Temporomandibular disorders after whiplash injury: a controlled, prospective study.
OBJECTIVE
Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision.


METHODS
Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were obtained at each visit.


RESULTS
One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months.


CONCLUSIONS
TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.
Kasch
Helge
H
Department of Neurology, Aarhus University Hospital, Danish Pain Research Center, Aarhus University, Noerrebrogade 44, Building 1C, DK-8000 Aarhus C, Denmark. helge.kasch@dadlnet.dk
Hjorth
Tine
T
Svensson
Peter
P
Nyhuus
Lone
L
Jensen
Troels S
TS
D000328:Adult; D001732:Bite Force; D016022:Case-Control Studies; D005157:Facial Pain / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009043:Motor Activity; D010147:Pain Measurement; D017288:Pain Threshold; D010173:Palpation; D011434:Proprioception; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D014911:Whiplash Injuries / Q000150:complications*