Dentistry's Role in Whiplash Injuries
Temporomandibular Disorder (TMJ)
Understanding "TMJ"
The mandible, TM joints are the most-used joints in the entire body.
(See figure 1 for normal craniomandibular
relation.)
Trauma may be the result of an automobile accident, home or
occupational injury, or physical assault. Such accidents may trigger a
condition in which the muscles go into spasm and become very painful. The
discs which cushion and protect the neck, vertebrae and TM joint may also be
damaged.
How Damage Occurs
When whiplash, the most common trauma, takes place the
muscles that attach to the front of the neck and chest do not have time to
relax. As a result, these muscles anchor the jaw but not the head by holding
it still so that the mouth opens too wide while the head snaps back (figure
2). The jaw joints dislocate when they are pulled out of the socket and ram
against the back of the socket when the head whips forward (figure 3). Since
the head and neck are forced to move beyond their normal range of motion,
muscles and ligaments are injured.
Symptoms may not be felt until hours or months after the
injury. And, since soft tissue (muscles and ligaments) damage does not show up
on x-rays, it is difficult to immediately see structural damage. Commonly,
medical testing does not provide a conclusive diagnosis. Many times, neither
patients nor health care providers suspect damage to the jaw joints and
muscles.
When this aspect is not recognized and treated it can become the dominant medical problem causing various disabilities and legal claims. When trauma/damage occurs, the result (or symptoms) can include one or more of the following:
- Headaches
- Face or jaw pain
- Ear ringing, sounds or stuffiness
- Dizziness/Balance problems
- Difficulty swallowing and chewing
- Neck, shoulder stiffness
- Unusual fatigue - no energy
- Unexplained teeth pain
- Clicking or popping of the jaw
- Limited mouth opening or locking
- Difficulty closing teeth together
Dentistry's Role
The dentist plays a crucial role in treatment
and mitigation of damages by clinical examination and such corroborative
testing as x-rays (when appropriate), magnetic resonance imaging (MRI), and
psychometrics.
When you are representing clients who have sustained head,
face, neck or jaw injury, they need to have a thorough dental evaluation.
Tests and measurements can be performed which identify and measure damage to
the muscles and TM joint. Rather than irreversible surgery or drugs, often the
most effective treatment for long term pain relief is conservative treatment:
As you can see, the dentist's early involvement can be
highly instrumental in early settlement of many cases.
For additional information on the effect of whiplash
injuries on the temporomandibular joint, please
contact our office.