Differential Diagnosis for Lockjaw after Oral Surgery
Single most likely diagnosis
- Tetanus infection: This is the most likely diagnosis given the recent oral surgery and the development of lockjaw (trismus), which is a classic symptom of tetanus infection. The bacteria that cause tetanus, Clostridium tetani, can enter the body through wounds or cuts, and oral surgery provides a potential entry point.
Other Likely diagnoses
- Temporomandibular joint (TMJ) disorder: TMJ disorders can cause jaw pain and stiffness, which may be mistaken for lockjaw. Recent oral surgery could exacerbate an existing TMJ condition.
- Osteomyelitis of the jaw: This is an infection of the jawbone that can cause pain, swelling, and stiffness in the jaw, potentially leading to lockjaw. Recent oral surgery increases the risk of osteomyelitis.
- Trismus due to surgical complication: Trismus can occur as a direct result of oral surgery, especially if there was significant tissue trauma or if the surgery involved the TMJ or surrounding muscles.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ludwig's angina: This is a severe infection of the tissues in the neck, which can cause swelling and stiffness in the jaw, potentially leading to airway obstruction. Although less common, it is a medical emergency that requires prompt attention.
- Cavernous sinus thrombosis: This is a rare but potentially life-threatening condition that can occur as a complication of facial or dental infections, including those following oral surgery. It involves the formation of a blood clot in the cavernous sinus, which can lead to severe neurological symptoms.
Rare diagnoses
- Dystonic reaction: Certain medications, including those used in oral surgery, can cause dystonic reactions, which may involve involuntary muscle contractions leading to abnormal postures, including lockjaw.
- Neurological disorders (e.g., tetany, dystonia): Various neurological conditions can cause muscle spasms or stiffness, including the jaw. These would be rare causes of lockjaw in the context of recent oral surgery but should be considered if other explanations are ruled out.