local anesthetic, especially
if the injections have’ penetrated muscles. The muscle most likely to be involved is ‘the medial pterygoid muscle,which may be  nadvertently penetrated by {he local anesthetic   needle during the inferior ‘alveolar nerve block. Surgical extraction of impacted mandibular third molars frequently results in trismus, because the inflammatory response to the surgical procedure is sufficiently widespread to involve several muscles of mastication. Trismususually is not severe and does not hamper the patient’s activity. However, to prevent alarm, patientsshould be warned that thi henomenon might occur,The application of heat mav be helpful in helping to
resolve persistent trismus and swelling, It ~s dear that for maximum effectiveness, the application of heat must be  by use of moist heat. Because of the closer contact with the skin, heat transfer to the tissue is most effective when the heat source is from a wet surface.

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