Delayed temporomandibular joint pain and dysfunction induced by whiplash trauma: a controlled prospective study.
BACKGROUND
The Quebec Task Force on Whiplash-Associated Disorders urged for controlled, prognostic studies of symptoms after whiplash trauma. The authors conducted a study that met the design requirements to enhance knowledge about short-term and long-term temporomandibular joint (TMJ) pain, dysfunction or both induced by whiplash trauma.


METHODS
The authors studied 60 consecutive patients who had neck symptoms after whiplash trauma and were seen at a hospital emergency department. They followed up 59 subjects one full year later. At the inceptive examination and at follow-up, each subject completed a self-administered questionnaire, followed by a comprehensive interview. Fifty-three frequency-matched control subjects followed the same protocol concurrently.


RESULTS
The incidence of new symptoms of TMJ pain, dysfunction or both between the inceptive examination and follow-up was five times higher in subjects (34 percent) than in control subjects (7 percent). The frequency of TMJ pain increased significantly in female subjects, as did the frequency of TMJ symptoms that were reported to be the main complaint. At the follow-up, 20 percent of all subjects reported that TMJ symptoms were their main complaint.


CONCLUSIONS
Our results suggest that one in three people who are exposed to whiplash trauma is at risk of developing delayed TMJ symptoms that may require clinical management.


CONCLUSIONS
Awareness of a significant risk for delayed onset of TMJ symptoms after whiplash trauma is crucial for making adequate diagnoses, prognoses and medicolegal decisions.
Oral and Maxillofacial Radiology, Umeå University, Sweden.
Hanna
H
Salé
Annika
A
Isberg
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D018771:Arthralgia / Q000209:etiology*; D016022:Case-Control Studies; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D012893:Sleep Wake Disorders / Q000209:etiology; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology*; D014911:Whiplash Injuries / Q000150:complications*
D000700:Analgesics