title: Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety.
abstract: Trismus is a restriction in the ability to open the mouth. Trismus can occur following trauma, surgery, radiation therapy, infection, inflammatory diseases, temporomandibular disorders (TMD) or less commonly as a result of malignancy. Following two cases of delayed diagnosis of carcinoma presenting with features of TMD to a specialist clinic, a checklist was developed for completion in cases of trismus, to alert the clinician to suspicious features suggesting a possible non-TMD cause. The use of this checklist, together with an increased awareness, has improved early recognition of atypical features in patients presenting with trismus and has contributed to the early diagnosis of a further case of malignancy presenting to this clinic. This article discusses the presentation of malignancy with trismus, the relevance of imaging in these cases, and the implementation of a checklist to reduce the risk of future misdiagnosis.
authors.affiliation: Department of Restorative Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU.
authors.forename: H P
authors.initials: HP
authors.lastname: Beddis
authors.affiliation: University Dental Hospital of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH.|School of Dentistry, University of Manchester.
authors.forename: S J
authors.initials: SJ
authors.lastname: Davies
authors.affiliation: University Dental Hospital of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH.
authors.forename: A
authors.initials: A
authors.lastname: Budenberg
authors.affiliation: University Dental Hospital of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH.|School of Dentistry, University of Manchester.
authors.forename: K
authors.initials: K
authors.lastname: Horner
authors.affiliation: University Dental Hospital of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH.|School of Dentistry, University of Manchester.
authors.forename: M N
authors.initials: MN
authors.lastname: Pemberton
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D061214:Patient Safety; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000628:therapy*; D014313:Trismus / Q000150:complications / Q000628:therapy*