Why can't I open my mouth wide?

Q: I have a problem of closing my mouth / jaw, whenever I open it wide to drink water (specially when I tilt it upwards to drink from a bottle)? Can you enlighten me on this?

A:This is a fairly common problem, this could be part of a systemic problem like arthritis in another joint or it could be an isolated problem of the joint that moves the jaw (called the temporomandibular joint). Do you have any symptoms of any associated joint pains in your hands or feet? Do you have any morning stiffness? Do you have any swelling in any of your joints? Have you ever had any tests for any arthritis which tested positive? If you have indicated positively to any of these then your problem will part an arthritic problem and you would need to consult a rheumatologist to take care of your problem. If you have no other associated problem, pain in the TM joint can be as a result of an injury to the cartilage or a disc like washer within the joint. This can easily be checked by a clinician by feeling for clicks in the joint when you are opening and closing your jaw. If you do have such symptoms then you may need an MRI of temporomandibular joint and you may need to have a surgery if it is torn. At times simple exercises like using a chewing gum for short periods like 10 minutes may help keep the joint mobile but if you use it too long you could have an aggravation of pain. Sometimes impacted wisdom tooth or your last molar may present like this. You may then need to show a dentist. You have not mentioned anything about any addiction to paan or chewing tobacco. If you are some degree of fibrosis (thickening because of excessive tissue reaction from the irritants in paan and tobacco may cause difficulty in opening the mouth. Again you may need to show an ENT surgeon or a dentist.