Using the Trismus Checklist to identify potential malignancy

The primary dental care team commonly encounters patients presenting with trismus as the result of various benign causes. Common among these causes are the range of temporomandibular disorder diagnoses. In a rare but significant number of cases the cause may be an underlying malignancy in which case urgent referral is mandatory. This article describes the implementation of the Trismus Checklist, a nine-item screening tool designed to improve patient safety by structuring the diagnostic process for trismus. Objective measurement techniques, including recording the intra-incisal distance, while emphasising the need to account for a pre-existing overbite or open bite are outlined. A passive stretch test is recommended to differentiate between myogenic limitations and mechanical obstructions. The routine use of the described Trismus Checklist helps safeguard clinicians against missing significant pathology. It is suggested that objective monitoring and follow-up are essential for all patients presenting with trismus, regardless of the initial suspected diagnosis.